March 2, 1994JAMA
Efficacy of BCG Vaccine in the Prevention of Tuberculosis
Authors
Discussion
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Implication
Meta-analysis demonstrates a 50% reduction in tuberculosis risk in vaccinated populations, indicating substantial protective benefits against severe disease and death.
Key Points
- To quantify the overall protective efficacy of the BCG vaccine against tuberculosis cases, meningitis, and related mortality.
- Systematic review and meta-analysis evaluating 14 prospective trials and 12 case-control studies selected from 1,264 screened publications.
- Applied random-effects models to derive weighted relative risk (RR) and odds ratio (OR) estimates, defining protective efficacy as 1 - RR or 1 - OR.
- BCG vaccination conferred a 51% protective effect against tuberculosis in prospective trials (RR, 0.49; 95% CI, 0.34 to 0.70) and a 50% protective effect in case-control studies (OR, 0.50; 95% CI, 0.39 to 0.64).
- Protection was substantially higher against tuberculous death across seven trials (RR, 0.29; 95% CI, 0.16 to 0.53; 71% efficacy) and against tuberculous meningitis across five studies (OR, 0.36; 95% CI, 0.18 to 0.70; 64% efficacy).
- Geographic latitude of study sites and study validity scores accounted for 66% of the heterogeneity observed across trials in random-effects meta-regression.
Cite This Study
Graham A. Colditz (1994) studied this question.