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Pros and Cons of BCG Vaccination in Countries with Low Incidence of Tuberculosis

Published online by Cambridge University Press:  02 January 2015

Eero O. Tala  and
Marianna M. Tala-Heikkila
Eero O. Tala*
Affiliation:
University Central Hospital, Department of Diseases of the Chest, Turku, Finland
Marianna M. Tala-Heikkila
Affiliation:
Department of Paediatrics, Turku, Finland
*
Department of Diseases of the Chest, FIN-21540 Preitilä, Finland
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Abstract

Preventive bacilleCalmette-Guérin (BCG) vaccination, together with case finding and effective chemotherapy, has formed an integral part of the tuberculosis (TB) control program in most countries. In some low-incidence countries the balance of prevention has been more on the side of chemoprophylaxis than of BCG vaccination. The time clearly has come when the strategy of mass BCG vaccination no longer is indicated medically, nor is it cost-effective. The pros and cons of the programs need to be critically evaluated against the present epidemiological background, taking into account the facts that TB, the killer disease, is recovering strength, human immunodeficiency virus infection is on the increase, and multidrug-resistant TB has changed the outcome of this previously fully curable disease.

Although no longer appropriate for mass programs, BCG vaccination still should be considered for the protection of selected risk groups in low-incidence countries. The overall efficacy may be of the order 50% to 80%, but the variation is great. Therefore, further research urgently is needed on the effectiveness of BCG as an intervention in local TB programs.

Type
From the Third International Conference on the Prevention of Infection
Information
Infection Control & Hospital Epidemiology , Volume 15 , Issue 7 , July 1994 , pp. 497 - 499
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1994

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