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Meta-Analysis
. 2022 Nov-Dec;33(6S):S3-S16.
doi: 10.1097/DER.0000000000000945. Epub 2022 Sep 22.

Neonatal Bacillus Calmette-Guérin Vaccination to Prevent Early-Life Eczema: A Systematic Review and Meta-analysis

Laure F Pittet, Lisbeth M Thøstesen  1 , Peter Aaby  2 , Poul-Erik Kofoed  3 , Nigel Curtis, Christine S Benn
Affiliations
Meta-Analysis

Neonatal Bacillus Calmette-Guérin Vaccination to Prevent Early-Life Eczema: A Systematic Review and Meta-analysis

Laure F Pittet et al. Dermatitis. 2022 Nov-Dec.

Abstract

Increasing evidence suggests that early-life bacillus Calmette-Guérin (BCG) vaccine could prevent atopic eczema through its beneficial off-target effects. In this meta-analysis, 3 randomized control trials with similar methods were included and enabled robust estimations with low heterogeneity, involving a total of 5655 children randomized to early-life BCG Denmark (n = 2832) or no BCG (n = 2823). Meta-analyses suggest a beneficial effect of BCG to prevent eczema (risk ratio [RR], 0.89; 95% confidence interval [CI], 0.82-0.98). In subgroup analyses, BCG was more beneficial in boys (RR, 0.84; 95% CI, 0.74-0.95) and in children born to 2 atopic parents (RR, 0.81; 95% CI, 0.68-0.97). The NNT to prevent one case of eczema among children of 1 or 2 atopic parent was 20 (95% CI, 12-50). Bacillus Calmette-Guérin Denmark leads to an 11% reduction in the risk of eczema in early life. A greater effect was observed with increasing predisposition. Given its well-established safety profile, neonatal BCG vaccination should be considered for children of atopic parents.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
PRISMA flow diagram of the systematic review.
Figure 2
Figure 2
Meta-analysis of RCTs assessing the risk of eczema following early-life BCG vaccination. BCG, Bacille Calmette-Guérin; M-H, Mantel-Haenszel.
Figure 3
Figure 3
Sex and predisposition subgroup meta-analysis. BCG, Bacille Calmette-Guérin; M-H, Mantel-Haenszel.
Figure 4
Figure 4
Bacille Calmette-Guérin scar subgroup meta-analysis. BCG, Bacille Calmette-Guérin; M-H, Mantel-Haenszel.
Figure 5
Figure 5
Sex and predisposition combined subgroup meta-analysis. BCG, Bacille Calmette-Guérin; M-H, Mantel-Haenszel.
See this image and copyright information in PMC

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