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Rapid decrease in tuberculin skin test reactivity at preschool age after newborn vaccination.

L Kröger1, M L Katila, M Korppi

  • 1Department of Paediatrics, Kuopio University Hospital, Finland.

Acta Paediatrica (Oslo, Norway : 1992)
|September 1, 1992
PubMed
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Tuberculin sensitivity wanes significantly in children aged 4-6 years after BCG vaccination at birth. Revaccination with the MPR vaccine showed larger tuberculin reactions, suggesting potential immune interactions.

Area of Science:

  • Immunology
  • Pediatrics
  • Vaccinology

Background:

  • Bacille Calmette-Guérin (BCG) vaccination at birth is standard practice for tuberculosis prevention.
  • Tuberculin sensitivity testing assesses cell-mediated immunity post-BCG vaccination.
  • Understanding the duration and factors influencing tuberculin sensitivity is crucial for interpreting test results and vaccine efficacy.

Purpose of the Study:

  • To evaluate tuberculin sensitivity waning in children aged 4-6 years following BCG vaccination at birth.
  • To investigate the influence of age, revaccination with Measles, Rubella, and Parotitis (MPR) vaccine, atopic dermatitis, and recent infections on tuberculin reaction size.

Main Methods:

  • A cross-sectional study involving 353 children aged 4-6 years, all BCG-vaccinated at birth.

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  • Tuberculin sensitivity was measured, and reaction sizes were analyzed in relation to age groups.
  • Data on MPR revaccination, atopic dermatitis, and recent infections were collected and correlated with tuberculin reactions.

    • Main Results:

    • Significant waning of tuberculin reactions was observed with increasing age (p < 0.05).
    • Mean reaction sizes decreased from 6.6 mm (< 4.5 years) to 3.5 mm (> 5.5 years).
    • Children revaccinated with MPR vaccine exhibited significantly larger tuberculin reactions compared to non-revaccinated children.

    Conclusions:

    • Tuberculin sensitivity after BCG vaccination at birth wanes rapidly between ages 4.0 and 6.3 years.
    • MPR revaccination may influence tuberculin sensitivity, warranting further investigation.
    • Age is a significant factor in the decline of tuberculin sensitivity in early childhood.