{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T16:32:29Z","timestamp":1771259549784,"version":"3.50.1"},"reference-count":111,"publisher":"Duke University Press","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The Bacillus Calmette\u2013Gu\u00e9rin (BCG) vaccine for tuberculosis (TB) is widely used globally. Many high-income countries discontinued nationwide vaccination policies starting in the 1980s as the TB prevalence decreased. However, there is continued scientific interest in whether the general childhood immunity boost conferred by the BCG vaccination impacts adult health and mortality in low-TB contexts (known as nonspecific effects). While recent studies have found evidence of an association between BCG vaccination and survival to ages 34\u201345, it is unclear whether these associations are causal or driven by the unobserved characteristics of those who chose to voluntarily vaccinate. We use the abrupt discontinuation of mandatory BCG vaccination in Sweden in 1975 as a natural experiment to estimate the causal nonspecific effect of the BCG vaccine on cohort survival to midlife. Applying two complementary study designs, we find no evidence that survival to age 40 was affected by the discontinuation of childhood BCG vaccination. The results are consistent among both males and females and are robust to several sensitivity tests. Overall, despite prior correlational studies suggesting large nonspecific effects, we do not find any population-level evidence for a nonspecific effect of the BCG vaccine discontinuation on survival to age 40 in Sweden.<\/jats:p>","DOI":"10.1215\/00703370-10970757","type":"journal-article","created":{"date-parts":[[2023,9,21]],"date-time":"2023-09-21T13:39:53Z","timestamp":1695303593000},"page":"1607-1630","source":"Crossref","is-referenced-by-count":1,"title":["Does Early Childhood BCG Vaccination Improve Survival to Midlife in a Population With a Low Tuberculosis Prevalence? Quasi-experimental Evidence on Nonspecific Effects From 32 Swedish Birth Cohorts"],"prefix":"10.1215","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3413-232X","authenticated-orcid":true,"given":"Michaela","family":"Theilmann","sequence":"first","affiliation":[{"name":"Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany"},{"name":"Professorship of Behavioral Science for Disease Prevention and Health Care and Institute for Advanced Study, Technical University of Munich, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8878-5505","authenticated-orcid":true,"given":"Pascal","family":"Geldsetzer","sequence":"additional","affiliation":[{"name":"Division of Primary Care and Population Health, Stanford University, Stanford, CA, USA"},{"name":"Chan Zuckerberg Biohub San Francisco, San Francisco, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4182-4212","authenticated-orcid":true,"given":"Till","family":"B\u00e4rnighausen","sequence":"additional","affiliation":[{"name":"Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany"},{"name":"Harvard Center for Population and Development Studies, Cambridge, MA, USA"},{"name":"Africa Health Research Institute, KwaZulu-Natal, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1710-4634","authenticated-orcid":true,"given":"Nikkil","family":"Sudharsanan","sequence":"additional","affiliation":[{"name":"Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany"},{"name":"Professorship of Behavioral Science for Disease Prevention and Health Care and Institute for Advanced Study, Technical University of Munich, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"73","published-online":{"date-parts":[[2023,10,1]]},"reference":[{"issue":"37","key":"2023100213320926000_dem10970757C1","volume":"17","author":"Abubakar","year":"2013","journal-title":"Systematic review and meta-analysis of the current evidence on the duration of protection by bacillus Calmette-Gu\u00e9rin vaccination against tuberculosis"},{"key":"2023100213320926000_dem10970757C2","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s12979-018-0117-8","article-title":"Immune-inflammatory responses in the elderly: An update","volume":"15","author":"Accardi","year":"2018","journal-title":"Immunity & Ageing"},{"key":"2023100213320926000_dem10970757C3","volume-title":"Molecular biology of the cell","author":"Alberts","year":"2015","edition":"6th"},{"key":"2023100213320926000_dem10970757C4","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1257\/jel.20171164","article-title":"Childhood circumstances and adult outcomes: Act II","volume":"56","author":"Almond","year":"2018","journal-title":"Journal of Economic Literature"},{"key":"2023100213320926000_dem10970757C5","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1257\/000282805774669943","article-title":"The 1918 influenza pandemic and