Co-appearance of OPV and BCG vaccine-derived complications in two infants with severe combined immunodeficiency

Sophia Heiman, Merav Weil, Lester M. Shulman, Amos J. Simon, Atar Lev, Raz Somech, Tali Stauber

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Infants with severe combined immunodeficiency (SCID) are at risk of developing severe life-threatening infections if they are inadvertently given attenuated live vaccines. Concomitant appearance of two live vaccine-associated complications in one person is rarely reported. In this study, we present two SCID infants, who received BCG and oral polio vaccines according to their local immunization schedule early in life, before the diagnosis of immunodeficiency was made. Their clinical presentation, extensive immunological workup, genetic tests, and clinical disease course are presented. Both patients developed localized and disseminated infections originating from the BCG vaccine (BCGitis and BCGiosis, respectively) and in addition suffered from diarrhea and chronic fecal secretion of vaccine-derived poliovirus. Alarmingly, in case 2, the poliovirus was a type 2 vaccine-derived poliovirus in which both neurovirulence attenuation sites reverted to the neurovirulent genotype. These cases highlight the importance of early recognition of SCID by neonatal screening or thorough family anamnesis, and the need to further defer the timing of administration of attenuated live vaccines.

Original languageEnglish
Pages (from-to)437-443
Number of pages7
JournalImmunologic Research
Issue number3
StatePublished - 1 Jun 2018
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2018, Springer Science+Business Media, LLC, part of Springer Nature.


  • BCG
  • Immune deficiency
  • Live vaccines
  • Poliovirus
  • SCID


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