ArticleEBioMedicine2017
Co-administration of BCG and Diphtheria-tetanus-pertussis (DTP) Vaccinations May Reduce Infant Mortality More Than the WHO-schedule of BCG First and Then DTP. A Re-analysis of Demographic Surveillance Data From Rural Bangladesh.
Article in EBioMedicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07005726 (BCG2-DTP3), which is not on this map. Cited by 19 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
BCG2-DTP3: Providing BCG Revaccination With the Third Dose of Diphtheria-tetanus-pertussis Vaccine to Improve Female Survival in Africa
Who cites it
19 citing papers in PubMed, 46 citations in OpenAlex.
- Non-specific effects of BCG and DTP vaccination on infant mortality: An analysis of birth cohorts in Ghana and Tanzania.Vaccine · 2022Trial
- Clinical characteristics and risk factors of severe bocavirus-positive pneumonia in children and a literature review.Pediatric discovery · 2025Article
- Biometric Strategies to Improve Vaccine Immunogenicity and Effectiveness.Biomimetics (Basel, Switzerland) · 2025Review
- Non-specific protection against severe COVID-19 associated to typhoid fever and DTP vaccination.Heliyon · 2024Article
- Specific and Nonspecific Effects of Influenza Vaccines.Vaccines · 2024Review
- Bordetella pertussis whole cell immunization protects against Pseudomonas aeruginosa infections.NPJ vaccines · 2022Article
- Stopping Oral Polio Vaccine (OPV) After Defeating Poliomyelitis in Low- and Middle-Income Countries: Harmful Unintended Consequences? Review of the Nonspecific Effects of OPV.Open forum infectious diseases · 2022Article
- BCG-induced trained immunity enhances acellular pertussis vaccination responses in an explorative randomized clinical trial.NPJ vaccines · 2022Article
- Observational
- 100 years of Mycobacterium bovis bacille Calmette-Guérin.The Lancet. Infectious diseases · 2022Review
- Parental Bacillus Calmette-Guérin vaccine scars decrease infant mortality in the first six weeks of life: A retrospective cohort study.EClinicalMedicine · 2021Article
- BCG vaccination improves DTaP immune responses in mice and is associated with lower pertussis incidence in ecological epidemiological studies.EBioMedicine · 2021Article
- Penta is associated with an increased female-male mortality ratio: cohort study from Bangladesh.Human vaccines & immunotherapeutics · 2021Article
- Do inequalities exist in the disadvantaged populations? Levels and trends of full and on-time vaccination coverage in two Nairobi urban informal settlements.Global epidemiology · 2020Article
- BCG skin reactions by 2 months of age are associated with better survival in infancy: a prospective observational study from Guinea-Bissau.BMJ global health · 2020Observational
- Potential effect of age of BCG vaccination on global paediatric tuberculosis mortality: a modelling study.The Lancet. Global health · 2019Article
- TLR agonist combinations that stimulate Th type I polarizing responses from human neonates.Innate immunity · 2018Article
- Evidence of Increase in Mortality After the Introduction of Diphtheria-Tetanus-Pertussis Vaccine to Children Aged 6-35 Months in Guinea-Bissau: A Time for Reflection?Frontiers in public health · 2018Article
- The Yin and Yang of the Non-Specific Effects of Vaccines.EBioMedicine · 2017Article
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Authors and funding
4 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWHO recommends BCG at birth and diphtheria-tetanus-pertussis (DTP)-containing vaccine at 6, 10 and 14weeks of age. However, BCG and DTP are often co-administered in low-income countries. The health implications have not been examined.
settingWe reanalysed data from Matlab, Bangladesh, to examine the influence of co-administration on mortality; 37,894 children born 1986-1999 were followed with registration of vaccinations and survival.
methodsUsing Cox models, survival was analysed from 6weeks to 9months of age when measles vaccine is given; 712 children died in this age group. We calculated mortality rate ratios (MRR) for children starting the vaccination schedule with BCG-first, BCG+DTP1-first or DTP1-first.
resultsOnly 17% followed the WHO-schedule with BCG-first. Mortality was 16/1000 person-years for children who initiated the vaccination schedule with BCG+DTP1 but 32/1000 and 20/1000 for children who received BCG-first or DTP-first, respectively. Compared with BCG+DTP1-first and adjusting for background factors, the BCG-first-schedule was associated with 2-fold higher mortality (MRR=1.94 (1.42-2.63)). DTP1 administered after BCG-first was associated with higher mortality than receiving DTP1 with BCG (MRR=1.78 (1.03-3.03)).
conclusionsCo-administration of BCG and DTP may further reduce mortality. Since all observational studies support this trend, co-administration of BCG and DTP should be tested in randomised trials.
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