Factors influencing scar formation following Bacille Calmette-Guérin (BCG) vaccination

Paola Villanueva; Nigel W. Crawford; Mariana Garcia Croda; Simone Collopy; Bruno Araújo Jardim; Tyane de Almeida Pinto Jardim; Laurens Manning; Michaela Lucas; Helen Marshall; Cristina Prat-Aymerich; Alice Sawka; Ketaki Sharma; Darren Troeman; Ushma Wadia; Adilia Warris; Nicholas Wood; Nicole L. Messina; Nigel Curtis; Laure F. Pittet

Heliyon (Apr 2023)

Factors influencing scar formation following Bacille Calmette-Guérin (BCG) vaccination

Paola Villanueva,
Nigel W. Crawford,
Mariana Garcia Croda,
Simone Collopy,
Bruno Araújo Jardim,
Tyane de Almeida Pinto Jardim,
Laurens Manning,
Michaela Lucas,
Helen Marshall,
Cristina Prat-Aymerich,
Alice Sawka,
Ketaki Sharma,
Darren Troeman,
Ushma Wadia,
Adilia Warris,
Nicholas Wood,
Nicole L. Messina,
Nigel Curtis,
Laure F. Pittet

Affiliations

Paola Villanueva: Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia; Infection and Immunity, Murdoch Children's Research Institute, Parkville, VIC, Australia; Infectious Diseases, Royal Children's Hospital Melbourne, Parkville, VIC, Australia; Department of General Medicine, Royal Children's Hospital Melbourne, Parkville, VIC, Australia; Corresponding author.
Nigel W. Crawford: Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia; Infection and Immunity, Murdoch Children's Research Institute, Parkville, VIC, Australia; Department of General Medicine, Royal Children's Hospital Melbourne, Parkville, VIC, Australia; Immunisation Service, Royal Children's Hospital Melbourne, Parkville, VIC, Australia
Mariana Garcia Croda: School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
Simone Collopy: Department of Pediatrics, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, Brazil
Bruno Araújo Jardim: Carlos Borborema Clinical Research Institute, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
Tyane de Almeida Pinto Jardim: Carlos Borborema Clinical Research Institute, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
Laurens Manning: Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia; School of Medicine, University of Western Australia, Perth, WA, Australia; Department of Infectious Diseases, Fiona Stanley Hospital, Perth, WA, Australia
Michaela Lucas: School of Medicine, University of Western Australia, Perth, WA, Australia; Department of Immunology, Sir Charles Gairdner Hospital, Perth, WA, Australia; Departments of Immunology, Perth Children's Hospital, Perth, WA, Australia; Department of Immunology, Pathwest, QE2 Medical Centre, Perth, WA, Australia
Helen Marshall: Robinson Research Institute and Adelaide Medical School, The University of Adelaide and Department of Paediatrics, The Women's and Children's Health Network, Australia
Cristina Prat-Aymerich: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands; Institut d'Investigació Germans Trias i Pujol, Departament de Genètica i Microbiologia, CIBER de enfermedades respiratorias (CIBERES), Instituto de Salud Carlos III, Universitat Autònoma de Barcelona, Catalunya, Badalona, Spain
Alice Sawka: Department of Thoracic Medicine, Royal Adelaide Hospital, Adelaide, SA, Australia
Ketaki Sharma: National Centre for Immunisation Research and Surveillance, Westmead, NSW, Australia; The Children's Hospital at Westmead, Westmead, NSW, Australia
Darren Troeman: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
Ushma Wadia: Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
Adilia Warris: Medical Research Council Centre for Medical Mycology, University of Exeter, UK; Great Ormond Street Hospital, London, UK
Nicholas Wood: National Centre for Immunisation Research and Surveillance, Westmead, NSW, Australia; The Children's Hospital at Westmead, Westmead, NSW, Australia; The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, NSW, Australia
Nicole L. Messina: Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia; Infection and Immunity, Murdoch Children's Research Institute, Parkville, VIC, Australia
Nigel Curtis: Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia; Infection and Immunity, Murdoch Children's Research Institute, Parkville, VIC, Australia; Infectious Diseases, Royal Children's Hospital Melbourne, Parkville, VIC, Australia; Corresponding author. Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia.
Laure F. Pittet: Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia; Infection and Immunity, Murdoch Children's Research Institute, Parkville, VIC, Australia; Infectious Diseases, Royal Children's Hospital Melbourne, Parkville, VIC, Australia; Infectious Diseases Unit, Department of Paediatrics, Gynaecology and Obstetrics, Faculty of Medicine, University of Geneva and University Hospitals of Geneva, Geneva, Switzerland

Journal volume & issue: Vol. 9, no. 4
p. e15241

Abstract

Read online

The prevalence of scar formation following Bacille Calmette-Guérin (BCG) vaccination varies globally. The beneficial off-target effects of BCG are proposed to be stronger amongst children who develop a BCG scar. Within an international randomised trial (‘BCG vaccination to reduce the impact of coronavirus disease 2019 (COVID-19) in healthcare workers’; BRACE Trial), this nested prospective cohort study assessed the prevalence of and factors influencing scar formation, as well as participant perception of BCG scarring 12 months following vaccination . Amongst 3071 BCG-recipients, 2341 (76%) developed a BCG scar. Scar prevalence was lowest in Spain and highest in UK. Absence of post-injection wheal (OR 0.4, 95%CI 0.2–0.9), BCG revaccination (OR 1.7, 95%CI 1.3–2.0), female sex (OR 2.0, 95%CI 1.7–2.4), older age (OR 0.4, 95%CI 0.4–0.5) and study country (Brazil OR 1.6, 95%CI 1.3–2.0) influenced BCG scar prevalence. Of the 2341 participants with a BCG scar, 1806 (77%) did not mind having the scar. Participants more likely to not mind were those in Brazil, males and those with a prior BCG vaccination history. The majority (96%) did not regret having the vaccine.Both vaccination-related (amenable to optimisation) and individual-related factors affected BCG scar prevalence 12 months following BCG vaccination of adults, with implications for maximising the effectiveness of BCG vaccination.

Published in Heliyon

ISSN: 2405-8440 (Online)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Science: Science (General); Social Sciences: Social sciences (General)
Website: https://www.cell.com/heliyon/home

About the journal

Abstract

Keywords