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[Adenitis following BCG vaccination]
Insights
BCG vaccine complications, specifically adenitis, were studied in 167 newborns. Higher virulence BCG vaccine (A) caused more severe adenitis and fistulization than vaccine B, highlighting the need for vaccine testing before mass use.
Area of Science:
- Immunology
- Pediatrics
- Vaccinology
Context:
- Study of 167 cases of post-vaccinal adenitis following Bacillus Calmette-Guérin (BCG) administration in newborns.
- Comparison of two BCG vaccines (A and B) from different laboratories based on virulence and germ concentration.
Purpose:
- To analyze the incidence, clinical course, and complications of post-vaccinal adenitis.
- To evaluate the impact of BCG vaccine virulence and dosage on adenitis development.
- To assess the efficacy of treatments and the relationship between adenitis and post-vaccinal allergy.
Summary:
- Higher virulence BCG vaccine (A) led to manifest adenitis and fistulization in 7.79% (0.10 mg dose) and 6.95% (0.05 mg dose), with most cases developing within 6 months.
- Adenitis often had a prolonged course (78.3%), lasting months to years, with limited response to tuberculostatic treatment (INH).
- Post-vaccinal allergy was intense and persistent in complicated cases, unlike non-complicated cases where allergy diminished over time.
Impact:
- Findings underscore the importance of pre-mass use vaccine testing, especially in infants, to select optimal dosage for maximum efficacy and minimal complications.
- Highlights the correlation between BCG vaccine virulence and the severity of post-vaccinal adenitis.
- Provides insights into the long-term course of adenitis and its management, including surgical interventions for abscesses.
Abstract:
The authors present a study on 167 cases of post-vaccinal adenitis after B.C.G. administration. These occured after the experimental application in 1,187 newborns of two vaccines produced by different laboratories. Manifest adenitis developed only after the application of the vaccine with a higher virulence and a significant concentration of live germs (A), while the vaccine with a low concentration of live germs only determined inflammatory adenitis (vaccine B). In the cases when vaccine A was applied, both after intra-dermal introduction of a 0,10 mg dose or of a 0,05 mg dose, it determined adenitis with a long evolution and in 7,79 percent, respectively in 6,95 percent of the vaccinated children fistulization occured. In most of the cases adenitis developed in the first 6 months following vaccination (86,77 percent) but in some cases it appeared even after 1-2 years. In 78,3 percent of the cases adenitis had a long course and in only 21,7 percent they regressed rapidly. Adenitis did not involve the general condition of the children but determined a concern of the parents. The duration of evolution of adenitis was, as a general rule, of several months, or 1-2 years and even longer and the treatment with tuberculostatics (INH) did not significantly alter their evolution. When there was a tendency to the formation of abscesses, especially in the case of gigantic adenitis, a reduction of the duration of the evolution was obtained by puncture, and especially by lymph-node curettage. The intensity of the post-vaccinal allergy is noted in cases complicated by adenitis (100 percent), as well as its long persistance, while in non-complicated cases the allergy diminished each year both in intensity and frequency. The authors recommend that before the mass use of a vaccine this should be tested, especially in young children, in view of making the correct choice of the efficient dose, with a maximal efficiency and the lowest number of complications.