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A total of 105 low–birth-weight children presenting for first vaccination were randomized to receive bacillus Calmette-Guérin (BCG) immediately or later (current practice). The mortality rate ratio for BCG was 0.17 (95% CI = 0.02–1.35) within 3 days of enrollment, 0.28 (0.06–1.37) in the first month, and 0.27 (0.07–0.98) after 2 months of age. The mortality rate ratio was 0.41 (0.14–1.18) (P = 0.098) in infancy. Administration of BCG vaccine at first contact may contribute to lower mortality.