subsequent health outcomes: An analysis of SIPP data","volume":"95","author":"Almond","year":"2005","journal-title":"American Economic Review: Papers & Proceedings"},{"key":"2023100213320926000_dem10970757C6","doi-asserted-by":"crossref","DOI":"10.2307\/j.ctvcm4j72","volume-title":"Mostly harmless econometrics: An empiricist's companion","author":"Angrist","year":"2008"},{"key":"2023100213320926000_dem10970757C7","doi-asserted-by":"crossref","first-page":"105364","DOI":"10.1016\/j.jbspin.2022.105364","article-title":"Trained immunity and inflammation in rheumatic diseases","volume":"89","author":"Badii","year":"2022","journal-title":"Joint Bone Spine"},{"key":"2023100213320926000_dem10970757C8","article-title":"The history of tuberculosis: From the first historical records to the isolation of Koch's bacillus","volume":"58","author":"Barberis","year":"2017","journal-title":"Journal of Preventive Medicine and Hygiene"},{"key":"2023100213320926000_dem10970757C9","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1007\/s13524-018-0673-8","article-title":"Birth intervals and health in adulthood: A comparison of siblings using Swedish register data","volume":"55","author":"Barclay","year":"2018","journal-title":"Demography"},{"key":"2023100213320926000_dem10970757C10","volume-title":"Vaccinationsstatistik fr\u00e5n BVC: Rapporter ins\u00e4nda januari 2000 och januari 2001\u2009g\u00e4llande barn f\u00f6dda 1997 och 1998","author":"Bergstr\u00f6m","year":"2001"},{"key":"2023100213320926000_dem10970757C11","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1093\/infdis\/jix612","article-title":"Rapid protective effects of early BCG on neonatal mortality among low birth weight boys: Observations from randomized trials","volume":"217","author":"Biering-S\u00f8rensen","year":"2018","journal-title":"Journal of Infectious Diseases"},{"key":"2023100213320926000_dem10970757C12","doi-asserted-by":"crossref","first-page":"S120","DOI":"10.1016\/S0264-410X(99)00306-0","article-title":"Demographic impact of vaccination: A review","volume":"17","author":"Bonanni","year":"1999","journal-title":"Vaccine"},{"key":"2023100213320926000_dem10970757C13","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1111\/j.1651-2227.1982.tb09454.x","article-title":"Osteitis and other complications caused by generalized BCG-itis. Experiences in Sweden","volume":"71","author":"B\u00f6ttiger","year":"1982","journal-title":"Acta P\u00e6diatrica"},{"key":"2023100213320926000_dem10970757C14","doi-asserted-by":"crossref","first-page":"2204","DOI":"10.1016\/S0140-6736(04)17593-4","article-title":"Effect of infant immunisation on childhood mortality in rural Bangladesh: Analysis of health and demographic surveillance data","volume":"364","author":"Breiman","year":"2004","journal-title":"Lancet"},{"key":"2023100213320926000_dem10970757C15","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1007\/s13524-020-00868-6","article-title":"Double trouble: The burden of child-rearing and working on maternal mortality","volume":"57","author":"Bucher-Koenen","year":"2020","journal-title":"Demography"},{"key":"2023100213320926000_dem10970757C16","doi-asserted-by":"crossref","first-page":"S65","DOI":"10.1353\/dem.2010.0007","article-title":"Causes and consequences of early life health","volume":"47","author":"Case","year":"2010","journal-title":"Demography"},{"key":"2023100213320926000_dem10970757C17","doi-asserted-by":"crossref","DOI":"10.1017\/9781108684606","volume-title":"A practical introduction to regression discontinuity designs: Foundations","author":"Cattaneo","year":"2019"},{"key":"2023100213320926000_dem10970757C18","volume-title":"Trend of mortality and causes of death in Norway 1856\u20131955","author":"Central Bureau of Statistics Norway","year":"1961"},{"key":"2023100213320926000_dem10970757C19","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1093\/emph\/eoaa037","article-title":"Old friends meet a new foe: A potential role for immune-priming parasites in mitigating COVID-19 morbidity and mortality","volume":"2020","author":"Cepon-Robins","year":"2020","journal-title":"Evolution, Medicine, and Public Health"},{"key":"2023100213320926000_dem10970757C20","doi-asserted-by":"crossref","first-page":"9051","DOI":"10.1073\/pnas.1603224113","article-title":"Controlled fire use in early humans might have triggered the evolutionary emergence of tuberculosis","volume":"113","author":"Chisholm","year":"2016","journal-title":"Proceedings of the National Academy of Sciences"},{"key":"2023100213320926000_dem10970757C21","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1016\/j.chom.2020.05.014","article-title":"BCG vaccination in humans elicits trained immunity via the hematopoietic progenitor compartment","volume":"28","author":"Cirovic","year":"2020","journal-title":"Cell