BCG vaccination in patients with severe combined immunodeficiency

Complications, risks, and vaccination policies

Beatriz E. Marciano, Chiung Yu Huang, Gyan Joshi, Nima Rezaei, Beatriz Costa Carvalho, Zoe Allwood, Aydan Ikinciogullari, Shereen M. Reda, Andrew Gennery, Vojtech Thon, Francisco Espinosa-Rosales, Waleed Al-Herz, Oscar Porras, Anna Shcherbina, Anna Szaflarska, Şebnem Kiliç, Jose L. Franco, Andrea C. Gómez Raccio, Persio Roxo, Isabel Esteves & 37 others Nermeen Galal, Anete Sevciovic Grumach, Salem Al-Tamemi, Alisan Yildiran, Julio C. Orellana, Masafumi Yamada, Tomohiro Morio, Diana Liberatore, Yoshitoshi Ohtsuka, Yu Lung Lau, Ryuta Nishikomori, Carlos Torres-Lozano, Juliana T L Mazzucchelli, Maria M S Vilela, Fabiola S. Tavares, Luciana Cunha, Jorge A. Pinto, Sara E. Espinosa-Padilla, Leticia Hernandez-Nieto, Reem A. Elfeky, Tadashi Ariga, Heike Toshio, Figen Dogu, Funda Cipe, Renata Formankova, M. Enriqueta Nuñez-Nuñez, Liliana Bezrodnik, Jose Gonçalo Marques, María I. Pereira, Viviana Listello, Mary A. Slatter, Zohreh Nademi, Danuta Kowalczyk, Thomas A. Fleisher, Graham Davies, Bénédicte Neven, Sergio D. Rosenzweig

Research output: Contribution to journalArticle

78 Citations (Scopus)

Abstract

Background Severe combined immunodeficiency (SCID) is a syndrome characterized by profound T-cell deficiency. BCG vaccine is contraindicated in patients with SCID. Because most countries encourage BCG vaccination at birth, a high percentage of patients with SCID are vaccinated before their immune defect is detected. Objectives We sought to describe the complications and risks associated with BCG vaccination in patients with SCID. Methods An extensive standardized questionnaire evaluating complications, therapeutics, and outcomes regarding BCG vaccination in patients given a diagnosis of SCID was widely distributed. Summary statistics and association analysis was performed. Results Data on 349 BCG-vaccinated patients with SCID from 28 centers in 17 countries were analyzed. Fifty-one percent of the patients had BCG-associated complications, 34% disseminated and 17% localized (a 33,000- and 400-fold increase, respectively, over the general population). Patients receiving early vaccination (≥1 month) showed an increased prevalence of complications (P =.006) and death caused by BCG-associated complications (P

Original languageEnglish
Pages (from-to)1134-1141
Number of pages8
JournalJournal of Allergy and Clinical Immunology
Volume133
Issue number4
DOIs
Publication statusPublished - 2014

Fingerprint

Severe Combined Immunodeficiency
Mycobacterium bovis
Vaccination
BCG Vaccine
Parturition
T-Lymphocytes
Population

Keywords

  • BCG
  • hematopoietic stem cell transplant
  • immune reconstitution syndrome
  • mycobacteria
  • newborn screening
  • Primary immunodeficiency
  • severe combined immunodeficiency
  • vaccine

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Marciano, B. E., Huang, C. Y., Joshi, G., Rezaei, N., Carvalho, B. C., Allwood, Z., ... Rosenzweig, S. D. (2014). BCG vaccination in patients with severe combined immunodeficiency: Complications, risks, and vaccination policies. Journal of Allergy and Clinical Immunology, 133(4), 1134-1141. https://doi.org/10.1016/j.jaci.2014.02.028

