• Journal of agricultural medicine and community health
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• v.20 no.1
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• pp.31-38
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• 1995

This study was designed to investigate the effectiveness of BCG vaccination. Examination of BCG scar was done among 2,065 first year pupils and tuberculin test with 5 T.U. PPD was performed among 2,730 sixth year pupils in a primary school in Kyongju City, from March to May 1994. The results were; 1. The positive rate of BCG scar was 88.6%, and the BCG vaccination rate was 98.3% among first year pupils. 2. On tuberculin test, 56.3% was negative, 20.4% was intermediate, and 23.3% was positive among sixth year pupils. 3. The BCG vaccination rate among negative and intermediate tuberculin test pupils was 99.6%. 4. The side effects of tuberculin test were reported on 0.4%, consist of blebs and local necrosis.

• Journal of Preventive Medicine and Public Health
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• v.16 no.1
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• pp.5-11
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• 1983

The BCG vaccination has been employed as the main control measure for pulmonary tuberculosis in Korea since 1952. However, the protective efficacy of BCG against tuberculosis has been controversial worldwide. This study was conducted to evaluate the protective efficacy of BCG against pulmonary tuberculosis by a case-cotrol study. The study subjects included all the pulmonary tuberculous patients under 20 years of age who were registered in six health centers in Taegu City between May 1 and September 30, 1982. The controls were randomly selected among non-tuberculous out-patients matched by the age, sex and residence of the cases. The history of BCG vaccination was confirmed by the scar of 400 cases and 659 controls. The relative risk of the BCG recipients for pulmonary tuberculosis were 0.5 and the protective efficacy of the BCG was. 51.5%. It appears that the BCG vaccination is an efficient preventive measure in Korea where tuberculosis is prevalent. Thus the routine BCG vaccination should be continued.

• Pediatric Infection and Vaccine
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• v.18 no.1
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• pp.91-96
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• 2011

Bacille Calmette-Gu$\acute{e}$rin (BCG) vaccine is a live attenuated vaccine derived from Mycobacterium bovis. Frequent complications after BCG vaccination are localized ulcer formation and regional lymphadenitis, but there could be rarely severe systemic reactions to BCG vaccine such as osteomyelitis and disseminated BCG infection. Although disseminated BCG infection can be complicated in infants with underlying immunodeficiency after BCG vaccination, it is very unlikely to develop in immunocompetent infants or children. We report a 13-month-old infant who presented with fever, skin nodules, and multiple enlarged lymph nodes 5 months following BCG vaccination. She was diagnosed with disseminated BCG infection by PCRconfirmed M. bovis BCG infection at ${\geq}$2 anatomical sites beyond the region of vaccination. The patient showed no obvious evidence of immunodeficiency as judged on the basis of previous disease history, plasma immunoglobulin levels, B and T lymphocytes counts in peripheral blood, DHR (dihydrorhodamine 123 fluorescence) test and HIV test. She started antituberculous treatment with isoniazid and rifampin, and now, apparently her symptoms have been improved.

• Pediatric Infection and Vaccine
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• v.6 no.1
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• pp.101-106
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• 1999

Purpose : Tuberculosis, a major public health problem, is an important cause of childhood infectious diseases. To decrease the tuberculosis morbidity rate, BCG vaccination and chemoprophylaxis are performed. Recently 2TU PPD skin test was introduced as a diagnostic method for tuberculous infection. We studied the positive conversion rate of 2TU PPD test after percutaneous multiple puncture BCG vaccination. Methods : Four hundred seventy six infants from well baby clinic of Samsung Cheil Hospital were enrolled. They were immunized with percutaneous multiple puncture technique BCG(Japan BCG laboratory, Japan) at 1 month of age. Approximately 6 months later, tuberculin skin test using RT23 2TU PPD was performed. Induration size, family history of tuberculosis and number of BCG scars were evaluated. Induration greater than or equal to 5mm was defined as positive conversion. Results : Among 476 infants, 248(52.1%) were male and 228(47.9%) were female. PPD skin tests were performed $6.2{\pm}0.5$($mean{\pm}S.D.$) months after BCG vaccination. Mean induration size was $7.3{\pm}3.2mm$ and positive conversion rate was 85.5%. Total number of BCG scars was $15.5{\pm}3.2$. Conclusion : The seroconversion rate by 2TU PPD test after percutaneous multiple puncture BCG vaccination was high. But, more comparative studies with various age groups may be needed for 2TU PPD test used as diagnostic method of tuberculosis in the hospitals.

