TB Vaccine Too Dangerous for Babies with AIDS Virus, Study Says
The World Health Organization is recommending that the Bacille Calmette-Guérin vaccine against tuberculosis be delayed until infants can be tested for HIV. A new WHO study finds BCG, which is routinely given to 75 percent of babies worldwide, is too risky for those born infected with the virus.
In use since 1921, BCG is effective against deadly tuberculosis meningitis, though it is less so against the lung disease. Because it is a live vaccine, it can cause “disseminated BCG disease,” a type of whole-body bacterial infection that is fatal in more than 70 percent of cases.
In countries with co-existing TB and HIV epidemics, giving BCG to HIV-infected newborns offers them no protection against TB and may kill them due to BCG disease, according to the study, which was performed at three South African pediatric hospitals. Since BCG disease and TB can look identical, the researchers had to culture each infection.
Even as they recommended delaying BCG vaccination, the investigators acknowledged this will not be easy. In poor countries, babies are frequently not brought back at six weeks for a test and 10 weeks for a shot. Thus the practice of vaccinating every newborn may continue, since it protects the ones not infected with HIV.
The study, “Disseminated Bacille Calmette-Guérin Disease in HIV-Infected South African Infants,” was published in the Bulletin of the World Health Organization (2009;87(7):485-564).
Date of Publication
Donald G. McNeil Jr.
BCG Vaccine HIV Positive Persons Immunizations Infants Studies or Surveys Tuberculosis (TB) Prevention
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