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Neonatal BCG has no effect on allergic sensitization and suspected food allergy until 13 months
Lisbeth Marianne Thøstesen1,2, Henrik Fomsgaard Kjaer3, Gitte Thybo Pihl1,2
1Department of Pediatrics, Kolding Hospital, Kolding, Denmark.
Insights
Neonatal Bacillus Calmette-Guérin (BCG) vaccination did not significantly impact suspected food allergy or allergic sensitization by 13 months of age in a randomized trial. This suggests BCG's non-specific benefits may not extend to early childhood allergies.
Area of Science:
- Immunology
- Pediatrics
- Public Health
Background:
- Bacillus Calmette-Guérin (BCG) vaccination is standard for tuberculosis prevention.
- BCG may confer non-specific benefits, including reduced mortality and atopic conditions.
- The study investigated BCG's impact on allergic sensitization and food allergy in infants.
Purpose of the Study:
- To evaluate the effect of neonatal BCG vaccination on allergic sensitization.
- To assess the impact of neonatal BCG vaccination on suspected food allergy.
- To determine if BCG vaccination influences the development of allergies in early childhood.
Main Methods:
- A randomized controlled trial (Danish Calmette Study) involving 4262 newborns.
- Participants were randomized to receive BCG vaccination or no intervention shortly after birth.
- Follow-up included telephone interviews and blood sampling at 13 months of age to assess allergies.
Main Results:
- No significant difference in suspected food allergy between BCG and control groups (Risk Ratio 0.91).
- Allergic sensitization rates were similar in both groups (Risk Ratio 0.94).
- Results were based on parental/physician suspicion and blood sample analysis at 13 months.
Conclusions:
- Neonatal BCG vaccination showed no significant effect on suspected food allergy at 13 months.
- BCG vaccination did not significantly alter allergic sensitization in infants by 13 months.
- The findings indicate BCG's non-specific effects do not extend to early-onset food allergy or sensitization.
Background:
Vaccination with Bacillus Calmette-Guérin (BCG) is used in many countries as protection against tuberculosis. Studies have suggested that BCG may also have non-specific effects, reducing non-tuberculosis mortality, morbidity, and atopic manifestations. In this study, we evaluated the effect of neonatal BCG vaccination on allergic sensitization and suspected food allergy at 13 months of age.
Methods:
The Danish Calmette Study was conducted from 2012 to 2015 at three Danish hospitals. Within 7 days of birth, the 4262 newborns of 4184 included mothers were randomized 1:1 to BCG or to a no-intervention control group. Exclusion criteria were gestational age <32 weeks, birth weight <1000 g, known immunodeficiency, or no Danish-speaking parent. Follow-up information was collected through telephone interviews at 3 and 13 months of age. Subgroups of participants were offered blood sampling at 13 months of age.
Results:
By 13 months of age, the parents and/or general practitioners of 5.6% (117/2089) of the children in the BCG group and 6.1% (126/2061) of the control group suspected food allergy, resulting in a risk ratio comparing BCG-vaccinated children with control children of 0.91 (95% CI 0.71-1.16). Among 1370 blood samples, sensitization (Phadiatop Infant >0.35 kUA/L) was found in 55 of 743 (7.4%) children in the BCG group and 50 of 627 (8.0%) of the control group (risk ratio 0.94 [0.65-1.36]).
Conclusion:
In this randomized clinical trial, neonatal BCG had no significant effect on suspected food allergy or on sensitization at 13 months of age.
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