Adverse reactions to Mycobacterium bovis bacille Calmette-Guérin vaccination against tuberculosis in Iranian children.
OBJECTIVE
There are considerable variations in the number of adverse reaction reports related to vaccine from different countries. The aim of this study was to review the development of adverse reactions to bacille Calmette-Guérin (BCG) vaccination among hospitalized patients in an Iranian referral hospital.


METHODS
We identified hospitalized patients with BCG complications in Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran during January 2007-April 2009. Data on demographics, clinical features, laboratory findings, personal history (including vaccination history), family history, and outcomes were retrieved from medical records.


RESULTS
There were 46 cases with BCG complication during the 2 years period. All of the children received vaccination at birth. Twenty-eight patients (61%) were male. The mean age of the patients was 13.5 ±11.3 months (range, 1 to 52 months; median, 10 months). The majority of children (57%) with BCG complication were less than 1 year old. Among hospitalized patients due to BCG complications, suppurative lymphadenitis was occurred in 28 children (61%) and lymphadenopathy was seen in 9 children (20%). Disseminated BCG was detected in 8 patients (17%) and only 1 child (2%) was presented with abscess. In 7% (n = 3) of children, the family history of BCG complications were positive.


CONCLUSIONS
The most common side effect of the BCG vaccine in our study was suppurative lymphadenitis. Disseminated BCG infection in complications leading to hospitalization in our study was 17%. With regard to the difficulty in implementing such a guideline in settings where BCG is given to all newborns, registration of Iranian primary immunodeficiency disorders (PID) patients would be helpful to increase the awareness of medical community of Iran to investigate underlying disease. In addition, BCG vaccination should postpone in each newborn with a family history of PID until the definite condition has been ruled out.
Pediatrics Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Shima
S
Mahmoudi
Department of Infectious Diseases, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Saeid
S
Khaheshi
Pediatrics Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Babak
B
Pourakbari
Research Center for Immunodeficiencies, Tehran University of Medical Sciences, Tehran, Iran.
Asghar
A
Aghamohammadi
School of medicine, Tehran University of Medical Sciences, Tehran, Iran.
Sepideh
S
Keshavarz Valian
Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Abbas
A
Bahador
Department of Infectious Diseases, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Farah
F
Sabouni
Clinical Research Department, Pasteur Institute of Iran, Tehran, Iran.
Amitis
A
Ramezani
Pediatrics Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran. ; Department of Infectious Diseases, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Setareh
S
Mamishi
Bacille Calmette-Guérin; Children; Complication