Host & Microbe"},{"key":"2023100213320926000_dem10970757C22","volume-title":"Causal inference: The mixtape","author":"Cunningham","year":"2021"},{"key":"2023100213320926000_dem10970757C23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1353\/dem.2005.0002","article-title":"The role of public health improvements in health advances: The twentieth-century United States","volume":"42","author":"Cutler","year":"2005","journal-title":"Demography"},{"key":"2023100213320926000_dem10970757C24","doi-asserted-by":"crossref","first-page":"1862","DOI":"10.1016\/j.rmed.2006.08.006","article-title":"The history of tuberculosis","volume":"100","author":"Daniel","year":"2006","journal-title":"Respiratory Medicine"},{"key":"2023100213320926000_dem10970757C25","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1183\/09031936.00113413","article-title":"Bacille Calmette-Gu\u00e9rin vaccination: The current situation in Europe","volume":"43","author":"Dara","year":"2014","journal-title":"European Respiratory Journal"},{"key":"2023100213320926000_dem10970757C26","doi-asserted-by":"crossref","first-page":"1611","DOI":"10.1093\/cid\/civ144","article-title":"Nonspecific (heterologous) protection of neonatal BCG vaccination against hospitalization due to respiratory infection and sepsis","volume":"60","author":"de Castro","year":"2015","journal-title":"Clinical Infectious Diseases"},{"key":"2023100213320926000_dem10970757C27","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2017.01134","article-title":"What have we learnt about BCG vaccination in the last 20 years?","volume":"8","author":"Dockrell","year":"2017","journal-title":"Frontiers in Immunology"},{"key":"2023100213320926000_dem10970757C28","doi-asserted-by":"crossref","first-page":"5945","DOI":"10.1016\/j.vaccine.2007.04.070","article-title":"Do we fully understand the economic value of vaccines?","volume":"25","author":"Drummond","year":"2007","journal-title":"Vaccine"},{"key":"2023100213320926000_dem10970757C29","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1111\/j.1365-3156.2005.01479.x","article-title":"Non-specific effects of vaccination on child survival? A prospective study in Senegal","volume":"10","author":"Elguero","year":"2005","journal-title":"Tropical Medicine & International Health"},{"key":"2023100213320926000_dem10970757C30","doi-asserted-by":"crossref","first-page":"186","DOI":"10.2307\/3644718","article-title":"Effects of early-life conditions on adult mortality: A review","volume":"58","author":"Elo","year":"1992","journal-title":"Population Index"},{"key":"2023100213320926000_dem10970757C31","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/S0140-6736(09)61717-7","article-title":"C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: An individual participant meta-analysis","volume":"375","author":"Emerging Risk Factors Collaboration","year":"2010","journal-title":"Lancet"},{"key":"2023100213320926000_dem10970757C32","first-page":"1822","article-title":"Chronic inflammation in the etiology of disease across the life span","volume":"25","author":"Furman","year":"2019","journal-title":"Nature: Medicine"},{"key":"2023100213320926000_dem10970757C33","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1136\/thx.2003.019588","article-title":"Association between chronic obstructive pulmonary disease and systemic inflammation: A systematic review and a meta-analysis","volume":"59","author":"Gan","year":"2004","journal-title":"Thorax"},{"key":"2023100213320926000_dem10970757C34","doi-asserted-by":"crossref","first-page":"2782","DOI":"10.1016\/S0264-410X(03)00181-6","article-title":"BCG scar and positive tuberculin reaction associated with reduced child mortality in West Africa","volume":"21","author":"Garly","year":"2003","journal-title":"Vaccine"},{"key":"2023100213320926000_dem10970757C35","doi-asserted-by":"crossref","first-page":"637087","DOI":"10.3389\/fimmu.2021.637087","article-title":"The hygiene hypothesis and new perspectives\u2014Current challenges meeting an old postulate","volume":"12","author":"Garn","year":"2021","journal-title":"Frontiers in Immunology"},{"key":"2023100213320926000_dem10970757C36","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/j.cell.2020.08.051","article-title":"Activate: Randomized clinical trial of BCG vaccination against infection in the elderly","volume":"183","author":"Giamarellos-Bourboulis","year":"2020","journal-title":"Cell"},{"key":"2023100213320926000_dem10970757C37","first-page":"392","article-title":"Harnessing the beneficial heterologous effects of vaccination","volume":"16","author":"Goodridge","year":"2016","journal-title":"Nature Reviews: Immunology"},{"key":"2023100213320926000_dem10970757C38","first-page":"11","article-title":"Trained innate immunity and its implications for mucosal immunity and inflammation","volume-title":"Advances in experimental medicine and biology: Vol. 1197. Oral mucosal immunity and microbiome","author":"Hajishengallis","year":"2019"},{"key":"2023100213320926000_dem10970757C39","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1007\/s13524-019-00799-x","article-title":"The long-lasting influenza: The impact of fetal stress during the 1918 influenza pandemic on socioeconomic attainment and health in Sweden, 1968\u20132012","volume":"56","author":"Helgertz","year":"2019","journal-title":"Demography"},{"issue":"Suppl. 