Pediatr Infect Vaccine.  2016 Apr;23(1):54-61. 10.14776/piv.2016.23.1.54.

The Incidence Rate of Lymphadenitis after Bacille Calmette-Guérin (BCG) Vaccination

• Kim J
• Lee K
• Kim JH
• Kim SJ
• Lee SY
• Lee HJ
• Cho KS
• Kwon YJ
• Lee BC
• Jo SM
• Ha JH
• Lee YK
• Seung SJ
• BCG Lymphadenitis Survey Committee

• KMID: 2163224
• DOI: http://doi.org/10.14776/piv.2016.23.1.54

Abstract

PURPOSE
Bacille Calmette-Guérin (BCG) lymphadenitis is a relatively frequent local adverse reactions after BCG vaccination. Its incidence rate is usually <1%. However, this rate may be different according to BCG strain, vaccination method or skill, etc. In the Republic of Korea, two BCG strains are used: intradermal Danish-1331 or percutaneous Tokyo-172. We surveyed the incidence rates of BCG lymphadenitis.
METHODS
This survey was performed in total 25 centers (5 general hospitals, 20 private pediatric clinics). Immunized type of BCG strain in study subjects was verified by directly observing the scar. The occurrence of BCG lymphadenitis was asked to their parent. In cases of BCG lymphadenitis, location, diameter size, progression of suppuration, and treatment method were investigated, as well.
RESULTS
The total number of study subjects was 3,342. Among these, the subjects suitable for enrollment criteria (total 3,222; Tokyo strain 2,501, Danish strain 721) were analyzed. BCG lymphadenitis regardless of its size developed in each five of subjects per strains, therefore, its incidence rate was 0.20% in Tokyo and 0.69% in Danish strain, respectively (P=0.086). However, when applying the WHO criteria - the development of lymph node swelling with diameter 1.5 cm or more, the incidence rate of BCG lymphadenitis was 0.16% (4 cases) in Tokyo and 0.42% (3 cases) in Danish strain, respectively.
CONCLUSIONS
The incidence rate of lymphadenitis in two BCG types, percutaneous Tokyo and intradermal Danish strain BCG, is 0.20% and 0.69%, respectively. Both rates are acceptable.

Keyword

Bacille Calmette Guerin (BCG); lymphadenitis; adverse reaction; Dannish strain; Tokyo strain

MeSH Terms

Cicatrix
Hospitals, General
Humans
Incidence*
Lymph Nodes
Lymphadenitis*
Mycobacterium bovis
Parents
Republic of Korea
Suppuration
Vaccination*

Figure

• 

  Fig. 1. The flow chart how to select the study population. Abbreviations: BCG, Bacille Calmette-Guérin; D, Dannish strain intradermal; N, number; T, Tokyo strain percutaneous.

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