{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T08:13:33Z","timestamp":1791274413250,"version":"4.1.0"},"reference-count":41,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2013,8,31]],"date-time":"2013-08-31T00:00:00Z","timestamp":1377907200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Recent evidence suggests that immunogenic interventions such as vaccines and micronutrients may affect atopic sensitization and atopic disease. We aimed to determine whether neonatal <jats:styled-content style=\"fixed-case\">BCG<\/jats:styled-content> vaccination, vitamin A supplementation and other vaccinations affect atopy in childhood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In Guinea\u2013Bissau, low\u2010birthweight infants were randomized to early (intervention) or delayed (usual policy) <jats:styled-content style=\"fixed-case\">BCG<\/jats:styled-content>. A subgroup was also randomly assigned vitamin A supplementation or placebo in a two\u2010by\u2010two factorial design. Participants were followed up at age 3\u20139\u00a0years. The main outcome was atopy defined as skin prick test reaction \u22653\u00a0mm. Secondary outcomes were symptoms of eczema, asthma and food allergy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred eighty\u2010one children had valid skin prick tests performed, and 14% (39\/281) were atopic. There was no significant difference in atopy between the early and delayed <jats:styled-content style=\"fixed-case\">BCG<\/jats:styled-content> groups (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 0.71; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.34\u20131.47). Atopy was significantly reduced in children who had responded to <jats:styled-content style=\"fixed-case\">BCG<\/jats:styled-content> with a scar (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 0.42; 0.19\u20130.94). Vitamin A supplementation was associated with increased atopy (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 2.88; 1.26\u20136.58), especially in those who received simultaneous <jats:styled-content style=\"fixed-case\">BCG<\/jats:styled-content> (5.99; 1.99\u201318.1, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.09 for interaction between vitamin A supplementation and <jats:styled-content style=\"fixed-case\">BCG<\/jats:styled-content>). Early <jats:italic>vs<\/jats:italic> delayed <jats:styled-content style=\"fixed-case\">BCG<\/jats:styled-content> was not associated with symptoms of atopic disease, but vitamin A supplementation increased odds of wheeze within the past 12\u00a0months (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 2.45; 1.20\u20134.96).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There were no statistically significant effects of early <jats:italic>vs<\/jats:italic> delayed <jats:styled-content style=\"fixed-case\">BCG<\/jats:styled-content> on atopy or symptoms of atopic disease. Having a <jats:styled-content style=\"fixed-case\">BCG<\/jats:styled-content> scar was associated with reduced atopy, whereas neonatal vitamin A supplementation was associated with increased atopy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Registration<\/jats:title><jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"Clinicaltrials.gov\">Clinicaltrials.gov<\/jats:ext-link> NCT 01420705.<\/jats:p><\/jats:sec>","DOI":"10.1111\/all.12216","type":"journal-article","created":{"date-parts":[[2013,8,31]],"date-time":"2013-08-31T07:13:11Z","timestamp":1377933191000},"page":"1168-1176","source":"Crossref","is-referenced-by-count":39,"title":["Vitamin <scp>A<\/scp> supplementation and <scp>BCG<\/scp> vaccination at birth may affect atopy in childhood: long\u2010term follow\u2010up of a randomized controlled trial"],"prefix":"10.1111","volume":"68","author":[{"given":"N.","family":"Kiraly","sequence":"first","affiliation":[{"name":"Bandim Health Project Indepth Network Bissau Guinea\u2013Bissau Australia"},{"name":"Murdoch Childrens Research Institute Parkville VIC Australia"},{"name":"Deakin University School of Medicine Geelong VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. S.","family":"Benn","sequence":"additional","affiliation":[{"name":"Bandim Health Project Indepth Network Bissau Guinea\u2013Bissau Australia"},{"name":"Research Center for Vitamins and Vaccines (CVIVA) Bandim Health Project Statens Serum Institute Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Biering\u2010S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Bandim Health Project Indepth Network Bissau Guinea\u2013Bissau Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Bandim Health Project Indepth Network Bissau Guinea\u2013Bissau Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. J.","family":"Jensen","sequence":"additional","affiliation":[{"name":"Bandim Health Project Indepth Network Bissau Guinea\u2013Bissau Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Ravn","sequence":"additional","affiliation":[{"name":"Research Center for Vitamins and Vaccines (CVIVA) Bandim Health Project Statens Serum Institute Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. J.","family":"Allen","sequence":"additional","affiliation":[{"name":"Murdoch Childrens Research Institute Parkville VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Aaby","sequence":"additional","affiliation":[{"name":"Bandim Health Project Indepth Network Bissau Guinea\u2013Bissau Australia"},{"name":"Research Center for Vitamins and Vaccines (CVIVA) Bandim Health Project Statens Serum Institute Copenhagen 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