Non-specific effects of BCG vaccination on morbidity among children in Greenland: a population-based cohort study
| Autor: | Anders Koch, Sascha Wilk Michelsen, Jan Wohlfahrt, S. Haahr, Mads Melbye, Mikael Andersson, Karen Bjorn-Mortensen, Bolette Søborg |
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| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
Pediatrics medicine.medical_specialty Tuberculosis Respiratory tract infections Epidemiology business.industry Retrospective cohort study General Medicine medicine.disease Confidence interval Vaccination 03 medical and health sciences Population based cohort symbols.namesake 030104 developmental biology 0302 clinical medicine Infectious disease (medical specialty) Immunology symbols Medicine 030212 general & internal medicine Poisson regression business |
| Zdroj: | International Journal of Epidemiology. :dyw244 |
| ISSN: | 1464-3685 0300-5771 |
| DOI: | 10.1093/ije/dyw244 |
| Popis: | Background The potential non-specific effects of BCG (Bacillus Calmette-Guerin) vaccination, with reported reduction of infectious disease morbidity among vaccinated children, in addition to the protective effect against tuberculosis (TB), are highly debated. In Greenland, BCG vaccination was introduced in 1955, but temporarily discontinued from 1991 to 1996 due to nationwide policy changes. Using the transient vaccination stop, we aimed to investigate possible non-specific effects of BCG vaccination by measuring nation-wide hospitalization rates due to infectious diseases other than TB among vaccinated and unvaccinated children. Methods A retrospective cohort study including all children born in Greenland aged 3 months to 3 years from 1989 to 2004. A personal identification number assigned at birth allowed for follow-up through national registers. Information on hospitalization due to infectious diseases was obtained from the Greenlandic inpatient register using ICD-8 and ICD-10 codes. Participants with notified TB were censored. Incidence rate ratios (IRR) were estimated using Poisson regression. Results Overall, 19 363 children, hereof 66% BCG-vaccinated, were followed for 44 065 person-years and had 2069 hospitalizations due to infectious diseases. IRRs of hospitalization in BCG-vaccinated as compared with BCG-unvaccinated children were 1.07 [95% confidence interval (CI) 0.96-1.20] for infectious diseases overall, and specifically 1.10 (95% CI 0.98-1.24) for respiratory tract infections. Among BCG-vaccinated children aged 3 to 11 months, the IRR of hospitalization due to infectious diseases was 1.00 (95% CI 0.84-1.19) as compared with BCG-unvaccinated children. Conclusion Our results do not support the hypothesis that neonatal BCG vaccination reduces morbidity in children caused by infectious diseases other than TB. |
| Databáze: | OpenAIRE |
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