Tuberculosis Vaccine Use Based on “Blind Faith”

November 8, 2010 by
Filed under: Vaccine Science, Vaccine/Disease Analysis, WHO Watch 

UK is planning to introduce the BCG vaccine for all newborns in London because of a resurgence of the disease. The article states:

Health experts believe the threshold at which routine immunisation is required — 40 cases per 100,000 — has been reached across the capital. Current policy has been to offer vaccination to children who are born abroad or whose parents are born abroad. [1]

Why is it that Spain and the U.S. have never used the vaccine and yet have a very low incidence of TB?

The BCG vaccine is the most widely used vaccines of all, as well as the most controversial. The first BCG vaccine trial resulted in a huge disaster which seriously marred its reputation.

The Lubeck disaster will remain a landmark in the history of immunization. In the summer of 1930, in Lubeck, Germany, 240 infants were vaccinated with BCG; 72 of the vaccinated infants developed tuberculosis and died….

Nevertheless, the disaster had done much to harm public acceptance of the vaccine, and mass vaccination of children was only reinstated after 1932, when new and safer production techniques were implemented. Its efficacy has been found to range from 0-80%. [2]

Not only is the BCG vaccine efficacy highly questionable, but it is not effective against the most common strains of TB:

The most common strains of tuberculosis in the most highly infected parts of the world may not be covered by the BCG vaccine. [3]

Dutch medical researchers, speaking September 10, 2001 at the bi-annual meeting of the Society of General Microbiology (SGM) at the University of East Anglia in the UK, said:

“We think that in Asia, the former USSR republics and other areas, Beijing type strains of Mycobacterium tuberculosis play a major role in the TB epidemic,” says Dr. Dick van Soolingen of the National Institute of Public Health and the Environment in Bilthoven, the Netherlands. “The Beijing strains are also more frequently resistant to the most important drugs used to treat tuberculosis.” [3]

Why is a vaccine with such low protective levels, being injected into newborns in many countries …when there are studies that show that it offers very little protection against pulmonary TB, and may cause severe complications in immunocompromised individuals?

In discussing the BCG vaccine, WHO says:

BCG is widely used and the safety of this vaccine has not been a serious issue until recently. There is a concern that use of the vaccine in persons who are immune compromised may result is an infection caused by the BCG itself. Also, even among immune competent persons, local reactions, including ulceration at the site of vaccination may result in shedding of live organisms which could infect others who may be immune compromised.

BCG vaccines currently in use, are produced at several (seven?) sites throughout the world. These vaccines are not identical. To what extent they differ in efficacy and safety in humans is not clear at present. Some differences in molecular and genetic characteristics are known. What is not known is if the “BCG” from one manufacturer is “better” than one produced at another site. (emphases added) [4]

Another study from India suggests

It is emphasized that BCG vaccination cannot prevent natural tuberculous infection of the lungs and its local complications, although it reduces the haematogenous complications of primary infection. However, this is not true for malnourished children who, in spite of BCG vaccination, develop serious, and often fatal types of tuberculosis such as miliary, meningitic and disseminated tuberculosis. The tuberculin anergy in malnourished children, is mainly responsible for high morbidity and mortality. BCG vaccinated, well-nourished children manifest modified patterns of tuberculous disease, following infection. The most important manifestation is the increased incidence of intrathoracic tuberculosis, specially enlargement of the various groups of mediastinal nodes and their local complications. Localisation of the disease by T cell immunity, due to BCG vaccination is responsible for this and the much lower incidence of haemotological complications such as neurotuberculosis and disseminated disease. In these children, the clinical picture of neurotuberculosis is also modified, with a tendency for more localised involvement of the brain and meninges. Similarly, vaccinated children may present with hepatomegaly, splenomegaly or isolated organ disease. It is important to relearn the new patterns of tuberculosis disease seen in vaccinated, non-malnourished children, and to a lesser extent in children with grade 1 to 2 protein energy malnutrition (PEM). With these limitations of BCG vaccination, other strategies like chemoprophylaxis need multicentric trials in high risk children, in different parts of the country.

Impact of BCG vaccination has demonstrated that classical or generalized tuberculosis meningitis, miliary TB, disseminated tuberculosis, and other serious complications of primary infections go on occurring in malnourished BCG-vaccinated children. The variable efficacy of the present BCG vaccine observed in different prospective human trials has shown the necessity of conducting research of immunoregulatory mechanisms, and developing newer vaccines for global control of tuberculosis. [5]

While this particular study (which can be downloaded as a PDF) –sheds more light on one of the many reasons why countries like the USA never used the BCG vaccine, the last paragraph sums it up perfectly.