BCG vaccination in patients with severe combined immunodeficiency : Complications, risks, and vaccination policies. / Marciano, Beatriz E.; Huang, Chiung Yu; Joshi, Gyan; Rezaei, Nima; Carvalho, Beatriz Costa; Allwood, Zoe; Ikinciogullari, Aydan; Reda, Shereen M.; Gennery, Andrew; Thon, Vojtech; Espinosa-Rosales, Francisco; Al-Herz, Waleed; Porras, Oscar; Shcherbina, Anna; Szaflarska, Anna; Kiliç, Şebnem; Franco, Jose L.; Gómez Raccio, Andrea C.; Roxo, Persio; Esteves, Isabel; Galal, Nermeen; Grumach, Anete Sevciovic; Al-Tamemi, Salem; Yildiran, Alisan; Orellana, Julio C.; Yamada, Masafumi; Morio, Tomohiro; Liberatore, Diana; Ohtsuka, Yoshitoshi; Lau, Yu Lung; Nishikomori, Ryuta; Torres-Lozano, Carlos; Mazzucchelli, Juliana T L; Vilela, Maria M S; Tavares, Fabiola S.; Cunha, Luciana; Pinto, Jorge A.; Espinosa-Padilla, Sara E.; Hernandez-Nieto, Leticia; Elfeky, Reem A.; Ariga, Tadashi; Toshio, Heike; Dogu, Figen; Cipe, Funda; Formankova, Renata; Nuñez-Nuñez, M. Enriqueta; Bezrodnik, Liliana; Marques, Jose Gonçalo; Pereira, María I.; Listello, Viviana; Slatter, Mary A.; Nademi, Zohreh; Kowalczyk, Danuta; Fleisher, Thomas A.; Davies, Graham; Neven, Bénédicte; Rosenzweig, Sergio D.

In: Journal of Allergy and Clinical Immunology, Vol. 133, No. 4, 2014, p. 1134-1141.

Research output: Contribution to journalArticle

Marciano, BE, Huang, CY, Joshi, G, Rezaei, N, Carvalho, BC, Allwood, Z, Ikinciogullari, A, Reda, SM, Gennery, A, Thon, V, Espinosa-Rosales, F, Al-Herz, W, Porras, O, Shcherbina, A, Szaflarska, A, Kiliç, Ş, Franco, JL, Gómez Raccio, AC, Roxo, P, Esteves, I, Galal, N, Grumach, AS, Al-Tamemi, S, Yildiran, A, Orellana, JC, Yamada, M, Morio, T, Liberatore, D, Ohtsuka, Y, Lau, YL, Nishikomori, R, Torres-Lozano, C, Mazzucchelli, JTL, Vilela, MMS, Tavares, FS, Cunha, L, Pinto, JA, Espinosa-Padilla, SE, Hernandez-Nieto, L, Elfeky, RA, Ariga, T, Toshio, H, Dogu, F, Cipe, F, Formankova, R, Nuñez-Nuñez, ME, Bezrodnik, L, Marques, JG, Pereira, MI, Listello, V, Slatter, MA, Nademi, Z, Kowalczyk, D, Fleisher, TA, Davies, G, Neven, B & Rosenzweig, SD 2014, 'BCG vaccination in patients with severe combined immunodeficiency: Complications, risks, and vaccination policies', Journal of Allergy and Clinical Immunology, vol. 133, no. 4, pp. 1134-1141. https://doi.org/10.1016/j.jaci.2014.02.028
Marciano, Beatriz E. ; Huang, Chiung Yu ; Joshi, Gyan ; Rezaei, Nima ; Carvalho, Beatriz Costa ; Allwood, Zoe ; Ikinciogullari, Aydan ; Reda, Shereen M. ; Gennery, Andrew ; Thon, Vojtech ; Espinosa-Rosales, Francisco ; Al-Herz, Waleed ; Porras, Oscar ; Shcherbina, Anna ; Szaflarska, Anna ; Kiliç, Şebnem ; Franco, Jose L. ; Gómez Raccio, Andrea C. ; Roxo, Persio ; Esteves, Isabel ; Galal, Nermeen ; Grumach, Anete Sevciovic ; Al-Tamemi, Salem ; Yildiran, Alisan ; Orellana, Julio C. ; Yamada, Masafumi ; Morio, Tomohiro ; Liberatore, Diana ; Ohtsuka, Yoshitoshi ; Lau, Yu Lung ; Nishikomori, Ryuta ; Torres-Lozano, Carlos ; Mazzucchelli, Juliana T L ; Vilela, Maria M S ; Tavares, Fabiola S. ; Cunha, Luciana ; Pinto, Jorge A. ; Espinosa-Padilla, Sara E. ; Hernandez-Nieto, Leticia ; Elfeky, Reem A. ; Ariga, Tadashi ; Toshio, Heike ; Dogu, Figen ; Cipe, Funda ; Formankova, Renata ; Nuñez-Nuñez, M. Enriqueta ; Bezrodnik, Liliana ; Marques, Jose Gonçalo ; Pereira, María I. ; Listello, Viviana ; Slatter, Mary A. ; Nademi, Zohreh ; Kowalczyk, Danuta ; Fleisher, Thomas A. ; Davies, Graham ; Neven, Bénédicte ; Rosenzweig, Sergio D. / BCG vaccination in patients with severe combined immunodeficiency : Complications, risks, and vaccination policies. In: Journal of Allergy and Clinical Immunology. 2014 ; Vol. 133, No. 4. pp. 1134-1141.
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T1 - BCG vaccination in patients with severe combined immunodeficiency

T2 - Complications, risks, and vaccination policies

AU - Marciano, Beatriz E.

