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Bacille Calmette-Guérin Vaccination and Incidence of IDDM in Montreal, Canada

  1. Eleanor Colle, MD
  1. Epidemiology and Biostatistics Unit, Monash University Melbourne, Australia
  2. Institut Armand-Frappier, Université du Québec, Laval, Department of Epidemiology and Biostatistics, Monash University Melbourne, Australia
  3. the Montreal Chest Hospital, Monash University Melbourne, Australia
  4. McGill University, Montreal Children's Hospital, Monash University Melbourne, Australia
  5. McGill University Research Institute Montreal, Quebec, Canada Department of Epidemiology and Preventive Medicine, Monash University Melbourne, Australia
  1. Address correspondence and reprint requests to Marie-Élise Parent, PhD, Epidemiology and Biostatistics Unit, Institut Armand-Frappier, 531 Boulevard des Prairies, C.P100, Laval, Quebec H7N 4Z3, Canada. E-mail: marie-elise_parent{at}iaf.uquebec.ca

Abstract

OBJECTIVE To describe the association between Bacille Calmette-Guérin (BCG) vaccination and IDDM development in two different case-control series (A and B) in Montreal.

RESEARCH DESIGN AND METHODS Case-control series A comprised 93 IDDM cases and 2,903 control subjects who participated in a community-based tuberculin reactivity survey and who belonged to the same birth cohorts and areas of residence as the IDDM cases, Case-control series B comprised 249 IDDM cases and 431 age- and sex-matched friends and neighborhood control subjects.

RESULTS In series A, the BCG vaccination prevalence among cases and control subjects was 21.5% (95% CI 13.2–29.8%) and 22.3% (95% CI 20.8–23.8%), respectively. The odds ratio (OR) for IDDM associated with BCG vaccination was 1.09 (95% CI 0.62–1.91), after adjusting for the birth cohorts and areas of residence. The vaccination prevalence in series B was 17.7% (95% CI 13.0–22.4%) among cases and 15.1% (95% CI 11.7–18.5%) among control subjects. The OR for IDDM due to BCG vaccination was 1.26 (95% CI 0.79–2.02), taking into account the matched sets. Only one case (3.3%) from series B who had been vaccinated at birth was diagnosed by age 5, compared with 52 cases (24.5%) who had not been vaccinated (P < 0.01).

CONCLUSIONS The lower proportion of birth-vaccinated IDDM cases diagnosed at a very young age, compared with nonvaccinated cases, possibly reflects a temporary boost of the immune functions after vaccination. However, as a whole, results from these analyses fail to support a protective role of BCG vaccination against juvenile-onset IDDM.

  • Received September 17, 1996.
  • Accepted December 10, 1996.
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