Journal Article

Clinical Reactogenicity of Intradermal Bacille Calmette-Guérin Vaccination

Daniel F. Hoft, Craig Leonardi, Thomas Milligan, George T. Nahass, Brian Kemp, Sandra Cook, Jan Tennant and Marjorie Carey

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 28, issue 4, pages 785-790
Published in print April 1999 | ISSN: 1058-4838
Published online April 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/515201
Clinical Reactogenicity of Intradermal Bacille Calmette-Guérin Vaccination

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Clinical, microbiological, and immunologic responses were evaluated in volunteers vaccinated intradermally with bacille Calmette-Guérin (BCG). Most volunteers (98%) developed ulcerative lesions that drained for a mean ± SE of 4.3 ± 0.29 weeks. Mycobacterial DNA was detected by a polymerase chain reaction-based amplification technique in biopsy specimens from BCG ulcers 2 weeks after vaccination and in blood specimens 3 days after vaccination. Mycobacteria were cultured from ulcer drainage 2 months after vaccination, demonstrating a prolonged potential risk of contact spread of the vaccine strain. The duration of ulcer drainage was inversely correlated with prevaccination lymphoproliferative (r = −0.515; P < .002) and interferon γ (r = −0.841; P < .002) responses specific to mycobacteria and directly correlated with postvaccination increases in lymphoproliferative (r = 0.498; P < .002) and interferon γ (r = 0.688; P < .02) responses specific to mycobacteria. These results demonstrate the clinical reactogenicity of BCG and the potential risk of contact spread of the vaccine strain and suggest that clinical reactogenicity is a trade-off for the induction of protective mycobacterial immunity.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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