Dr Ludoviko Zirimenya
MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
A randomised clinical trial investigating the effect of BCG revaccination on the response to unrelated vaccines in Ugandan adolescents
Introduction: There is evidence to suggest that BCG vaccination has (beneficial) non-specific effects beyond its protection against tuberculosis disease. These effects may also influence responses to unrelated vaccines but this has so-far been investigated only in high-income settings. We investigated the effect of BCG revaccination on responses to live and inert, parenteral and oral, vaccines in Ugandan adolescents.
Methods and analysis: We undertook a clinical trial in adolescents aged 13 to 17 years who had received BCG (of known vaccine strain) at birth. Participants were randomised in a 1:1 ratio to receive, or not to receive, BCG revaccination (BCG-Russia) at trial baseline (week 0). Participants then received yellow fever (YF), oral typhoid (Ty21a) and human papillomavirus (HPV) prime at week 4; and HPV boost and tetanus/diphtheria (Td) boost at week 28. The primary outcomes were vaccine specific antibody responses (IgG) assessed 4 weeks post vaccination (YF, Ty21a, HPV) and at week 52 for Td specific responses.
Results: We enrolled 300 participants of which 151 were in the BCG revaccination arm and 149 in the no BCG revaccination arm. 178 (59%) of the participants were male. 291 participants (97%) reached the primary end point at week 8 and 283 (94%) were followed up to end of the study at week 52. Analyses for vaccine specific outcome measures are ongoing and will be available for the meeting.
Conclusion: Our data will contribute to the debate on whether BCG revaccination affects responses to unrelated vaccines, as well as contributing to understanding of the non-specific effects of BCG.
Dr Ludoviko Zirimenya is a Clinical Research Scientist in the Immunomodulation and Vaccines Programme at the MRC/UVRI & LSHTM Uganda Research Unit, a unit of the London School of Hygiene and Tropical Medicine, a leading research institution on public health. Ludoviko has a Master’s in Public Health and an MSc in Internal Medicine. His research interests are population differences in vaccine responses, non-specific (beneficial) effects of vaccines and clinical palliative care research. He is currently a PhD student at the London School of Hygiene and Tropical Hygiene in the faculty of Infectious and Tropical Diseases.