Neonatal BCG Vaccination and Atopic Dermatitis

Australia: Neonatal bacillus Calmette-Guérin (BCG) vaccination may reduce the incidence of atopic dermatitis and should be considered for children of atopic parents, a recent study in the Dermatitis journal has suggested.

Neonatal BCG vaccination, one of the most widely used vaccines globally, has been reported to have beneficial effects beyond preventing infantile tuberculous meningitis and miliary disease. Atopic dermatitis, also known as eczema, is a skin condition that causes itchy, dry, and inflamed skin. It commonly occurs in young children but can occur at any age. The state is chronic (long-lasting) and sometimes tends to flare. It can be irritating but not contagious.

Accumulated evidence has suggested that early life BCG vaccine could prevent atopic eczema via its beneficial off-target effects. The meta-analysis by Laure F Pittet, Department of Paediatrics, The University of Melbourne, Australia, and colleagues, included three randomized control trials with similar methods and enabled robust estimations with low heterogeneity. It included a total of 5655 children randomized to early-life BCG Denmark (n = 2832) or no BCG (n = 2823).

The findings indicate a beneficial effect of BCG for eczema prevention (risk ratio [RR], 0.89). In subgroup analyses, BCG was more useful in boys (RR, 0.84) and children born to atopic parents (RR, 0.81). The number needed to treat (NNT) to prevent one eczema case among children of 1 or 2 atopic parents was 20. Bacillus Calmette-Guérin Denmark resulted in an 11% reduction in eczema risk in early life. A more significant effect was seen with an increased predisposition.

The researchers conclude, "given its well-established safety profile, neonatal BCG vaccination should be considered for children of atopic parents."

Reference

Pittet, Laure F. MD, PhD∗,†,‡,§; Thøstesen, Lisbeth M. MD, PhD∥; Aaby, Peter DMSc; Kofoed, Poul-Erik MD, DMSc#; Curtis, Nigel FRCPCH, PhD∗,†,‡; Benn, Christine S. MD, DMSc∗∗,††. Neonatal Bacillus Calmette-Guérin Vaccination to Prevent Early-Life Eczema: A Systematic Review and Meta-analysis. Dermatitis: September 22, 2022 - Volume - Issue - 10.1097/DER.0000000000000945 doi: 10.1097/DER.0000000000000945