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The timing of tuberculin tests in relation to immunization with live viral vaccines
Insights
Routine tuberculosis screening does not need to precede live viral vaccines. Simultaneous administration of measles, mumps, or rubella vaccines does not invalidate tuberculosis screening tests in children.
Area of Science:
- Pediatrics
- Immunology
- Infectious Diseases
Background:
- A common recommendation suggests tuberculosis screening before live viral vaccine administration.
- The validity of this recommendation in clinical practice requires empirical testing.
Purpose of the Study:
- To evaluate whether simultaneous administration of live viral vaccines affects the results of tuberculosis screening tests.
- To determine if tuberculosis screening tests remain valid when performed concurrently with measles, mumps, or rubella vaccination.
Main Methods:
- A field study involving 110 tuberculin-positive children (many BCG-vaccinated).
- Children received live viral vaccines (measles, mumps, rubella) and were retested with tuberculin.
- A control group had repeated tuberculin tests without vaccination.
Main Results:
- Tine test reversion to negative occurred in 3% of vaccinated children and 3.6% of controls.
- Mantoux reactions rarely reverted to negative (2/68) in vaccinated children.
- No significant difference in Mantoux reaction size changes between vaccinated and control groups, except for an unexplained increase in rubella vaccine recipients.
Conclusions:
- Simultaneous administration of measles, mumps, or rubella vaccines does not invalidate tuberculosis screening by tine or Mantoux tests.
- Tuberculosis screening can be safely integrated with live viral vaccination schedules.
- This finding supports current preventive care programs that combine vaccination and screening.
Abstract:
The validity of the recommendation that routine screening for tuberculosis precede the administration of live viral vaccines was tested in a field study. One hundred and ten children already known to be tuberculin-positive, mostly on the basis of prior vaccination with BCG, were immunized with live viral vaccine and retested with tuberculin at the same time. Reversion to a negative tine test occurred in 3% of children given measles, mumps, or rubella vaccine, and 3.6% of controls who received no vaccine but had the tuberculin test repeated at the same interval. Very few Mantoux reactions (two of 68) reverted to negative in children given one of the three vaccines, singly or in combination; some became smaller, but there was no significant difference in the changes in the size of the Mantoux reaction between the vaccinated group and the control group, with the exception of an unexplained increase in the size of the reaction in many of those who received rubella vaccine. Screening for tuberculosis by tine or Mantoux test is not invalidated by simultaneous administration of vaccines against measles, mumps, or rubella, given singly or in combination, as part of preventive care programs.