Does timing of the Bacillus Calmette-Guérin vaccine affect weight in children under the age of 5 years? An observational study in Guinea-Bissau

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2025-05-16 DOI:10.1016/j.vaccine.2025.127246

Emil Buhl , Julie O. Vedel , Line M. Nanque , Claudino Correia , Andreas M. Jensen , Ane B. Fisker

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Abstract

Introduction

The live Bacillus Calmette-Guérin (BCG) vaccine has beneficial non-specific effects (NSEs) affecting susceptibility to other infections than tuberculosis. The non-live Pentavalent vaccine (Penta) may have negative NSEs on overall health, particularly for girls. We tested whether timing of BCG (scheduled at birth) and first Penta (Penta1) vaccination (scheduled from 6 weeks) were associated with weight-for-age z-score (WAZ) in children under 5 years of age.

Methods

Bandim Health Project (BHP) monitors vaccination status of children under 5 years through a Health and Demographic Surveillance System in Guinea-Bissau. Between 2016 and 2020, BHP weighed children eligible for enrolment in two large cluster-randomized trials. We classified BCG as timely if given during the neonatal period and Penta1 as timely if given within 2 months of age. Using linear regression models, we quantified the association between WAZ and timing of vaccination, adjusted for background factors associated with vaccination timeliness.

Results

A total of 25,693 children were included in the BCG cohort and 24,400 in the Penta cohort: 46 % had received no neonatal BCG and 54 % no timely Penta1. Children with no neonatal BCG had lower WAZ (adjusted difference − 0.08 (95 % confidence interval (95 %CI) -0.12 to −0.04)). The adjusted difference in WAZ for each week of delay in BCG vaccination was −0.005 (95 %CI -0.007 to −0.003). Associations were similar for boys and girls. Overall estimates for no timely Penta1 were similar (adjusted difference − 0.08 (95 % CI -0.11 to −0.05)) but the difference tended to be larger in males (adjusted difference − 0.10 (95 %CI -0.14 to −0.06)) than in females (adjusted difference − 0.06 (95 %CI -0.11 to −0.02) (p = 0.27 for interaction with sex).

Conclusion

Receiving no timely BCG or Penta1 (or none at all) was associated with lower WAZ though much of the difference is likely explained by confounding. Timely Penta1 vaccination seemed less beneficial for girls.

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卡介苗疫苗接种时间是否会影响5岁以下儿童的体重？几内亚比绍的一项观察性研究

卡介苗（Bacillus calmette - gusamrin， BCG）活疫苗具有有益的非特异性效应（NSEs），影响对除结核病以外的其他感染的易感性。非活的五价疫苗（Penta）可能对整体健康产生负面的nse，特别是对女孩。我们测试了卡介苗的接种时间（出生时）和首次五联疫苗（Penta1）的接种时间（从6周开始接种）是否与5岁以下儿童的年龄体重z-评分（WAZ）相关。方法班迪姆卫生项目（BHP）通过几内亚比绍的卫生和人口监测系统监测5岁以下儿童的疫苗接种状况。在2016年至2020年期间，必和必拓对两项大型集群随机试验中符合入组条件的儿童进行了称重。我们将新生儿期给予卡介苗分类为及时，2个月以内给予Penta1分类为及时。使用线性回归模型，我们量化了WAZ与疫苗接种时间之间的关系，并调整了与疫苗接种及时性相关的背景因素。结果共有25693名儿童被纳入BCG队列，24400名儿童被纳入Penta队列，其中46%的儿童未接受新生儿BCG治疗，54%的儿童未及时接受Penta治疗。新生儿未接种卡介苗的儿童WAZ较低（校正差为- 0.08(95%可信区间(95% CI) -0.12至- 0.04)）。延迟接种卡介苗一周后WAZ校正差异为- 0.005 （95% CI -0.007至- 0.003）。男孩和女孩的关联相似。未及时Penta1的总体估计值相似（调整差值- 0.08 (95% CI -0.11至- 0.05)），但男性的差异（调整差值- 0.10 (95% CI -0.14至- 0.06)）往往大于女性(调整差值- 0.06 (95% CI -0.11至- 0.02)（与性别相互作用的p = 0.27）。结论未及时接受BCG或Penta1（或完全不接受）与较低的WAZ相关，但大部分差异可能是由混杂因素解释的。及时接种Penta1疫苗似乎对女孩的益处不大。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

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