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Neonatal BCG vaccination and atopic dermatitis before 13 months of age: A randomized clinical trial

L M Thøstesen1, J Kjaergaard2, G T Pihl1

  • 1Paediatric Department, Kolding Hospital, Kolding, Denmark.

Allergy
|September 21, 2017
PubMed

Insights

Neonatal Bacillus Calmette-Guérin (BCG) vaccination reduced atopic dermatitis risk in infants with an atopic predisposition. The study highlights BCG

Area of Science:

  • Immunology
  • Pediatrics
  • Allergy Research

Background:

  • Emerging evidence suggests Bacillus Calmette-Guérin (BCG) vaccination may offer protection against allergic diseases.
  • Atopic dermatitis is a common allergic condition in infants and children.

Purpose of the Study:

  • To investigate the efficacy of neonatal BCG vaccination in preventing clinical atopic dermatitis.
  • To explore whether the effect of BCG vaccination on atopic dermatitis differs based on atopic predisposition.

Main Methods:

  • A randomized controlled trial (Danish Calmette Study, 2012-2015) involving newborns randomized to receive BCG or no BCG within 7 days of birth.
  • Exclusion criteria included prematurity (<32 weeks gestation), low birth weight (<1000 g), known immunodeficiency, or non-Danish speaking parents.
  • Data collection involved telephone interviews and clinical examinations up to 13 months of age.

Main Results:

  • Clinical atopic dermatitis occurred in 22.7% of the BCG group versus 25.4% of the control group (Relative Risk [RR] = 0.90).
  • BCG vaccination significantly reduced atopic dermatitis risk in infants with an atopic predisposition (RR = 0.84) but not in those without (RR = 1.09).
  • The interaction between BCG vaccination and atopic predisposition was statistically significant (P = .04).

Conclusions:

  • Neonatal BCG vaccination is effective in preventing atopic dermatitis, particularly in infants with a genetic predisposition.
  • The number needed to treat with BCG to prevent one case of atopic dermatitis in predisposed infants was 21.
Abstract

Keywords:
Bacillus Calmette-Guérinatopic dermatitisheterologous immunityinfantsrandomized controlled trial

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