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Villanueva P, Wadia U, Crawford NW, Messina NL, Kollmann TR, Lucas M, Manning L, Richmond P, Pittet LF, Curtis N. The safety of co-administration of Bacille Calmette-Guérin (BCG) and influenza vaccines. PLoS One 2022; 17:e0268042. [PMID: 35657850 PMCID: PMC9165819 DOI: 10.1371/journal.pone.0268042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 04/19/2022] [Indexed: 11/26/2022] Open
Abstract
Background With the emergence of novel vaccines and new applications for older vaccines, co-administration is increasingly likely. The immunomodulatory effects of BCG could theoretically alter the reactogenicity of co-administered vaccines. Using active surveillance in a randomised controlled trial, we aimed to determine whether co-administration of BCG vaccination changes the safety profile of influenza vaccination. Methods Participants who received influenza vaccine alone (Influenza group) were compared with those who also received BCG-Denmark vaccine in the contralateral arm (Influenza+BCG group). Data on the influenza vaccination site were collected using serial questionnaires and active follow-up for 3 months post vaccination. Results Of 1351 participants in the Influenza+BCG group and 1418 participants in the Influenza group, 2615 (94%) provided influenza vaccine safety data. There was no significant difference in the proportion of participants with any local adverse reaction between the Influenza+BCG group and the Influenza group (918/1293 [71.0%] versus (906/1322 [68.5%], p = 0.17). The proportion of participants reporting any pain, erythema and tenderness at the influenza vaccination site were similar in both groups. Swelling was less frequent (81/1293 [6.3%] versus 119/1322 (9.0%), p = 0.01) and the maximal diameter of erythema was smaller (mean 1.8 cm [SD 2.0] versus 3.0 cm [SD 2.5], p<0.001) in the Influenza+BCG group. Sixteen participants reported serious adverse events: 9 participants in the Influenza+BCG group and 7 in the Influenza group. Conclusions Adverse events following influenza vaccination are not increased when BCG is co-administered.
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Affiliation(s)
- Paola Villanueva
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Infection and Immunity, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Infectious Diseases, Royal Children’s Hospital Melbourne, Parkville, VIC, Australia
- Department of General Medicine, Royal Children’s Hospital Melbourne, Parkville, VIC, Australia
| | - Ushma Wadia
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Nigel W. Crawford
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Infection and Immunity, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Department of General Medicine, Royal Children’s Hospital Melbourne, Parkville, VIC, Australia
- Immunisation Service, Royal Children’s Hospital Melbourne, Parkville, VIC, Australia
| | - Nicole L. Messina
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Infection and Immunity, Murdoch Children’s Research Institute, Parkville, VIC, Australia
| | - Tobias R. Kollmann
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Michaela Lucas
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Department of Immunology, Sir Charles Gairdner Hospital, Perth, WA, Australia
- Departments of Immunology and General Paediatrics, Perth Children’s Hospital, Perth, WA, Australia
- Department of Immunology, Pathwest, QE2 Medical Centre, Perth, WA, Australia
| | - Laurens Manning
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Department of Infectious Diseases, Fiona Stanley Hospital, Perth, WA, Australia
| | - Peter Richmond
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Departments of Immunology and General Paediatrics, Perth Children’s Hospital, Perth, WA, Australia
| | - Laure F. Pittet
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Infection and Immunity, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Infectious Diseases, Royal Children’s Hospital Melbourne, Parkville, VIC, Australia
| | - Nigel Curtis
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Infection and Immunity, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Infectious Diseases, Royal Children’s Hospital Melbourne, Parkville, VIC, Australia
- * E-mail:
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