Intervention Clinical Trial
Official title:
Bacille Calmette Guérin Immunisation at Birth and Childhood Morbidity in Danish Children. A Prospective, Randomised, Clinical Trial.
In high-income societies the use of health care and medication is steadily increasing.
Children have high morbidity, many visits at the general practitioner, an increasing number
of hospitalisations, and an increasing use of medication. And, when children are ill,
someone has to stay home to care for them. An un-explained global increase in the incidence
of the allergic diseases eczema, wheezing, asthma and allergies means that 25% of
high-income populations are affected. Cheap preventive measures are highly warranted. Recent
studies have shown a positive, non-specific effect of early Bacille Calmette Guérin (BCG)
immunisation on neonatal mortality in low-income countries and suggested a positive,
non-specific effect on allergic disease in high-income countries. "Non-specific" means that
the vaccine effect goes beyond prevention of the targeted disease, i.e. the BCG vaccine
benefits the health status of the immunised individual in ways unrelated to protection
against tuberculosis (TB). For instance, in a recent randomised trial in West Africa the
investigators showed that the BCG vaccine at birth was safe in low birth weight (LBW)
infants and significantly reduced neonatal mortality in these children, with a significant
long-lasting effect on infant mortality in the smallest newborns with a birth weight <1.5
kg. There is an urgent need to explore the huge potential of the BCG's beneficial
immune-stimulatory effects among children in high-income populations.
Therefore, the investigators will carry out a large prospective randomised clinical trial in
Denmark primarily designed to test the hypothesis that infants who get the BCG vaccine at
birth experience 20% fewer hospitalisations during early childhood.
Secondary outcomes
1. To test the hypothesis that infants who get the BCG vaccine at birth are prescribed
less antibiotics during early childhood than non-BCG-immunised infants.
2. To test the hypothesis that Danish infants who get the BCG vaccine at birth develop
less eczema, asthmatic bronchitis/wheeze and food allergy at 3 and 12 months of age:
self-reported, diagnosed by a physician, or found at clinical examination; and are
prescribed less anti-eczema/asthma/allergy medication during early childhood than
non-BCG-immunised infants.
3. To test the hypothesis that infants who receive the BCG at birth respond in
paraclinical measures: Specific IgE, thymic gland size, leucocyte count and
differentiation, monocyte memory, cytokine profiles, and antibody titres following
immunisation against diphtheria, tetanus, pertussis, pneumococcus, hemophilus.
4. To test the hypothesis that infants who get the BCG vaccine at birth respond in growth
measures: weight, length and head circumference.
5. To test the hypothesis that infants who get the BCG vaccine at birth respond with
decreased morbidity: common cold, pneumonia, febrile episodes, diarrhoea and vomiting,
acute otitis media, febrile convulsions.
6. To test the hypothesis that premature infants with gestational age less than 37 weeks
who get the BCG vaccine at birth have unaffected psychomotor development measures: Ages
and Stages scores.
7. To test the hypothesis that infants who get the BCG vaccine at birth has unaffected
coverage with the subsequent vaccinations in the Child Vaccination Programme.
8. To test the above mentioned hypotheses specifically in the strata of premature and
low-birth-weight Danish infants.
n/a
Allocation: Randomized, Intervention Model: Single Group Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Prevention
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