Among BCG vaccinated children having a scar was associated with reduced mortality

In rural Guinea-Bissau we found that only 52% of 15,911 BCG-vaccinated children had developed a vaccination scar. In the scar positive group mortality was 52% (10-74%) lower than in the scar negative group during the first year of life and 26% (4-44%) lower during the first 5 years of life. 

Under optimal conditions more than 95% of BCG vaccinated children develop a scar. Thus, much could be gained by attaining the highest possible scar prevalence among all vaccinated children. The first step would be to identify factors associated with scar development. At present the BCG vaccination programme performance is assessed by BCG coverage at 12 month of age. Our results suggest that it would be relevant to use BCG scar prevalence as programme performance indicator.

For more information read the paper by  Storgaard et al: Development of BCG scar and subsequent morbidity and mortality in rural Guinea-Bissau, Clinical Infectious Diseases, advance access (doi:10.1093/cid/civ452)