1","key":"2023100213320926000_dem10970757C40","article-title":"Tuberculosis origin: The Neolithic scenario","volume":"95","author":"Hershkovitz","year":"2015","journal-title":"Tuberculosis"},{"key":"2023100213320926000_dem10970757C41","article-title":"Association of BCG, DTP, and measles containing vaccines with childhood mortality: Systematic review","volume":"355","author":"Higgins","year":"2016","journal-title":"BMJ"},{"key":"2023100213320926000_dem10970757C42","unstructured":"Human Mortality Database . (2023). Berkeley, CA: University of California, Berkeley; Rostock, Germany: Max Planck Institute for Demographic Research. Available from www.mortality.org"},{"key":"2023100213320926000_dem10970757C43","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1093\/restud\/rdr043","article-title":"Optimal bandwidth choice for the regression discontinuity estimator","volume":"79","author":"Imbens","year":"2012","journal-title":"Review of Economic Studies"},{"key":"2023100213320926000_dem10970757C44","doi-asserted-by":"crossref","first-page":"2097","DOI":"10.1016\/j.vaccine.2015.03.016","article-title":"Effectiveness and impact of rotavirus vaccines in Europe, 2006\u20132014","volume":"33","author":"Karafillakis","year":"2015","journal-title":"Vaccine"},{"key":"2023100213320926000_dem10970757C45","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.ejca.2004.09.023","article-title":"Prior immunisation of patients with malignant melanoma with vaccinia or BCG is associated with better survival. An European Organization for Research and Treatment of Cancer cohort study on 542 patients","volume":"41","author":"K\u00f6lmel","year":"2005","journal-title":"European Journal of Cancer"},{"key":"2023100213320926000_dem10970757C46","first-page":"1076","article-title":"The immunology of the allergy epidemic and the hygiene hypothesis","volume":"18","author":"Lambrecht","year":"2017","journal-title":"Nature: Immunology"},{"key":"2023100213320926000_dem10970757C47","doi-asserted-by":"crossref","first-page":"7308","DOI":"10.1016\/j.vaccine.2021.08.026","article-title":"A BCG success story: From prevention of tuberculosis to optimal bladder cancer treatment","volume":"39","author":"Lamm","year":"2021","journal-title":"Vaccine"},{"key":"2023100213320926000_dem10970757C48","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1007\/s10552-008-9259-x","article-title":"Vaccination history and risk of non-Hodgkin lymphoma: A population-based, case-control study","volume":"20","author":"Lankes","year":"2009","journal-title":"Cancer Causes & Control"},{"key":"2023100213320926000_dem10970757C49","doi-asserted-by":"crossref","first-page":"2150","DOI":"10.1016\/j.vaccine.2014.01.081","article-title":"Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: A systematic review of published literature, 2007\u20132012","volume":"32","author":"Larson","year":"2014","journal-title":"Vaccine"},{"key":"2023100213320926000_dem10970757C50","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1007\/s13524-018-0758-4","article-title":"Early-life assets in oldest-old age: Evidence from primary care reform in early twentieth century Sweden","volume":"56","author":"Lazuka","year":"2019","journal-title":"Demography"},{"key":"2023100213320926000_dem10970757C51","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1093\/ije\/dyh262","article-title":"Benefits of routine immunizations on childhood survival in Tari, Southern Highlands Province, Papua New Guinea","volume":"34","author":"Lehmann","year":"2005","journal-title":"International Journal of Epidemiology"},{"key":"2023100213320926000_dem10970757C52","doi-asserted-by":"crossref","first-page":"2240","DOI":"10.1016\/j.socscimed.2009.03.041","article-title":"Drivers of tuberculosis epidemics: The role of risk factors and social determinants","volume":"68","author":"L\u00f6nnroth","year":"2009","journal-title":"Social Science & Medicine"},{"key":"2023100213320926000_dem10970757C53","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1136\/jech-2019-213289","article-title":"Association between C reactive protein and all-cause mortality in the ELSA-Brasil cohort","volume":"74","author":"Maluf","year":"2020","journal-title":"Journal of Epidemiology