{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T14:07:53Z","timestamp":1789049273390,"version":"build-2803163510"},"reference-count":31,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2020,12,1]],"date-time":"2020-12-01T00:00:00Z","timestamp":1606780800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical\n                                    Research Council","doi-asserted-by":"publisher","award":["MR\/R02118X\/1"],"award-info":[{"award-number":["MR\/R02118X\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome","doi-asserted-by":"publisher","award":["107743"],"award-info":[{"award-number":["107743"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec>\n                        <jats:title>Introduction<\/jats:title>\n                        <jats:p>There is evidence that BCG immunisation may protect against\n                            unrelated infectious illnesses. This has led to the postulation that\n                            administering BCG before unrelated vaccines may enhance responses to\n                            these vaccines. This might also model effects of BCG on unrelated\n                            infections.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                        <jats:title>Methods and analysis<\/jats:title>\n                        <jats:p>To test this hypothesis, we have designed a randomised controlled\n                            trial of BCG versus no BCG immunisation to determine the effect of BCG\n                            on subsequent unrelated vaccines, among 300 adolescents (aged 13\u201317\n                            years) from a Ugandan birth cohort. Our schedule will comprise three\n                            main immunisation days (week 0, week 4 and week 28): BCG (or no BCG)\n                            revaccination at week 0; yellow fever (YF-17D), oral typhoid (Ty21a) and\n                            human papillomavirus (HPV) prime at week 4; and HPV boost and\n                            tetanus\/diphtheria (Td) boost at week 28. Primary outcomes are\n                            anti-YF-17D neutralising antibody titres,<jats:italic>Salmonella\n                                typhi<\/jats:italic>lipopolysaccharide-specific IgG concentration,\n                            IgG specific for L1-proteins of HPV-16\/HPV-18 and tetanus and diphtheria\n                            toxoid-specific IgG concentration, all assessed at 4 weeks after\n                            immunisation with YF, Ty21a, HPV and Td, respectively. Secondary\n                            analyses will determine effects on correlates of protective immunity\n                            (where recognised correlates exist), on vaccine response waning and on\n                            whether there are differential effects on priming versus boosting\n                            immunisations. We will also conduct exploratory immunology assays among\n                            subsets of participants to further characterise effects of BCG\n                            revaccination on vaccine responses. Further analyses will assess which\n                            life course exposures influence vaccine responses in\n                            adolescence.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                        <jats:title>Ethics and dissemination<\/jats:title>\n                        <jats:p>Ethics approval has been obtained from relevant Ugandan and UK\n                            ethics committees. Results will be shared with Uganda Ministry of\n                            Health, relevant district councils, community leaders and study\n                            participants. Further dissemination will be done through conference\n                            proceedings and publications.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                        <jats:title>Trial registration number<\/jats:title>\n                        <jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" specific-use=\"clinicaltrial pre-results\" xlink:href=\"NCT10482904\">NCT10482904<\/jats:ext-link>.<\/jats:p>\n                    <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-040430","type":"journal-article","created":{"date-parts":[[2022,11,4]],"date-time":"2022-11-04T14:46:11Z","timestamp":1667573171000},"page":"e040430","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Impact of BCG revaccination on the response to unrelated vaccines in a\n                        Ugandan adolescent birth cohort: randomised controlled trial protocol C for\n                        the \u2018POPulation differences in VACcine responses\u2019 (POPVAC) programme"],"prefix":"10.1136","volume":"11","clinical-trial-number":[{"clinical-trial-number":"nct10482904","registry":"10.18810\/clinical-trials-gov","type":"preResults"}],"author":[{"given":"Ludoviko","family":"Zirimenya","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4062-9105","authenticated-orcid":false,"given":"Gyaviira","family":"Nkurunungi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacent","family":"Nassuuna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnes","family":"Natukunda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Mutebe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Oduru","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Kabami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hellen","family":"Akurut","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Onen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milly","family":"Namutebi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel","family":"Serubanja","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Nakazibwe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence","family":"Akello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josephine","family":"Tumusiime","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moses","family":"Sewankambo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Kiwanuka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fred","family":"Kiwudhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Kizindo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moses","family":"Kizza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Wajja","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Cose","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moses","family":"Muwanga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Webb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison 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