AU - Huang, Chiung Yu

AU - Joshi, Gyan

AU - Rezaei, Nima

AU - Carvalho, Beatriz Costa

AU - Allwood, Zoe

AU - Ikinciogullari, Aydan

AU - Reda, Shereen M.

AU - Gennery, Andrew

AU - Thon, Vojtech

AU - Espinosa-Rosales, Francisco

AU - Al-Herz, Waleed

AU - Porras, Oscar

AU - Shcherbina, Anna

AU - Szaflarska, Anna

AU - Kiliç, Şebnem

AU - Franco, Jose L.

AU - Gómez Raccio, Andrea C.

AU - Roxo, Persio

AU - Esteves, Isabel

AU - Galal, Nermeen

AU - Grumach, Anete Sevciovic

AU - Al-Tamemi, Salem

AU - Yildiran, Alisan

AU - Orellana, Julio C.

AU - Yamada, Masafumi

AU - Morio, Tomohiro

AU - Liberatore, Diana

AU - Ohtsuka, Yoshitoshi

AU - Lau, Yu Lung

AU - Nishikomori, Ryuta

AU - Torres-Lozano, Carlos

AU - Mazzucchelli, Juliana T L

AU - Vilela, Maria M S

AU - Tavares, Fabiola S.

AU - Cunha, Luciana

AU - Pinto, Jorge A.

AU - Espinosa-Padilla, Sara E.

AU - Hernandez-Nieto, Leticia

AU - Elfeky, Reem A.

AU - Ariga, Tadashi

AU - Toshio, Heike

AU - Dogu, Figen

AU - Cipe, Funda

AU - Formankova, Renata

AU - Nuñez-Nuñez, M. Enriqueta

AU - Bezrodnik, Liliana

AU - Marques, Jose Gonçalo

AU - Pereira, María I.

AU - Listello, Viviana

AU - Slatter, Mary A.

AU - Nademi, Zohreh

AU - Kowalczyk, Danuta

AU - Fleisher, Thomas A.

AU - Davies, Graham

AU - Neven, Bénédicte

AU - Rosenzweig, Sergio D.

PY - 2014

Y1 - 2014

N2 - Background Severe combined immunodeficiency (SCID) is a syndrome characterized by profound T-cell deficiency. BCG vaccine is contraindicated in patients with SCID. Because most countries encourage BCG vaccination at birth, a high percentage of patients with SCID are vaccinated before their immune defect is detected. Objectives We sought to describe the complications and risks associated with BCG vaccination in patients with SCID. Methods An extensive standardized questionnaire evaluating complications, therapeutics, and outcomes regarding BCG vaccination in patients given a diagnosis of SCID was widely distributed. Summary statistics and association analysis was performed. Results Data on 349 BCG-vaccinated patients with SCID from 28 centers in 17 countries were analyzed. Fifty-one percent of the patients had BCG-associated complications, 34% disseminated and 17% localized (a 33,000- and 400-fold increase, respectively, over the general population). Patients receiving early vaccination (≥1 month) showed an increased prevalence of complications (P =.006) and death caused by BCG-associated complications (P

AB - Background Severe combined immunodeficiency (SCID) is a syndrome characterized by profound T-cell deficiency. BCG vaccine is contraindicated in patients with SCID. Because most countries encourage BCG vaccination at birth, a high percentage of patients with SCID are vaccinated before their immune defect is detected. Objectives We sought to describe the complications and risks associated with BCG vaccination in patients with SCID. Methods An extensive standardized questionnaire evaluating complications, therapeutics, and outcomes regarding BCG vaccination in patients given a diagnosis of SCID was widely distributed. Summary statistics and association analysis was performed. Results Data on 349 BCG-vaccinated patients with SCID from 28 centers in 17 countries were analyzed. Fifty-one percent of the patients had BCG-associated complications, 34% disseminated and 17% localized (a 33,000- and 400-fold increase, respectively, over the general population). Patients receiving early vaccination (≥1 month) showed an increased prevalence of complications (P =.006) and death caused by BCG-associated complications (P

KW - BCG

KW - hematopoietic stem cell transplant

KW - immune reconstitution syndrome

KW - mycobacteria

KW - newborn screening

KW - Primary immunodeficiency

KW - severe combined immunodeficiency

KW - vaccine

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JO - Journal of Allergy and Clinical Immunology

JF - Journal of Allergy and Clinical Immunology

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