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

Introduction Infants born to mothers with autoimmune rheumatic diseases, including rheumatoid arthritis, spondyloarthropathy, and inflammatory bowel disease, may be exposed antenatally to tumor necrosis factor-alpha (TNF-α) inhibitors. Recent guidelines recommend deferring live attenuated vaccines, such as Bacillus Calmette–Guérin (BCG), until after 6–12 months of age in this population, owing to conflicting safety data. This study aimed to evaluate the safety of administering BCG vaccination at