title: Recommendations for pediatric tuberculosis vaccination in Italy.
abstract: Bacillus Calmette-Guérin (BCG) vaccine is still the only vaccine approved for the prevention of tuberculosis (TB), and is widely used in highly endemic countries, where all newborns receive a single intradermal dose immediately after birth; however, the recommendations concerning its use in Europe vary widely from country to country. This document describes the recommendations of a group of Italian scientific societies concerning its pediatric use in Italy, the persistence of the protection it provides, its safety, its interference with tuberculin skin test (TST) responses, and the children who should be vaccinated. The experts conclude that BCG vaccination provides a good level of protection against tuberculous meningitis and disseminated forms, and a fair level of protection against pulmonary disease; the protective effective lasts at least 10 years, and revaccination offers no advantages over a single administration. The vaccine is safe in immunocompetent subjects, and affects the response to a TST for at least 6 y On the basis of these observations, we recommend its use in Italy in all TST-negative immunocompetent newborns and breastfeeding infants aged <6 months, and all TST-negative children aged between 6 months and 5 y who come from highly epidemic areas, or whose parents come from highly endemic areas, or who have been in contact with a family member with active TB without contracting the disease themselves.
authors.affiliation: a Pediatric Clinic, Meyer Hospital, University of Florence , Florence , Italy.
authors.forename: Carlotta
authors.initials: C
authors.lastname: Montagnani
authors.affiliation: b Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milan , Italy.
authors.forename: Susanna
authors.initials: S
authors.lastname: Esposito
authors.affiliation: a Pediatric Clinic, Meyer Hospital, University of Florence , Florence , Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Galli
authors.affiliation: a Pediatric Clinic, Meyer Hospital, University of Florence , Florence , Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Chiappini
authors.affiliation: b Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milan , Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Principi
authors.affiliation: a Pediatric Clinic, Meyer Hospital, University of Florence , Florence , Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: de Martino
mesh_terms: D001500:BCG Vaccine / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology*; D006801:Humans; D007115:Immunization Schedule; D007558:Italy / Q000453:epidemiology; D014376:Tuberculosis / Q000453:epidemiology* / Q000517:prevention & control*
chemical_list: D001500:BCG Vaccine
keywords: BCG; children; prevention; tuberculosis; vaccination; vaccine