The Effect of Live-Virus Vaccines on Tests For Tuberculosis Infection During the US Immigration Medical Examination: Are Vaccines Causing False-Negative Results?

Details

• Alternative Title:
  Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 2025, v. 81, no. 5: The Effect of Live-Virus Vaccines on Tests For Tuberculosis Infection During the US Immigration Medical Examination: Are Vaccines Causing False-Negative Results?
• Journal Article:
  Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
• Personal Author:
  Regan, Joanna J. ; Wang, Zanju ; Phares, Christina R.
• Description:
  It is not recommended to perform tuberculin skin tests (TSTs) or interferon-γ release assays (IGRAs) in the 4 weeks following live-virus vaccination because these vaccines are thought to increase the risk of false-negative results.
  
  We retrospectively analyzed TST and IGRA results for 158 484 US-bound immigrant and refugee children aged 2-14 years who received a required medical examination and live-virus vaccines (measles, mumps, rubella; oral polio; or varicella) overseas during 2014-2022. We created logistic regression models to assess the association between test positivity and vaccination during the critical interval (1-28 days after live-virus vaccination) versus after or before, adjusting for sex, age group, country of examination, and other factors.
  
  The percentage of positive results and the adjusted odds of a positive IGRA result were higher for children tested during the critical interval (4.6%) than for those tested after (3.5%) (adjusted odds ratio, 1.27 95% confidence interval, 1.13-1.43) or before (3.3%) (1.26 1.13-1.41). The percentage of positive results and the adjusted odds of a positive TST were also higher for children tested during the critical interval (15.7%) than for those tested after (7.2%) (adjusted odds ratio, 2.40 95% confidence interval, 1.79-3.22) or before (6.6%) (3.81 2.80--5.18).
  
  The concern that recent administration of live-virus vaccines leads to false-negative TST and IGRA results is not supported by these findings. Instead, we observed a modest increase in positive results among children tested during the critical postvaccination interval, challenging the need for the testing delay.
• Content Notes:
  Author manuscript
• Subjects:
  • Humans
  • Child
  • Male
  • Female
  • Adolescent
  • Child, Preschool
  • Interferon-gamma Release Tests
  • Tuberculin Test
  • Retrospective Studies
  • False Negative Reactions
  More +
• Keywords:
  • tuberculosis
  • immigration
  • screening
  • live-virus vaccines
  • latent tuberculosis infection (LTBI)
• Source:
  Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 2025, v. 81, no. 5
• DOI:
  https://doi.org/10.1093/cid/ciaf129
• ISSN:
  1058-4838 ; 1537-6591
• Pubmed ID:
  40370038
• Pubmed Central ID:
  PMC12631575
• Document Type:
  Text
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Genre:
  Journal Article
• Place as Subject:
  United States
• Pages in Document:
  e378-e384 (16 pdf pages)
• Volume:
  81
• Issue:
  5
• Download URL:
  https://stacks.cdc.gov/view/cdc/261408/cdc_261408_DS1.pdf
• File Type:
  [PDF - 362.77 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:a4e630c12c3e33120172adf92a846ddb9b34623b9a7bea2417b8a43c11ff9dbb3a41c7713d0f06ef558e196d5f22c2c8ee0e08174f472cf671e96252e8fc34f8