and Community Health"},{"key":"2023100213320926000_dem10970757C54","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1111\/padr.12174","article-title":"Economic conditions in early life and circulatory disease mortality","volume":"44","author":"Masters","year":"2018","journal-title":"Population and Development Review"},{"key":"2023100213320926000_dem10970757C55","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1111\/j.1439-0450.2004.00763.x","article-title":"Taking advantage of the positive side-effects of smallpox vaccination","volume":"51","author":"Mayr","year":"2004","journal-title":"Journal of Veterinary Medicine: Series B"},{"key":"2023100213320926000_dem10970757C56","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1353\/dem.0.0093","article-title":"Early life exposures and the occurrence and timing of heart disease among the older adult Puerto Rican population","volume":"47","author":"McEnry","year":"2010","journal-title":"Demography"},{"key":"2023100213320926000_dem10970757C57","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1080\/0032472031000141496","article-title":"Smallpox and epidemiological-demographic change in Europe: The role of vaccination","volume":"39","author":"Mercer","year":"1985","journal-title":"Population Studies"},{"key":"2023100213320926000_dem10970757C58","doi-asserted-by":"crossref","first-page":"9159","DOI":"10.1016\/j.vaccine.2011.08.008","article-title":"A systematic review of the evidence on the effectiveness and risks of inactivated influenza vaccines in different target groups","volume":"29","author":"Michiels","year":"2011","journal-title":"Vaccine"},{"key":"2023100213320926000_dem10970757C59","doi-asserted-by":"crossref","first-page":"1473","DOI":"10.1016\/j.cmi.2019.04.020","article-title":"Non-specific effects of BCG vaccine on viral infections","volume":"25","author":"Moorlag","year":"2019","journal-title":"Clinical Microbiology and Infection"},{"key":"2023100213320926000_dem10970757C60","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.mad.2014.06.005","article-title":"Inflamm-aging does not simply reflect increases in pro-inflammatory markers","volume":"139","author":"Morrisette-Thomas","year":"2014","journal-title":"Mechanisms of Ageing and Development"},{"key":"2023100213320926000_dem10970757C61","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.15585\/mmwr.mm7043a1","article-title":"Routine vaccination coverage\u2014Worldwide, 2020","volume":"70","author":"Muhoza","year":"2021","journal-title":"Morbidity and Mortality Weekly Report"},{"key":"2023100213320926000_dem10970757C62","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1183\/09031936.01.17305580","article-title":"A thousand years of pulmonary medicine: Good news and bad","volume":"17","author":"Murray","year":"2001","journal-title":"European Respiratory Journal"},{"key":"2023100213320926000_dem10970757C63","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1186\/s12889-015-1497-8","article-title":"Child survival and BCG vaccination: A community based prospective cohort study in Uganda","volume":"15","author":"Nankabirwa","year":"2015","journal-title":"BMC Public Health"},{"key":"2023100213320926000_dem10970757C64","unstructured":"National Board of Health and Welfare (Sweden). (2019). Statistikdatabas f\u00f6r d\u00f6dsorsaker [Statistics database for causes of death] [Dataset]. Retrieved from https:\/\/sdb.socialstyrelsen.se\/if_dor\/val.aspx"},{"key":"2023100213320926000_dem10970757C65","first-page":"375","article-title":"Defining trained immunity and its role in health and disease","volume":"20","author":"Netea","year":"2020","journal-title":"Nature Reviews: Immunology"},{"key":"2023100213320926000_dem10970757C66","volume-title":"Norge tuberkulinstatus 9. klasse 1975\u20131999","author":"Norwegian Institute of Public Health","year":"1975"},{"key":"2023100213320926000_dem10970757C67","unstructured":"Norwegian Institute of Public Health. (2008). Utredning om bruk av BCG-vaksine i Norge [Study on the use of BCG vaccine in Norway] (Report No. 2008:12). Oslo, Norway: Folkehelseinstituttet. Retrieved from https:\/\/www.fhi.no\/globalassets\/dokumenterfiler\/rapporter\/2009-og-eldre\/rapport-200812---utredning-om-bruk-av-bcg-vaksine-i-norge-pdf.pdf"},{"key":"2023100213320926000_dem10970757C68","unstructured":"Norwegian Institute of Public Health. (2010). The history of the Norwegian Institute of Public Health. NIPH. Retrieved from https:\/\/www.fhi.no\/en\/about\/this-is-the-norwegian-institute-of-public-health\/history-of-the-norwegian-institute-\/"},{"key":"2023100213320926000_dem10970757C69","unstructured":"Norwegian Institute of Public Health. (2016). Tuberculosis (TB) in Norway. NIPH. Retrieved from