Title : BCG an old vaccine, but still it is effective
All asylum-seekers coming to Sweden (100 000-150 000 per year 2010-2019).are offered a voluntary free-of-charge health examination. About 70 % attend the health control, which includes examination for latent tuberculosis with Quantiferon. Patients with active tuberculosis were excluded. Few of them had written documentation of BCG vaccination so the presence of a typical BCG scar was used as evidence that they were BCG vaccinated and vaccine effectiveness was calculated with the formula:
ARU=Attack rate of unvaccinaied
ARV= attack rate of vaccinated
A total of 1404 children and adolescents 0-17 years were included. Of those 1011 had BCG scars (72 %) and 239 had latent tuberculosis (17 %).The vaccine effectiveness was 59 % (95 % CI 48 -67 %, p<0.001). A significant effect was seen in the largest population groups, Afghanistan, Somalia, Syria and Iraq. In conclusion, BCG is effective in preventing latent tuberculosis.
Birger Trollfors graduated from the Medical Faculty in Gothenburg in 1974. After that he immediately started working at the Department of Infectious Diseases in Gothenburg, where he became a specialist in Imfectious Diseases. He also got a diploma in Parasitology and Tropical Diseases at the Bernhard Nocht Institute in Hamburg, Germany. After 10 years in Gotheburg he worked with a new acellular pertussis vaccine at the US Natuional Insitutes of Health in Bethesda, Maryland. When coming home to Gothenburg he led a double-blid placebo controlled trial of this pertussis vaccine. When the trial was over he started working at the Department of Pediatrics in Gothenburg, where he has stayed. He has published more than 200 original articles in peer-reviewed journals and supervised 12 young physicians to their dissertation. His research has mainly been devoted to vaccines and vaccine-preventable diseases notably, pertussis, pneumocacci and Hib. His clinical work has for the last 15 years been devoted to immigarnt patients with latent and active tuberculosis.