Bangladeshi neonates miss the potential benefits of early BCG vaccination
Future Health Systems
Abstract
Bangladesh is a high-TB-burden country. It is recommended, for TB-endemic areas, that BCG be given to neonates at the first possible opportunity of their life. Several observational studies and lately a few randomized trials show that BCG offers ‘heterologous protective effects’ beyond its target disease tuberculosis. A recent review by WHO’s Strategic Advisory Group of Experts on Immunization (SAGE) on non-specific effects of BCG vaccine shows that vaccination at birth reduces neonatal mortality by 48% (18–67%), which is mainly due to the prevention of neonatal sepsis and respiratory infections. In Bangladesh, neonatal mortality is high (28 per 1000 live births) (and accounts for about two-thirds of all under-five deaths), mainly due to infections, birth asphyxia, respiratory infection and prematurity.