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BCG Revaccination Does Not Protect Against Leprosy in the Brazilian Amazon: A Cluster Randomised Trial ´ 1 2 1 3 ˆ 1 Sergio S. Cunha *, Neal Alexander , Mauricio L. Barreto , Emilia S. Pereira , Ines Dourado , Maria de ´ 3 4 1 1 2 Fatima Maroja , Yury Ichihara , Silvana Brito , Susan Pereira , Laura C. Rodrigues ´ ˜ 1 Instituto de Saude Coletiva, Universidade Federal da Bahia, State of Bahia, Brazil, 2 London School of Hygiene and Tropical Medicine, United Kingdom, 3 Fundac¸ao ˜ ´ Alfredo da Matta, Manaus, State of Amazonas, Brazil, 4 Fundac¸ao Nacional de Saude, State of Bahia, Brazil Abstract Background: Although BCG has been found to impart protection against leprosy in many populations, the utility of repeat or booster BCG vaccinations is still unclear. When a policy of giving a second BCG dose to school children in Brazil was introduced, a trial was conducted to assess its impact against tuberculosis, and a leprosy component was then undertaken in parallel. Objective: to estimate the protection against leprosy imparted by a second dose of BCG given to schoolchildren. Methods and Findings: This is a cluster randomised community trial, with 6 years and 8 months of follow-up. Study site: City of Manaus, Amazon region, a leprosy-endemic area in Brazil. Participants: 99,770 school children with neonatal