Bacillus Calmette-Guérin (BCG) Vaccine and Adult Mortality in Two Prospective Cohort Studies Open Access

Abstract

Background There is evidence of beneficial non-specific effects of live-attenuated vaccines, including Bacillus Calmette-Guérin (BCG) for tuberculosis, primarily in child mortality. The aim of this study is to examine whether this association remains consistent in adulthood in women in the Nurses’ Health Study (NHS) and Nurses’ Health Study II (NHS II).

Methods These are two prospective cohort studies of women followed from 1984 to 2014 in NHS and from 1991 to 2015 in NHS II. Vaccination status was self-reported at baseline and death obtained by post office, next-of-kin, and/ or via systematic searches of state records and National Death Index. 

Results Of the 87,699 women included in NHS, 13% had received the BCG vaccine and of the 93,514 in NHS, 2% received it. There was no association of mortality by vaccination status in either cohort. In NHS, there were 25,224 total deaths and the adjusted hazard ratio (HR) and 95% confidence interval (95% CI) of all-cause mortality was 1.04 (95% CI: 0.99– 1.08). In NHS II, there were 2,591 total deaths and the HR was 1.01 (95% CI: 0.79 – 1.30). These findings were consistent when participants were subset by race and by type of death (cardiovascular, cancer, or other). 

Conclusions Adult mortality was independent of BCG vaccine status, contrary to what is seen in child mortality. BCG vaccine may not provide non-specific benefits in adulthood. 

Table of Contents

Background                         1

Methods                               3

Results                                 6

Discussion                           8

References                          10

Tables                                   12

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology
Keyword	BCG Vaccine
Committee Chair / Thesis Advisor	K.M. Venkat Narayan, Emory University

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