Skip to main content
PMC home page
Bulletin of the World Health Organization logoLink to Bulletin of the World Health Organization
. 1966;35(4):459–478.

Relation between pre-vaccination and post-vaccination tuberculin sensitivity

A contribution to the ecology of BCG vaccination

Gerard Wijsmuller
PMCID: PMC2476037  PMID: 5297549

Abstract

BCG vaccination is commonly assessed in terms of post-vaccination sensitivity to tuberculin. If vaccination is followed by the development of a high degree of tuberculin sensitivity, it is assumed that the vaccination was successful. If, on the other hand, tuberculin sensitivity does not develop, it is assumed that the vaccination was unsuccessful. Both these assumptions equate post-vaccination tuberculin sensitivity with BCG-induced tuberculin sensitivity and disregard the possibility that environmental factors, such as the prevalence of low-grade naturally acquired tuberculin sensitivity, may affect the outcome of vaccination. Thus, while it seems reasonable to equate post-vaccination and BCG-induced tuberculin sensitivity in areas where low-grade sensitivity is uncommon, it might be unjustifiable to do so in areas where such sensitivity is prevalent.

This paper analyses the relation between pre- and post-vaccination tuberculin sensitivity in a community with a high prevalence of naturally acquired low-grade tuberculin sensitivity. From this analysis it appears that post-vaccination tuberculin sensitivity may be only partly BCG-induced and cannot therefore be considered a reliable measure of the success of BCG vaccination in the presence of naturally acquired low-grade sensitivity. The author discusses the implications of this finding and concludes that a further evaluation of the protection afforded by BCG in areas where low-grade tuberculin sensitivity is prevalent is much needed.

Full text

PDF
459

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. GULD J., BENTZON M. W., BLEIKER M. A., GRIEP W. A., MAGNUSSON M., WAALER H. Standardization of a new batch of purified tuberculin (PPD) intended for international use. Bull World Health Organ. 1958;19(5):845–951. [PMC free article] [PubMed] [Google Scholar]
  2. GULD J., MAGNUS K., MAGNUSSON M. Instability of the potency of tuberculin dilutions. Am Rev Tuberc. 1955 Jul;72(1):126–128. doi: 10.1164/artpd.1955.72.1.126. [DOI] [PubMed] [Google Scholar]
  3. GULD J. Quantitative aspects of the intradermal tuberculin test in humans. I. The dose-response function within the range 1-10 tuberculin units, determined by duplicate tests. Acta Tuberc Scand. 1953;28(3-4):222–245. [PubMed] [Google Scholar]
  4. GULD J. Quantitative aspects of the intradermal tuberculin test in humans. II. The relative importance of accurate injection technique. Acta Tuberc Scand. 1954;30(1-2):16–36. [PubMed] [Google Scholar]
  5. GULD J., RUD C. Measurement of leakage of tuberculin syringes. Br Med J. 1953 Feb 14;1(4806):368–370. doi: 10.1136/bmj.1.4806.368. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. MAGNUS K., EDWARDS L. B. The effect of repeated tuberculin testing on post-vaccination allergy; a preliminary note. Lancet. 1955 Sep 24;269(6891):643–644. doi: 10.1016/s0140-6736(55)92482-x. [DOI] [PubMed] [Google Scholar]
  7. MAGNUS K. Effect of intradermal tuberculin tests on BCG-induced allergy. Bull World Health Organ. 1957;17(2):249–254. [PMC free article] [PubMed] [Google Scholar]
  8. MAGNUS K., GULD J., WAALER H., MAGNUSSON M. Instability of the potency of tuberculin dilutions; a second report. Am Rev Tuberc. 1956 Aug;74(2 Pt 1):297–303. doi: 10.1164/artpd.1956.74.2-1.297. [DOI] [PubMed] [Google Scholar]
  9. PALMER C. E., SHAW L. W., COMSTOCK G. W. Community trials of BCG vaccination. Am Rev Tuberc. 1958 Jun;77(6):877–907. doi: 10.1164/artpd.1958.77.6.877. [DOI] [PubMed] [Google Scholar]
  10. VOORS A. W., METSELAAR D. The reliability of dental age as a yard-stick to assess the unknown calendar age. Trop Geogr Med. 1958 Jun;10(2):175–180. [PubMed] [Google Scholar]
  11. WIJSMULLER G. Naturally acquired tuberculin sensitivity in Netherlands New Guinea. Bull World Health Organ. 1959;20:641–665. [PMC free article] [PubMed] [Google Scholar]
  12. WIJSMULLER G., SCHNEIDER J. H. Comparative study of liquid and freeze-dried glutamate BCG. Results of a field trial in West Papua (Netherlands New Guinea). Am Rev Respir Dis. 1962 Aug;86:216–227. doi: 10.1164/arrd.1962.86.2.216. [DOI] [PubMed] [Google Scholar]
  13. WIJSMULLER G. Some implications of the addition of Tween 80 to dilutions of PPD tuberculin with respect to the study of "specific" and "nonspecific" tuberculin sensitivity. Am Rev Respir Dis. 1961 Jun;83:815–825. doi: 10.1164/arrd.1961.83.6.815. [DOI] [PubMed] [Google Scholar]

Articles from Bulletin of the World Health Organization are provided here courtesy of World Health Organization

RESOURCES