Revised BCG vaccination guidelines for infants at risk for HIV infection

Following a review of relevant data, the Global Advisory Committee on Vaccine Safety (GACVS) has revised its previous recommendations concerning bacille Calmette1 Guerin (BCG) vaccination of children infected with the human immunodeficiency virus (HIV).
WHO had previously recommended that in countries with a high burden of tuberculosis (TB), a single dose of BCG vaccine should be given to all healthy infants as soon as possible after birth, unless the child presented with symptomatic HIV infection. However, recent evidence shows that children who were HIV-infected when vaccinated with BCG at birth, and who later developed AIDS, were at increased risk of developing disseminated BCG disease. Among these children, the benefits of potentially preventing severe TB are outweighed by the risks associated with the use of BCG vaccine. GACVS therefore advised WHO to change its recommendation such that children who are known to be HIV-infected, even if asymptomatic, should no longer be immunized with BCG vaccine.