https:\/\/www.fhi.no\/en\/id\/infectious-diseases\/TB\/tuberculosis-tb-in-norway---fact-sh\/"},{"key":"2023100213320926000_dem10970757C70","doi-asserted-by":"crossref","first-page":"991","DOI":"10.4054\/DemRes.2016.35.33","article-title":"On the association between weather variability and total and cause-specific mortality before and during industrialization in Sweden","volume":"35","author":"Oudin \u00c5str\u00f6m","year":"2016","journal-title":"Demographic Research"},{"key":"2023100213320926000_dem10970757C71","doi-asserted-by":"crossref","first-page":"543","DOI":"10.4054\/DemRes.2013.29.21","article-title":"The fragility of the future and the tug of the past: Longevity in Latin America and the Caribbean","volume":"29","author":"Palloni","year":"2013","journal-title":"Demographic Research"},{"key":"2023100213320926000_dem10970757C72","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1046\/j.1523-1747.2002.00643.x","article-title":"Inverse association between melanoma and previous vaccinations against tuberculosis and smallpox: Results of the FEBIM study","volume":"119","author":"Pfahlberg","year":"2002","journal-title":"Journal of Investigative Dermatology"},{"key":"2023100213320926000_dem10970757C73","volume-title":"Demography: Measuring and modeling population processes","author":"Preston","year":"2001"},{"key":"2023100213320926000_dem10970757C74","doi-asserted-by":"crossref","first-page":"e0116206","DOI":"10.1371\/journal.pone.0116206","article-title":"Systemic inflammation predicts all-cause mortality: A Glasgow inflammation outcome study","volume":"10","author":"Proctor","year":"2015","journal-title":"PLoS One"},{"key":"2023100213320926000_dem10970757C75","unstructured":"Public Health Agency of Sweden. (2020). Previous Swedish vaccination programmes. Retrieved from https:\/\/www.folkhalsomyndigheten.se\/the-public-health-agency-of-sweden\/communicable-disease-control\/vaccinations\/previous-swedish-vaccination-programmes\/"},{"key":"2023100213320926000_dem10970757C76","first-page":"1236","volume-title":"Harrison's principles of internal medicine","author":"Raviglione","year":"2018"},{"key":"2023100213320926000_dem10970757C77","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.jaci.2017.05.015","article-title":"An exposome perspective: Early-life events and immune development in a changing world","volume":"140","author":"Renz","year":"2017","journal-title":"Journal of Allergy and Clinical Immunology"},{"key":"2023100213320926000_dem10970757C78","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1016\/j.freeradbiomed.2010.09.006","article-title":"Oxidative stress, inflammation, and cancer: How are they linked?","volume":"49","author":"Reuter","year":"2010","journal-title":"Free Radical Biology and Medicine"},{"key":"2023100213320926000_dem10970757C79","doi-asserted-by":"crossref","first-page":"6730","DOI":"10.1016\/j.vaccine.2019.09.023","article-title":"Smallpox and BCG vaccination in childhood and cutaneous malignant melanoma in Danish adults followed from 18 to 49 years","volume":"37","author":"Rieckmann","year":"2019","journal-title":"Vaccine"},{"key":"2023100213320926000_dem10970757C80","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofx130","article-title":"The effect of smallpox and bacillus Calmette-Gu\u00e9rin vaccination on the risk of human immunodeficiency virus-1 infection in Guinea-Bissau and Denmark","volume":"4","author":"Rieckmann","year":"2017","journal-title":"Open Forum Infectious Diseases"},{"key":"2023100213320926000_dem10970757C81","first-page":"695","article-title":"Vaccinations against smallpox and tuberculosis are associated with better long-term survival: A Danish case-cohort study 1971\u20132010","volume":"46","author":"Rieckmann","year":"2017","journal-title":"International Journal of Epidemiology"},{"key":"2023100213320926000_dem10970757C82","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/0041-3879(83)90034-X","article-title":"Childhood tuberculosis in Sweden: An epidemiological study made six years after the cessation of general BCG vaccination of the newborn","volume":"64","author":"Romanus","year":"1983","journal-title":"Tubercle"},{"issue":"3","key":"2023100213320926000_dem10970757C83","doi-asserted-by":"crossref","first-page":"14","DOI":"10.2807\/esm.11.03.00606-en","article-title":"Selective BCG vaccination in a country with low incidence of tuberculosis","volume":"11","author":"Romanus","year":"2006","journal-title":"Eurosurveillance"},{"key":"2023100213320926000_dem10970757C84","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/S0140-6736(17)30566-4","article-title":"Evolution, human-microbe interactions, and life history plasticity","volume":"390","author":"Rook","year":"2017","journal-title":"Lancet"},{"key":"2023100213320926000_dem10970757C85","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1007\/s12016-011-8285-8","article-title":"Hygiene