ADVERSE REACTIONS IN HEALTHY AND IMMUNOCOMPROMISED CHILDREN UNDER 6 YEARS OF AGE VACCINATED WITH THE DANISH BCG VACCINE, STRAIN COPENHAGEN 1331 - IMPLICATIONS FOR THE VACCINATION POLICY IN SWEDEN

A retrospective analysis of the adverse reactions reported between 197 9 and 1991, in the 139 000 children under six years of age vaccinated in Sweden with the Danish BCG vaccine, strain Copenhagen 1331, showed an incidence of 1.9 per 1000 vaccinated children. Regional lymphogland ular swellings and/or abscesses were most commonly reported in 1.4 per 1000. Serious, disseminated, BCG infections developed in four infants vaccinated neonatally. Three of the infants suffered from severe, com bined, immunodeficiency syndrome, undiagnosed at the time of vaccinati on. The incidence of severe, combined, immunodeficiency syndrome was h igher in the BCG-vaccinated population (4 per 100 000 infants vaccinat ed within a year of their births), compared with all newborns in Swede n (1 per 100 000). The mean age at the onset of symptoms was 2.4 month s for the seven non-BCG-vaccinated infants versus 1.3 months for the f our BCG-vaccinated ones, while the immunodeficiency syndrome was diagn osed at an average age of 7.6 months in those who were not vaccinated versus 5.3 months in those BCG-vaccinated. It is recommended that the selective BCG vaccination bf infants at high risk of exposure to tuber culosis should be postponed to six months of age to reduce the risk of inoculating infants suffering from immunodeficiency syndromes.