BCG vaccination in South African HIV-exposed infants - risks and benefits
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2009
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South African Medical Journal
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University of Cape Town
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Abstract
Until 2007, the World Health Organization (WHO) recommended that bacille Calmette-Guérin (BCG) vaccination should be contraindicated in infants with symptomatic HIV disease in countries with a high burden of tuberculosis. This recommendation was based on the perceived low risk of serious adverse events in HIV-infected infants. The WHO revised its recommendations regarding BCG vaccination in HIV-infected infants in 2007, making HIV infection a full contraindication to BCG vaccination. BCG induces protective efficacy against tuberculous meningitis of 73% (67 - 79%) and against miliary disease of 77% (58 - 87%) in HIV-uninfected children. The efficacy against childhood pulmonary disease is variable;3 there is no evidence that BCG induces a protective effect against tuberculosis in HIV-infected infants and children. BCG is a safe vaccine in immunocompetent infants, and severe vaccine adverse events in HIV-uninfected infants occur only with rare primary immune deficiencies in approximately 1 per million vaccinees.
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Hesseling, A. C., Caldwell, J., Cotton, M. F., Eley, B. S., Jaspan, H. B., Jennings, K., . . . Schaaf, H. S. (2009). BCG vaccination in south african HIV-exposed infants - risks and benefits : Issues in public health : SAMJ forum. South African Medical Journal, 99(2), 88-91.