hypothesis and autoimmune diseases","volume":"42","author":"Rook","year":"2012","journal-title":"Clinical Reviews in Allergy & Immunology"},{"key":"2023100213320926000_dem10970757C86","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1093\/emph\/eot004","article-title":"Microbial \u2018old friends,\u2019 immunoregulation and stress resilience","volume":"2013","author":"Rook","year":"2013","journal-title":"Evolution, Medicine, and Public Health"},{"key":"2023100213320926000_dem10970757C87","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1093\/ije\/dyh392","article-title":"BCG vaccination scar associated with better childhood survival in Guinea-Bissau","volume":"34","author":"Roth","year":"2005","journal-title":"International Journal of Epidemiology"},{"key":"2023100213320926000_dem10970757C88","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/0962-8479(94)90132-5","article-title":"Cohort approach in tuberculosis surveillance: Comparison of the situation in Sweden and Finland","volume":"75","author":"Sakari H\u00e4r\u00f6","year":"1994","journal-title":"Tubercle and Lung Disease"},{"key":"2023100213320926000_dem10970757C89","volume-title":"Achieving universal health coverage: Learning from Chile, Japan, Malaysia and Sweden","author":"Savedoff","year":"2011"},{"key":"2023100213320926000_dem10970757C90","doi-asserted-by":"crossref","first-page":"1935","DOI":"10.1093\/infdis\/jiab220","article-title":"Immediate bacille Calmette-Gu\u00e9rin vaccination to neonates requiring perinatal treatment at the maternity ward in Guinea-Bissau: A randomized controlled trial","volume":"224","author":"Schaltz-Buchholzer","year":"2021","journal-title":"Journal of Infectious Diseases"},{"key":"2023100213320926000_dem10970757C91","doi-asserted-by":"crossref","first-page":"1516","DOI":"10.1016\/j.vaccine.2021.06.006","article-title":"The introduction of BCG vaccination to neonates in Northern Sweden, 1927\u201331: Re-analysis of historical data to understand the lower mortality among BCG-vaccinated children","volume":"40","author":"Schaltz-Buchholzer","year":"2022","journal-title":"Vaccine"},{"key":"2023100213320926000_dem10970757C92","unstructured":"Statistics Norway. (2022). Deaths, by sex, age and detailed cause of death (closed time series) 1969\u20132012 [Dataset]. Retrieved from https:\/\/www.ssb.no\/en\/statbank\/table\/08880\/"},{"key":"2023100213320926000_dem10970757C93","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1111\/j.1365-2222.2007.02859.x","article-title":"Bacille-Calmette-Guerin vaccination and the development of allergic disease in children: A randomized, prospective, single-blind study","volume":"38","author":"Steenhuis","year":"2008","journal-title":"Clinical & Experimental Allergy"},{"key":"2023100213320926000_dem10970757C94","doi-asserted-by":"crossref","first-page":"143","DOI":"10.2147\/ITT.S61528","article-title":"The hygiene hypothesis: Current perspectives and future therapies","volume":"4","author":"Stiemsma","year":"2015","journal-title":"ImmunoTargets and Therapy"},{"key":"2023100213320926000_dem10970757C95","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1093\/gerona\/glw166","article-title":"Development and validation of a 10-year mortality prediction model: Meta-analysis of individual participant data from five cohorts of older adults in developed and developing countries","volume":"72","author":"Suemoto","year":"2017","journal-title":"Journals of Gerontology, Series A: Biological Sciences and Medical Sciences"},{"key":"2023100213320926000_dem10970757C96","doi-asserted-by":"crossref","first-page":"e035595","DOI":"10.1136\/bmjopen-2019-035595","article-title":"Neonatal BCG vaccination and child survival in TB-exposed and TB-unexposed children: A prospective cohort study","volume":"10","author":"Thysen","year":"2020","journal-title":"BMJ Open"},{"key":"2023100213320926000_dem10970757C97","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/0041-3879(88)90074-8","article-title":"Protective effect of BCG vaccination in Norway 1956\u201373","volume":"69","author":"Tverdal","year":"1988","journal-title":"Tubercle"},{"key":"2023100213320926000_dem10970757C98","unstructured":"U.S. Senate Committee on Government Operations. (1959). The status of world health: In outline text and chart (Report). Washington, DC: U.S. Government Printing Office. Retrieved from https:\/\/www.google.com\/books\/edition\/The_Status_of_World_Health\/hojQqyqKnaYC?hl=en&gbpv=1&dq=Committee+on+Government+Operations,+United+States+Congress+Senate.