Safety and eVectiveness of BCG vaccination in preterm babies

Aim—To assess the cell mediated immune response to BCG vaccine in preterm babies. Methods—Sixty two consecutive preterm babies born at < 35 weeks of gestation were randomly allocated into two groups. Babies in group A were vaccinated early at 34–35 weeks and group B were vaccinated late at 38–40 weeks of postconceptional age. The two groups were similar in terms of: gestational age (mean (SD) 33.1 (1.1) and 33 (1.2) weeks, respectively); birthweight 1583 (204) and 1546 (218) g; neonatal problems; socioeconomic status; and postnatal weight gain. The cell mediated immune response to BCG was assessed using the Mantoux test and the lymphocyte migration inhibition test (LMIT) 6–8 weeks after BCG vaccination. Induration of >5 mm after the Mantoux test was taken as a positive response. Results—There was no significant diVerence in the tuberculin conversion rates (80% and 80.7%, respectively), positive LMIT (86.6% and 90.3%, respectively), or BCG scar (90.0% and 87.1%, respectively) among the two groups. Conclusions—Prematurity seems to be an unlikely cause for poor vaccine uptake. Preterm babies can be eVectively vaccinated with BCG at 34–35 weeks of postconceptional age, the normal time of discharge in a developing country. (Arch Dis Child Fetal Neonatal Ed 1999;81:F64–F66)