Bacille Calmette Guérin vaccination in pre-term infants

To evaluate the efficacy of bacillus Calmette Guerin (BCG) vaccine in pre-term infants.

BCG vaccine was given to three groups of neonates: 1) 36 pre-terms born at different gestational ages (GA) vaccinated at birth, 2) 16 pre-terms vaccinated at 40 weeks post conceptional age, and 3) 20 full-terms vaccinated at birth. All of the infants were tested by purified protein derivative (PPD) 2-4 months post vaccination.

The mean sizes of BCG scarring and PPD tuberculin induration were largest in full-term and smallest in pre-term infants vaccinated at birth. The pre-term infants of lower GA (27-33 weeks) had non-significantly smaller BCG scar and PPD induration than the pre-terms of higher GA (34-36 weeks). The results of logistic regression analyses revealed that female infants were more likely to have a BCG scar, and both birth weight and female sex were significantly associated with a reactive PPD induration.

This study indicates that male pre-term infants of lower GA (<33 weeks) are less likely to develop BCG scar and a reactive PPD tuberculin test after BCG vaccination. These findings do not support routine BCG vaccination at birth of pre-term neonates of GA <33 weeks. Studies including larger groups of infants are needed to confirm these findings.