+The+status+of+world+health+in+outline+text+and+chart&pg=PA10&printsec=frontcover"},{"key":"2023100213320926000_dem10970757C99","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1007\/s13524-011-0021-8","article-title":"Being born under adverse economic conditions leads to a higher cardiovascular mortality rate later in life: Evidence based on individuals born at different stages of the business cycle","volume":"48","author":"van den Berg","year":"2011","journal-title":"Demography"},{"key":"2023100213320926000_dem10970757C100","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1136\/bmj.38261.496366.82","article-title":"Non-specific effects of vaccination on child survival: Prospective cohort study in Burkina Faso","volume":"329","author":"Vaugelade","year":"2004","journal-title":"BMJ"},{"key":"2023100213320926000_dem10970757C101","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1097\/MIB.0b013e318281f34e","article-title":"Risk of inflammatory bowel disease following bacille Calmette-Gu\u00e9rin and smallpox vaccination: A population-based Danish case-cohort study","volume":"19","author":"Villumsen","year":"2013","journal-title":"Inflammatory Bowel Diseases"},{"key":"2023100213320926000_dem10970757C102","doi-asserted-by":"crossref","first-page":"6950","DOI":"10.1016\/j.vaccine.2009.08.103","article-title":"Risk of lymphoma and leukaemia after bacille Calmette-Gu\u00e9rin and smallpox vaccination: A Danish case-cohort study","volume":"27","author":"Villumsen","year":"2009","journal-title":"Vaccine"},{"key":"2023100213320926000_dem10970757C103","first-page":"5","article-title":"The risk of tuberculosis infection in Norway","volume":"45","author":"Waaler","year":"1971","journal-title":"Bulletin of the International Union Against Tuberculosis and Lung Disease"},{"issue":"3","key":"2023100213320926000_dem10970757C104","first-page":"185","article-title":"The efficacy of bacillus Calmette-Guerin vaccinations for the prevention of acute upper respiratory tract infection in the elderly","volume":"43","author":"Wardhana","year":"2011","journal-title":"Acta Medica Indonesia"},{"key":"2023100213320926000_dem10970757C105","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/s13524-010-0003-2","article-title":"The effects of childhood, adult, and community socioeconomic conditions on health and mortality among older adults in China","volume":"48","author":"Wen","year":"2011","journal-title":"Demography"},{"key":"2023100213320926000_dem10970757C106","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1093\/jhmas\/45.3.366","article-title":"The historical decline of tuberculosis in Europe and America: Its causes and significance","volume":"45","author":"Wilson","year":"1990","journal-title":"Journal of the History of Medicine and Allied Sciences"},{"key":"2023100213320926000_dem10970757C107","unstructured":"World Bank. (2022). Population, total\u2014Norway. Retrieved from https:\/\/data.worldbank.org\/indicator\/SP.POP.TOTL?locations=NO"},{"key":"2023100213320926000_dem10970757C108","doi-asserted-by":"crossref","first-page":"3408","DOI":"10.1016\/j.vaccine.2018.03.009","article-title":"BCG vaccine: WHO position paper, February 2018\u2014Recommendations","volume":"36","author":"World Health Organization","year":"2018","journal-title":"Vaccine"},{"key":"2023100213320926000_dem10970757C109","volume-title":"Global tuberculosis report: 2021","author":"World Health Organization","year":"2021"},{"key":"2023100213320926000_dem10970757C110","doi-asserted-by":"crossref","first-page":"2041","DOI":"10.1215\/00703370-9463660","article-title":"Inequality in place: Effects of exposure to neighborhood-level economic inequality on mortality","volume":"58","author":"Zhao","year":"2021","journal-title":"Demography"},{"key":"2023100213320926000_dem10970757C111","doi-asserted-by":"crossref","first-page":"e1001012","DOI":"10.1371\/journal.pmed.1001012","article-title":"The BCG world atlas: A database of global BCG vaccination policies and practices","volume":"8","author":"Zwerling","year":"2011","journal-title":"PLoS Medicine"}],"container-title":["Demography"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/read.dukeupress.edu\/demography\/article-pdf\/60\/5\/1607\/2013419\/1607theilmann.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/read.dukeupress.edu\/demography\/article-pdf\/60\/5\/1607\/2013419\/1607theilmann.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T08:20:29Z","timestamp":1703233229000},"score":1,"resource":{"primary":{"URL":"https:\/\/read.dukeupress.edu\/demography\/article\/60\/5\/1607\/382374\/Does-Early-Childhood-BCG-Vaccination-Improve"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,21]]},"references-count":111,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,10,1]]},"published-print":{"date-parts":[[2023,10,1]]}},"URL":"https:\/\/doi.org\/10.1215\/00703370-10970757","relation":{},"ISSN":["0070-3370","1533-7790"],"issn-type":[{"value":"0070-3370","type":"print"},{"value":"1533-7790","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,21]]}}}