BCG vaccination in early childhood and risk of atopic disease: a systematic review and meta-analysis

Keyu Zhao, Phoebe Miles, Xinyu Jiang, Qiongyan Zhou, Chao Cao, Wei Lin, Richard Hubbard, Panfeng Fu, Suling Xu, Isabella Annesi Maesano (Editor)

Research output: Journal PublicationArticlepeer-review

2 Citations (Scopus)


Background. Several large-scale studies suggest that Bacille Calmette-Guerin (BCG) vaccination in early childhood may reduce the risk of atopic diseases, but the findings remain controversial. Here, we aimed to investigate the potential correlation between early childhood BCG vaccination and the risk of developing atopic diseases. Methods. Eligible studies published on PubMed, EMBASE, and Cochrane CENTRAL were systematically sourced from 1950 to July 2021. Studies with over 100 participants and focusing on the association between BCG vaccine and atopic diseases including eczema, asthma, and rhinitis were included. Preliminary assessment of methods, interventions, outcomes, and study quality was performed by two independent investigators. Odds ratio (OR) with 95% confidence interval (CI) was calculated. Random effects of the meta-Analysis were performed to define pooled estimates of the effects. Results. Twenty studies with a total of 222,928 participants were selected. The quantitative analysis revealed that administering BCG vaccine in early childhood reduced the risk of developing asthma significantly (OR 0.77, 95% CI 0.63 to 0.93), indicating a protective efficacy of 23% against asthma development among vaccinated children. However, early administration of BCG vaccine did not significantly reduce the risk of developing eczema (OR 0.94, 95% CI 0.76 to 1.16) and rhinitis (OR 0.99, 95% CI 0.81 to 1.21). Further analysis revealed that the effect of BCG vaccination on asthma prevalence was significant especially in developed countries (OR 0.73, 95% CI 0.58 to 0.92). Conclusion. BCG vaccination in early childhood is associated with reduced risk of atopic disease, especially in developed countries.

Original languageEnglish
Article number5434315
Pages (from-to)1-12
JournalCanadian Respiratory Journal
Publication statusPublished - 24 Nov 2021
Externally publishedYes

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine


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