Does BCG vaccination protect against childhood asthma? Final results from the Manchester Community Asthma Study

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Mary F Linehan1, Ulugbek Nurmatov2, Timothy L Frank1

  • 1University of Manchester, Manchester Academic Health Science Centre, University Hospital South Manchester NHS Foundation Trust, NIHR South Manchester Respiratory and Allergy Clinical Research Facility, Manchester, United Kingdom.

The Journal of Allergy and Clinical Immunology
|October 3, 2013
PubMed

Insights

Neonatal BCG vaccination showed a protective effect against childhood asthma in the Manchester Community Asthma Study (MANCAS). However, this protective effect appears to be transient, diminishing by adolescence.

Area of Science:

  • Immunology
  • Pediatric Respiratory Medicine
  • Epidemiology

Background:

  • The Manchester Community Asthma Study (MANCAS) initially suggested neonatal BCG vaccination protected against wheeze in children.
  • Previous meta-analysis indicated BCG might protect against nonatopic asthma but not allergic sensitization.

Purpose of the Study:

  • To determine if the protective effect of BCG vaccination on wheeze persisted into adolescence (13-17 years) in the MANCAS cohort.
  • To update a systematic review and meta-analysis incorporating the final MANCAS data.

Main Methods:

  • Longitudinal cohort analysis of MANCAS participants with respiratory outcomes from questionnaires.
  • Updated systematic review and meta-analysis using fixed-effects and random-effects models.

Main Results:

  • The final MANCAS analysis (1608 participants) showed no difference in wheeze prevalence between BCG-vaccinated and unvaccinated children (15.8% vs 14.3%).
  • The updated meta-analysis, including 4 new studies, revealed an attenuated protective effect of BCG vaccination against asthma development (OR, 0.95; 95% CI, 0.89-1.00).
  • No protective effect was observed for BCG vaccination concerning allergic sensitization, eczema, or rhinoconjunctivitis.

Conclusions:

  • The protective effect of BCG vaccination on childhood asthma appears to be transient.
  • Updated meta-analysis and MANCAS cohort data provide stronger evidence for the temporary nature of BCG's protective effect on asthma.
Abstract

Keywords:
BCGWheezeallergyasthmaatopychildrenmeta-analysissystematic review

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