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Respiratory Diseases
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Aref T. Senno, Ryan K. Brannon
The BCG vaccine is a live attenuated vaccine commonly administered at birth for the prevention of TB. When administered to TB-naïve children, BCG vaccine prevents >70% M. tuberculosis infections and reduces >85% of TB death in children [111]. Although the efficacy of the BCG vaccine begins to decline after 15–20 years, several studies have shown that partial protection may last for several decades [112, 113]. Large-scale studies of booster BCG vaccines have not shown any benefit towards prevention of TB [114, 115]. BCG should not be administered during pregnancy due to theoretical re-activation.
Specific Infections in Children
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Neal Russell, Sarah May Johnson, Andrew Chapman, Christian Harkensee, Sylvia Garry, Bhanu Williams
The BCG vaccine is moderately effective in preventing TB (especially TB meningitis and miliary TB in the neonatal period) and is administered from birth in many high-incidence settings or to at-risk groups and those living in sub-regions with high incidence (>40/100,000 is an indication for BCG in the UK) within low-incidence settings.
Animal Tuberculosis
Published in Lloyd N. Friedman, Martin Dedicoat, Peter D. O. Davies, Clinical Tuberculosis, 2020
Used alone, the BCG vaccine does not provide cost-effective or useful protection against infection of M. bovis in cattle. The current BCG vaccine does not have a high enough efficacy to provide full protection against tuberculosis, and is currently administered to cattle to provide a “Ring Vaccination” initiative in exposed herds where a breakout of TB infection has occurred. The same concern with this vaccine exists in cattle as in humans, as cattle that have received the BCG vaccine may offer a false-positive reaction to the tuberculin SICCT and therefore cattle infected with tuberculosis, and those which have been vaccinated, cannot be differentiated. The rational development of an effective vaccine for cattle involves the development of the optimal combination of M. bovis antigens that are required for protective immunity. Diagnostic tests based on antigens not incorporated into the vaccine would allow differentiation of the immune response generated by either vaccination or infection.
Nanomaterials in tuberculosis DNA vaccine delivery: historical perspective and current landscape
Published in Drug Delivery, 2022
Xing Luo, Xiaoqiang Zeng, Li Gong, Yan Ye, Cun Sun, Ting Chen, Zelong Zhang, Yikun Tao, Hao Zeng, Quanming Zou, Yun Yang, Jieping Li, Hongwu Sun
Vaccination that promotes host immunity is the most effective intervention for TB treatment (Sia & Rengarajan, 2019); the Bacillus Calmette–Guerin (BCG) vaccine is approved worldwide for the prevention of TB meningitis (Puvacic et al., 2004) and miliary TB (Trunz et al., 2006). Currently, more than 90% TB vaccines are manufactured using five variants, namely, the 1173P2 (Pasteur), 1331 (Danish), 1077 (Glaxo), 172 (Japanese), and D2PB302 (China) strains (Li et al., 2020). Although TB vaccination is effective for infants (Schrager et al., 2020), its protective efficacy for adolescents and adults is low (Lowrie et al., 1994). Additionally, the effectiveness of vaccination varies greatly in different countries owing to significant differences in immune capacities (Abubakar et al., 2013). However, administering the BCG vaccine at an age of 3–5 years provides protection against active TB for the next 20 years (Mangtani et al., 2018). Furthermore, the BCG vaccine exhibits significant protective efficacy against persistent new M. tuberculosis infections, as indicated by recent studies (Nemes et al. 2018). According to data from the United States National Library of Medicine (http://clinicaltrials.gov), 149 studies on TB have been conducted in different phases of clinical trials (105 have been completed and 15 are in recruitment). However, these vaccines exhibit a poor ability to generate humoral and cell-mediated immunity (Ojha et al., 2020), necessitating the development of novel vaccines and delivery systems for TB.
Recurrent Infections and Immunodeficiency Caused by Severe Pancytopenia Associated with a Novel Life-Threatening Mutation in Hypoxia-Upregulated Protein 1
Published in Immunological Investigations, 2022
Hossein Jafari Khamirani, Mehdi Dianatpour, Sina Zoghi, Sanaz Mohammadi, Ashkan Habib, Seyed Alireza Dastgheib, Seyed Mohammad Bagher Tabei, Mohadeseh Molayemat, Babak Shirazi Yeganeh
BCG-vaccine-associated complications occur because of the vaccine strain variations, administration techniques, viable bacillary load in the batch, and most crucially host characteristics. In the setting of primary immunodeficiency patients, adverse events following immunization due to BCG vaccination has been repeatedly reported (Norouzi et al. 2012; Nunes-Santos and Rosenzweig 2018). Generally, immunocompromised infants are susceptible to develop systemic complications after vaccination, with an estimated incidence of 2 to 34 per million vaccination.9 In the study by Fekrvand et al, Iran (17.9%), China (17%), and Turkey (12.4%) had the most frequency of PID cases with BCG-VACs, all showing the effect of BCG-vaccination strategy on the frequency of adverse events (Fekrvand et al. 2020; Frankel et al. 2016; Lange et al. 2022).
Efficacy of viable BCG vaccine paste in the treatment of common warts: a double-blind randomized control trial
Published in Journal of Dermatological Treatment, 2022
Reza Yaghoobi, Mehrnaz Soghrati, Sedighe Tavakoli, Nader Pazyar, Mahdi Abounoori, Ali Abounoori, Gholamreza Houshmand
Our study's results demonstrated a significant difference between the therapeutic response of common wart to BCG paste and saline paste. There was a 67/5% total response rate without recurrence with a 20% complete response in the group (group A), but none of the control group patients (group B) had a response. In a similar study evaluating the efficacy of topical viable BCG vaccine in paste formula in the treatment of common and plane wart in children (3–14 years old), complete response was achieved in 65% of children with common warts, and no response was detected in the control group (4). Since we had different age groups from children to adults, we should be expected these differences as the immune system function altering during aging (14). Also, in that study, they didn't report any side effects, but we observed slight side effects (mild erythema and minimal bleeding) in 62.5% of those who had the complete response to BCG vaccine paste. In other studies evaluating BCG's intralesional and intradermal application in warts, side effects such as pain, erythema, fever, ulceration, etc., were reported previously (12,15,16). This could be explained by the differences in BCG vaccine sensitivity and injection method.