Important note: Information in this article was accurate in 2009. The state of the art may have changed since the publication date.
The New York Times - July 7, 2009
Donald G. Mcneil Jr.
The Bacille Calmette-Guerin vaccine, known as BCG, protects children well against deadly tuberculous meningitis, though it does less well against the lung form. It has been in use since 1921, and children in many countries -- though not the United States, which never adopted it -- bear its characteristic round scar.
But because it is a live vaccine, a weakened strain of bovine tuberculosis, it can cause its own problem -- "disseminated BCG disease," a type of bacterial infection that can rage through the body. It is fatal in more than 70 percent of cases.
In countries like South Africa, where both tuberculosis and mother-to-child transmission of the AIDS virus is common, the vaccine gives infected children almost no protection against tuberculosis and instead may kill them with BCG disease, the authors found. The study, done in three South African pediatric hospitals, was complex because BCG disease and tuberculosis can look identical, so each infection had to be cultured.
Although they recommend delaying vaccination, the authors acknowledge that will not be easy. In poor countries, babies are often not brought back at 6 weeks for a test and 10 weeks for a shot. So the dangerous practice of vaccinating every baby may continue, because it protects the uninfected ones.
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