BCG Vaccine

Please, excuse my english… I live in Venezuela and my wife had twins in march 25th (boy and girl). Their names are Daniel Eduardo (the boy) and Paula Vanessa (the girl) I want to know your opinion about BCG vaccine, because my pediatrician says me it is not so effective. Another people say me the BCG is necesary against some types of tuberculosis (“Miliar” and “Diseminada” [1]). I don’t know what is the best choice: apply or not apply the vaccine to my childs? In what circumstances do you think the BCG vaccine must be applied? [1] I wrote in spanish this types of tuberculosis.
Bernardo Campesino Martin – Caracas-Venezuela

Dr. Greene’s Answer:

Tuberculosis has been aptly called the “Captain of the Men of Death.” It remains the most important infectious disease in the world in terms of human suffering and death. Evidence of tuberculosis has been found in the earliest human remains, from Neanderthal skeletons to Egyptian mummies. As the planet became progressively more crowded, this contagious disease became even more of a problem.

A History of the BCG Vaccine

A vaccine that could safely and effectively prevent tuberculosis would be a tremendous gift to humanity. In 1908, Calmette and Guerin at the Institut Pasteur in Paris began working with slow-growing mycobacteria that produced tuberculosis in cattle. They selected the less virulent organisms, and 231 generations later they had a very mild strain that, when used as a vaccine, can greatly increase resistance to tuberculosis. It produces a mild infection that is effective at preventing the serious disseminated (diseminada) and miliary (miliar) forms of the disease. [These are not specific strains of TB, but the names given when TB runs rampantly through the bloodstream or organs of the entire body.] The BCG vaccine (the Bacillus of Calmette and Guerin) was first given in 1921, and is currently used in more than 100 countries (Red Book 2012).

BCG Vaccine Safety

Although mild infection is part of this vaccine, serious reactions are quite rare. The incidence of fatal reactions is 2 per million vaccinations with infants tending to be at higher risk. Most (but not all) of these occur in children with an underlying immunodeficiency (Red Book 2012). Overall, the BCG vaccine is one of the safest vaccines in use.

Research has shown that the BCG vaccine is most effective at preventing serious tuberculosis infections outside of the lungs. It is not as effective at preventing the more common tuberculosis infections of the lung.

Who Should Get the BCG Vaccine? Who Should Not?

People who benefit the most from BCG are those who are exposed to it most frequently. In light of this fact, BCG is indicated for infants, children, or adults who either:

  • live in area where infection rates of tuberculosis exceed 0.1% per year (WHO 2004)
  • are at high risk for prolonged exposure to infected adults who are untreated
  • or who are continuously exposed to adults with resistant TB

The BCG vaccine should not be given to individuals who either:

  • have known or suspected HIV infection (in most cases)
  • have congenital or acquired immunodeficiency
  • are on immunosuppressants, such as high-dose corticosteroids
  • have leukemia or lymphoma
  • or who have a history of radiation exposure
  • have current burns or skin infections
  • are currently pregnant

While the BCG vaccine is by no means a perfect solution, it has prevented untold misery and death. Used in the right setting, it is an excellent vaccine.

Dr. Alan Greene

As a father of four himself, Dr. Greene has devoted himself to freely giving real answers to parents' real questions -- from questions about those all too common childhood conditions to those that address the most recent and rare pediatric illnesses. His answers combine cutting edge science, practical wisdom, warm empathy, and a deep respect for parents, children, and the environment. He is also an electrifying public speaker, and has personally touched many during his talks in North America, Europe, Asia, and the Middle East.

Dr. Greene is a graduate of Princeton University and the University of California at San Francisco. Upon completion of his pediatric residency program at Children's Hospital Medical Center of Northern California he served as Chief Resident. He entered primary care pediatrics in January 1993.

Dr. Greene is the Past President of The Organic Center and on the Board of Directors of Healthy Child Healthy World. He is a founding partner of the Collaborative on Health and the Environment. He also consults for the Environmental Working Group.

In 1995, he launched DrGreene.com, cited by the AMA as “the pioneer physician Web site” on the Internet. His award-winning site has received over 80 million Unique Users from parents, concerned family members, students, and healthcare professionals. In addition to being the founder of DrGreene.com, he is the Medical Director for HealthTap.

In 2010 Dr. Greene founded the WhiteOut Movement to change how babies in the United States are fed. In 2012 he founded TICC TOCC - Transitioning Immediate Cord Clamping To Optimal Cord Clamping. He is also the founder of KidGlyphs, a free iPhone app that provides a tool for young children to express themselves beyond their verbal skills while teaching them important language skills.

Dr. Greene is the Founding President of the Society for Participatory Medicine and has served as both President and Board Chair of Hi-Ethics (Health Internet Ethics. He is on the Board of Directors for Healthy Child Healthy World, The Lunchbox Project, and The Society for Participatory Medicine. He has also served as an advisor to URAC for both their inaugural and their updated health web site accreditation program. He is a founding member of the e-Patient Scholars Working Group, and a founding board member of the Center for Information Therapy.

Dr. Greene is a regular columnist for Parenting Magazine. He is also the Pediatric Expert for The People’s Pharmacy (as heard on NPR) and Healing Quest (seen on PBS stations). He was the original Pediatric Expert for both Yahoo! and iVillage.

Dr. Greene is the author of Feeding Baby Green (Wiley, 2009), Raising Baby Green (Wiley, 2007), From First Kicks to First Steps (McGraw-Hill, 2004), The Parent's Complete Guide to Ear Infections (People's Medical Society, 1997), and a co-author of The A.D.A.M. Illustrated Family Health Guide (A.D.A.M., Inc., 2004). He is the medical expert for three additional books, The Parent's Soup A-to-Z Guide to Your New Baby, (Contemporary Books, 1998) The Parent's Soup A-to-Z Guide to Your Toddler, (Contemporary Books, 1999), and The Mother of All Baby Books, (Hungry Minds, Inc., 2002).

Dr. Greene is a frequent keynote speaker at important events such as Health 2.0 2011 held in San Diego, CA, IFOAM 2008 (International Federation of Organic Agriculture Movements), held in Modena Italy, the first European Internet health conference, held in Maastricht, the first International eHealth Association Conference, held in Jeddah, and the largest e-Healthcare World Conference, held in Las Vegas, and the first Green Power Baby Shower, held in Hollywood. Dr. Greene also appears frequently on TV, radio, websites, and in newspapers and magazines around the world, including such venues as the TODAY Show, Good Morning America, Fox and Friends, The Dr. Oz Show, CNN, ABC, CBS, and NBC network news, NPR, The New York Times, The Wall Street Journal, USA Today, Time Magazine, Parade, Parenting, Child, Baby Talk, Working Mother, Better Home's & Gardens, and the Reader's Digest.

Dr. Greene loves to think about challenging ideas, he enjoys being where nothing manmade can be seen, and he wears green socks.

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