Risk of disseminated tuberculosis and other infections after neonatal Bacillus Calmette–Guérin vaccination in infants with in-utero exposure to tumor necrosis factor-α inhibitors

To evaluate the safety of administering BCG vaccination at birth in infants exposed to TNF-α inhibitors in utero.

63 infants exposed to TNF-α inhibitors were identified; 49 (77.8%) received BCG vaccination within the first year.
27 infants (42.8%) were vaccinated at birth, with most exposed to TNF-α inhibitors during the third trimester.
Over half of the infants experienced at least three infections, but none developed disseminated tuberculosis.
Exposure to TNF-α inhibitors did not increase the risk of infection or hospitalization during the first year.

BCG vaccination at birth did not result in disseminated tuberculosis in infants exposed to TNF-α inhibitors during the third trimester.

Retrospective design may limit the ability to establish causation.
Data were collected from a single health system, which may affect generalizability.

BCG vaccination at birth is safe for infants exposed to TNF-α inhibitors in utero, with no cases of disseminated tuberculosis reported.