PubMed · 10736595
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D Goel, T J John. 1999. How to avoid multiple injections?. https://pubmed.ncbi.nlm.nih.gov/10736595/
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OBJECTIVE: To evaluate the safety of the intradermal Copenhagen BCG vaccine in neonates at different levels of delivery and neonatal units of the Durban Functional Region and surrounding regions. METHODS: A prospective study was carried out over a two-year period between July 1997 and June 1999. All neonates who had been vaccinated with the intradermal vaccine were evaluated at immunization clinics six weeks after immunization, or earlier if adverse effects occurred. FINDINGS: In total, 9763 neonates were examined: in 95.4% the vaccination scar had healed and 1.5% had no visible scar. Adverse events occurred in 3.1%. The proportion of neonates with no visible vaccination scars decreased over the study period, as did the number with adverse events. The lowest rate of adverse events and the highest rates of healed vaccination scars were seen in the tertiary hospital and regional and district hospitals that were in close proximity to the academic centre involved in this study. CONCLUSIONS: In the study sites, the transition from the percutaneous to intradermal route of administration of BCG vaccine was successful and took place without incurring unacceptably high rates of adverse events. To minimize adverse events, however, it is essential to continue training health personnel involved in implementing intradermal BCG vaccination programmes.
Pertussis (P) toxin acts as adjuvant for IgE formation against simultaneously administered Ags in animal models. P vaccination may also have an adjuvant impact on IgE formation against coadministered diphtheria (D) and tetanus (T) Ags in humans. Sera of 103 D-T-P-immunized and 319 D-T-immunized children aged 2 years were analyzed for IgE, IgG4, and IgG to D and T (radioallergosorbent test), total IgE and IgE against common inhalant allergens (CAP radioallergosorbent test fluoroenzyme immunoassay). Fewer D-T-P- than D-T-immunized children had sera positive for T-IgE (12.6 vs 53.6%, p < 0.001), T-IgG4 (71.6 vs 89.2%, p < 0.001), D-IgE (31.0 vs 70.5%, p < 0.001), and D-IgG4 (85.2 vs 93.4%, p = 0.039). Suppression of T-IgE was not dependent on the cutoff chosen for a positive test result, but was dependent on the proportion of D-T immunizations given with P. The risk for sensitization to common environmental allergens did not differ (odds ratio 0.953, 95% confidence interval 0.815-1.114). No significant differences between D-T- and D-T-P-immunized children were found with regard to T-IgG or D-IgG. In summary, IgE and IgG4 (but not IgG) serum levels to coadministered D- and T-Ags are suppressed among P-immunized children as compared with nonimmunized children. These results suggest that the presence of a microbial product during Ag exposure can down-regulate an IgE/IgG4 response in humans.
Konrad Elias Birkhaug (1892-1980) was born in Bergen to Elisa Marie Skorge and Karl Anders Birkhaug, a policeman, as the sixth of their ten children. After a period as a laboratory assistant at Bergen Municipal Hospital, he emigrated to USA in 1911. He graduated from the medical school of Johns Hopkins University in 1924. After residency in bacteriology, he became professor at Rochester University in 1927 and head of its laboratory of bacteriology. From 1932 to 1935 he worked as a senior scientist at the Institute Pasteur in Paris and from 1935 to 1945 as a fellow of the Chr. Michelsen Institute in Bergen. From 1937 he also headed the National Laboratory for production of BCG vaccine. After active involvement in the resistance movement against the Nazis during the Second World War, he returned to the USA in 1946 as head of the BCG laboratory of the State of New York in Albany. He retired in 1953 and settled in Bergen, where he died in 1980. Birkhaug is one of the pioneers in the research on immunity reactions to tuberculosis infection and BCG vaccination. He is also known for producing the first antiserum against erysipelas, which was used from 1927 until sulphonamides were discovered. In addition to his international scientific publications, he wrote two books in Norwegian, his autobiography and a book about the German eradication of a small fishermen's village in Western Norway during the Second World War.