• Advances in pediatric surgery
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• v.3 no.1
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• pp.1-5
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• 1997

Regional lymphadenitis is the most common complication following BCG vaccination in this country. The literature describes controversial results with medical, surgical and combined therpy. The purpose of this study is to clarify the therapeutic effect of isoniazid(INH) after surgical procedures. The early and late postoperative complications of 136 children with lymphadenitis following BCG vaccination at the Taegu Fatima Hospital between March 1985 and February 1996 were reviewed. In 90 children, INH was given for 3-4 days before operation and for 3 months after surgery. In the other 46 cases, INH was not given during the pre- or postoperative period. Surgical procedures were excision or incision and currettage according to the states of lesions. Postoperative complications were fluid accumulation, wound infection, sinus formation and others. Complication rates were 14.4 % in INH-treated group and 13.0% of INH-nontreated group. The difference was not significant. There was no recurrence or other late complication in either groups. The result suggest that surgical excision or incision and currettage are sufficient for the treatment of regional lymphadenitis following BCG vaccination and postoperative INH therapy is not necessary.

• Tuberculosis and Respiratory Diseases
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• v.84 no.1
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• pp.13-21
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• 2021

Several clinical trials are being conducted worldwide to investigate the protective effect of the bacillus Calmette-Guérin (BCG) vaccine against death in healthcare providers who are working directly with coronavirus disease 2019 (COVID-19) patients. Clinical studies suggested that certain live vaccines, particularly the BCG vaccine, could reduce the mortality due to other diseases caused by non-targeted pathogens, most probably through the nonspecific effects (heterologous effects). By the end of May 2020, the available information on the COVID-19 pandemic indicated the great effect of the BCG vaccine in reducing the number of COVID-19 death cases. The occurrence of death due to COVID-19 was found to be 21-fold lower in countries with a national BCG vaccination policy than in countries without such a policy, based on the medians of COVID-19 death case per 1 million of the population in these two groups of countries (p<0.001, Mann-Whitney test). Therefore, it can be concluded that the early establishment of a BCG vaccination policy in any country is a key element in reducing the number of COVID-19 and tuberculosis death cases.

• Clinical and Experimental Pediatrics
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• v.49 no.1
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• pp.46-50
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• 2006

Purpose : Intradermal BCG vaccine has not well been accepted by pediatric practitioners due to BCG lymphadenitis. Therefore, this study was undertaken to find out the incidence of lymphadenitis following intradermal BCG vaccination and its clinical outcome. Methods : One thousand and fifty infants, who received intradermal BCG(French 1173 P2, Korea Tuberculosis Association) vaccination in the Well Baby Clinic of Hanyang University Hospital from July 2001 to January 2004, were included in the study. Severe local reactions at the injection site and any mass noted on surrounding areas were reported to, and evaluated by, pediatricians. Surgical procedures, either surgical resection or needle aspiration, were recommended when lymph nodes progressed to suppurate without regression. Results : Twenty infants(1.9 percent) developed lymphadenitis 2 to 8 months following vaccination. The incidence of BCG lymphadenitis was significantly higher in infants born with intrauterine period of <38 weeks and birth weight of <2,700 g. The lymph nodes became suppurative in 7/17 infants (41.2 percent) and four infants required surgical procedures with which the rate for the requirement of surgical procedures among intradermal BCG vaccinnes approximated to be 0.45 percent. There was no correlation between the size of lymph nodes and suppuration, however surgical procedures were required significantly more often for lymph nodes of greater than 3 cm in diameter. Conclusion : The incidence of BCG lymphadenitis following intradermal BCG(French 1173 P2, Korea Tuberculosis Association) vaccinations would be more than 1.9 percent, when considering cases of lymphadenits not reported. More efforts need to be paid to decrease the incidence of BCG lymphadenitis in order to promote intradermal BCG vaccination in Korea.

