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Journal of Tropical Medicine
Volume 2011, Article ID 706304, 5 pages
http://dx.doi.org/10.1155/2011/706304
Review Article

Immunological Links to Nonspecific Effects of DTwP and BCG Vaccines on Infant Mortality

Laboratory for Experimental and Cellular Immunology, Department of International Health, Immunology and Microbiology, The Panum Institute, University of Copenhagen, Blegdamsvej 3, 2200 Copenhagen, Denmark

Received 18 November 2010; Accepted 4 March 2011

Academic Editor: Katie Flanagan

Copyright © 2011 Mogens Helweg Claesson. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A number of mainly observational studies suggest that many African females below the age of one year die each year from the nonspecific effects of vaccination with diphtheria-tetanus toxoids and killed (whole-cell) Bordetella pertussis (DTwP). In contrast, similar studies suggest that many African females and males may have their lives saved each year by the nonspecific immunological benefits of Bacillus Calmette-Guerin (BCG) vaccination. From an immunological point of view, we hypothesise that the adverse effects of DTwP vaccine may occur because of the Th2-polarising effect of the aluminium phosphate adjuvant in the vaccine and because intramuscular administration of the vaccine may cause chronic inflammation at the site of injection. However, the Th1-polarising effect of BCG is likely to be beneficial. Sexual dimorphism affecting immune functions and vitamin A supplementation may influence both the deleterious and beneficial nonspecific effects of immunisation.