It seems much more likely that some of the world’s BCG strains are virtually useless, some confer moderate protection, and some-perhaps only a few-are highly potent. Which is which cannot at present be told. Because BCG vaccination is the major method of tuberculosis control in all but a few highly developed nations, it is particularly tragic that the use of scarce resources to administer BCG must still be based on blind faith. [6]

If the BCG vaccine doesn’t work in the countries where these London children are born, what makes the UK infectious disease experts think it will work on these same children in the United Kingdom?

[1] Call to give London Babies TB Jabs as Cases Rise, Rashid Razaq,  London Evening Standard, July 15, 2010. http://www.thisislondon.co.uk/standard/article-23856346-call-to-give-london-babies-tb-jabs-as-cases-rise.do

[2] Discovery of the BCG Vaccine, Vaccine Visionaries, Tech Net 21, Accessed on November 2, 2010. http://technet21.org/Articles/BCG_vaccine.html

[3] Most Common TB Strains Not Covered by BCG Vaccine, Daily University Science News, September 11, 2001. http://cmbi.bjmu.edu.cn/news/0109/119.htm

[4] BCG – The Current Vaccine for Tuberculosis, Initiative for Vaccine Research (IVR), World Health Organization, Accessed on November 2, 2010. http://www.who.int/vaccine_research/diseases/tb/vaccine_development/bcg/en/index.html

[5] BCG Vaccination in India and Tuberculosis in Children: Newer Facets, P.M. Udani, Indian Journal of Pediatrics, 1994, September-October, (61) 5, 451-62. http://www.ncbi.nlm.nih.gov/pubmed/7744445

[6] Evaluation of BCG Vaccination among Puerto Rican Children, George W. Comstock, Verna T. Livesay, Shirley F. Woolpert, American Journal of Public Health, March, 1974, (64) 3, 283-291. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1775430/pdf/amjph00803-0085.pdf

Comments

6 Comments on Tuberculosis Vaccine Use Based on “Blind Faith”

  1. Christine Branden on Mon, 8th Nov 2010 7:55 am
  2. Another vaccine for brand new, perfect, precious babies?? NO!!!!!!!!! This is utter insanity. I’m mad as hell and I’m not going to take it anymore!

  3. Peter on Tue, 4th Jan 2011 6:43 am
  4. Some additional points:

    In my country authorities acknowledge that BCG vaccine is NOT as universally effective as other vaccines, but rely on their own evaluation and this meta-analysis:

    “The consensus is that the effect of BCG vaccine varies; this is why the World Health Organization recommends that countries undertake their own program evaluation studies. The scientific community is not searching for the overall protective effect.”
    http://jama.ama-assn.org/content/272/10/765.2

    I have no access to this article, so I cannot tell what it contains.

    In addition to WHO recommendation there are criteria from http://www.theunion.org/ which should be fullfilled in order to reduce mass vaccination to vaccination of high-risk groups (in countries where this vaccines is administered).

  5. gattarian on Tue, 4th Jan 2011 4:36 pm
  6. I’d like to point out a couple of things. The link you provided does not suggest that the BCG vaccine is ineffective against the strain of disease circulating in England where the policy you are discussing is going into effect. It seems inappropriate to apply global averages to a specific region as a criticism for a local problem.

  7. MinorityView on Tue, 4th Jan 2011 8:10 pm
  8. Hi Gattarian,
    Do you have a link that suggests the BCG vaccine is effective against the strain of disease circulating in England?

  9. Peter on Sun, 9th Jan 2011 2:06 am
  10. IV, do you have any link to statistics about TBC in US, starting at least in the 50’s? WHO publish data only from 1980, as far as I could see. Thank you.

  11. admin on Sun, 9th Jan 2011 7:56 am
  12. This one looks like it would be useful, but it isn’t free… http://www.ncbi.nlm.nih.gov/pubmed/19350762
    This one is interesting: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4829a1.htm, especially the graph on deaths from infectious disease. The introduction of the Salk vaccine seems to have made no difference at all…

    I think you can find what you want here: http://www.cdc.gov/nchs/products/vsus.htm
    but it will take a fair amount of digging.

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