• Pediatric Infection and Vaccine
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• v.21 no.2
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• pp.139-143
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• 2014

Bacille Calmette-$Gu\acute{e}rin$ (BCG) lymphadenitis is the most common complication of BCG vaccination. It commonly occurs in infants aged <6 months involving ipsilateral axillary lymph nodes. We described BCG lymphadenitis in a 22-month-old boy presenting swelling of left supraclavicular lymph node that was confirmed by real-time polymerase chain reaction (PCR) and the multiplex PCR targeting the region of difference (RD).

• Tuberculosis and Respiratory Diseases
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• v.72 no.4
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• pp.374-380
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• 2012

Background: Delivery of Bacille Calmette-Gur$\acute{e}$in (BCG) Tokyo vaccine, with the multipuncture device, has been much preferred over BCG Pasteur, with the intradermal method, possibly due to the easier manner of administration, a desire to avoid any trouble with scars, as well as side effects and higher profits to providers in South Korea. Methods: To determine BCG scar status in 0~6 year old children vaccinated with two BCG vaccines (Pasteur BCG vaccine with intradermal method and BCG Tokyo vaccine with percutaneous method), the data from the national BCG scar survey in 2006 was analyzed. Results: Based on the national survey, the high proportion that were vaccinated with BCG Tokyo vaccines with the multipuncture method (64.5%) was noted in 0~6 year old Korean children. From inspection of scar formation, as an indicator of vaccination, the median number of the visible pin scars from the percutaneous method was 16 (interquartile range, 12~18) in the Korean children, and pin scars decreased as the age of the children increased (p<0.001). Conclusion: The findings in this survey clearly showed a growing preference of parents for the BCG Tokyo vaccines by the multipuncture method in South Korea.

• Tuberculosis and Respiratory Diseases
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• v.38 no.1
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• pp.34-44
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• 1991

Restoration of skin reactivity to 1 TU of tuberculin (RT23) by repeated tests at 10 days interval has been investigated in the BCG vaccinated or unvaccinated primary school children. The results obtained are as follows. 1) Tuberculin reactors showing 6 mm or larger induration to the first tests were 20.0% in the first grade school children and 33.3% in the sixth grade children. Six millimeter or larger reaction than that of the first reaction was found in 14.9% of the first grade children and in 34.6% of the sixth grade children. 2) Six millimeter or larger reactors were 10.8% of the first grade children without BCG scar against both first and second tests and 11.8% of the sixth grade children on first tests and 10.6% on second tests. There was none or very few, if any, in number of 6 mm or larger difference between the first and second tests among children without BCG scar. In addition, there was no children shown 6 mm or larger second reaction than that of the first reaction and thus those reactors seemed to be natural infection. 3) From questionaire survey, parents of 73.3% of the first grade children and of 72.7% of the sixth grade children were aware of BCG vaccination of their children, while parents of 15.1% and 24.6% of the first and sixth grade children did not know their children's vaccination history even if children possessed BCG scar. 4) Of the first grade children whose parents remembered their BCG vaccination, 65.6% were vaccinated within 4 weeks after birth and 25.5% between 4 weeks and one year. Six millimeter or larger reaction on the first tests was observed in 20.2% of the former group and 15.9% of the latter group, however reactors on the second tests were 32.1% and 31.9% respectively. BCG scar was not observed in 13.9% of children. 5) The majority of children (87.3%) were vaccinated in the skin of deltoid area and some (7.7%) at buttock or other areas. Children received first vaccination at the health centers were 68.5% and 30.3% at hospitals. More than 5 mm reaction was found in 18.7% of the former children and in 15.0% of the latter children. From this study restoration of tuberculin reactivity by repeated tests was found very common among the vaccinated children and thus it should be taken into account for the vaccination policy if it is performed after tuberculin testing.