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  1. Khan MU, Ahmad A
    Lancet, 2015 Jul 25;386(9991):337.
    PMID: 26227462 DOI: 10.1016/S0140-6736(15)61405-2
    Matched MeSH terms: Vaccination/legislation & jurisprudence*
  2. Khan TM, Chiau LM
    Lancet, 2015 Oct 31;386(10005):1733.
    PMID: 26545429 DOI: 10.1016/S0140-6736(15)00689-3
    Matched MeSH terms: Vaccination/legislation & jurisprudence*
  3. Gupta V, Dawood FS, Muangchana C, Lan PT, Xeuatvongsa A, Sovann L, et al.
    PLoS ONE, 2012;7(12):e52842.
    PMID: 23285200 DOI: 10.1371/journal.pone.0052842
    Southeast Asia is a region with great potential for the emergence of a pandemic influenza virus. Global efforts to improve influenza surveillance in this region have documented the burden and seasonality of influenza viruses and have informed influenza prevention strategies, but little information exists about influenza vaccination guidelines and vaccine sales.
    Matched MeSH terms: Vaccination/legislation & jurisprudence*
  4. Marciano BE, Huang CY, Joshi G, Rezaei N, Carvalho BC, Allwood Z, et al.
    J. Allergy Clin. Immunol., 2014 Apr;133(4):1134-41.
    PMID: 24679470 DOI: 10.1016/j.jaci.2014.02.028
    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 < .0001). The odds of experiencing complications among patients with T-cell numbers of 250/μL or less at diagnosis was 2.1 times higher (95% CI, 1.4-3.4 times higher; P = .001) than among those with T-cell numbers of greater than 250/μL. BCG-associated complications were reported in 2 of 78 patients who received antimycobacterial therapy while asymptomatic, and no deaths caused by BCG-associated complications occurred in this group. In contrast, 46 BCG-associated deaths were reported among 160 patients treated with antimycobacterial therapy for a symptomatic BCG infection (P < .0001).

    CONCLUSIONS: BCG vaccine has a very high rate of complications in patients with SCID, which increase morbidity and mortality rates. Until safer and more efficient antituberculosis vaccines become available, delay in BCG vaccination should be considered to protect highly vulnerable populations from preventable complications.

    Matched MeSH terms: Vaccination/legislation & jurisprudence
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