Factors influencing scar formation following Bacille Calmette-Guérin (BCG) vaccination. Issue 4 (April 2023)

• Record Type: Journal Article
• Authors: Villanueva, Paola; Crawford, Nigel W.; Croda, Mariana Garcia; Collopy, Simone; Jardim, Bruno Araújo; de Almeida Pinto Jardim, Tyane; Manning, Laurens; Lucas, Michaela; Marshall, Helen; Prat-Aymerich, Cristina; Sawka, Alice; Sharma, Ketaki; Troeman, Darren; Wadia, Ushma; Warris, Adilia; Wood, Nicholas; Messina, Nicole L.; Curtis, Nigel; Pittet, Laure F.
• Is Part Of: Heliyon. Volume 9:Issue 4(2023)
• Publication Date: 2023-04
• Subjects: BCG vaccine -- BCG scar -- Vaccination technique -- Vaccine safety; Research -- Periodicals; Medical sciences -- Periodicals; Natural history -- Periodicals; Social sciences -- Periodicals; Earth sciences -- Periodicals; Physical sciences -- Periodicals; 507.2
• DOI: 10.1016/j.heliyon.2023.e15241
• Languages: English
• ISSNs: 2405-8440

Abstract

Abstract: The prevalence of scar formation following Bacille Calmette-Guérin (BCG) vaccination varies globally. The beneficial off-target effects of BCG are proposed to be stronger amongst children who develop a BCG scar. Within an international randomised trial ('BCG vaccination to reduce the impact of coronavirus disease 2019 (COVID-19) in healthcare workers'; BRACE Trial), this nested prospective cohort study assessed the prevalence of and factors influencing scar formation, as well as participant perception of BCG scarring 12 months following vaccination . Amongst 3071 BCG-recipients, 2341 (76%) developed a BCG scar. Scar prevalence was lowest in Spain and highest in UK. Absence of post-injection wheal (OR 0.4, 95%CI 0.2–0.9), BCG revaccination (OR 1.7, 95%CI 1.3–2.0), female sex (OR 2.0, 95%CI 1.7–2.4), older age (OR 0.4, 95%CI 0.4–0.5) and study country (Brazil OR 1.6, 95%CI 1.3–2.0) influenced BCG scar prevalence. Of the 2341 participants with a BCG scar, 1806 (77%) did not mind having the scar. Participants more likely to not mind were those in Brazil, males and those with a prior BCG vaccination history. The majority (96%) did not regret having the vaccine. Both vaccination-related (amenable to optimisation) and individual-related factors affected BCG scar prevalence 12 months following BCG vaccination of adults, with implications for maximising the effectiveness of BCG vaccination.