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PubMed1989

[BCG vaccination in low risk tuberculosis; first experiences after the suspension of BCG vaccination of newborns in Czechoslovakia].

With the steadily declining risk of tuberculosis infection in CSR the question arose whether vaccination of infants remains worthwhile considering not only resources spent but also complications to vaccination vis-a-vis benefits derived. A prospective study has been designed in which BCG vaccination of newborns is discontinued in an area with 30,000 newborns yearly. In the period from April 1, 1986 to January 31, 1988 there were not vaccinated 43,428 children (84.8% of the newborns). The collaboration of mothers was good. The one year old non-vaccinated children were tested with 2 TU PPD RT 23 with Tween 80. The distribution of positive tuberculin reactions appears unimodal, relatively large reactions being absent. 8 children had reactions with 6 or more mm induration. That corresponds to a risk of infection of 0.04%. The project continues in the research area and might be extended to another area.

BCG Vaccine↗
PubMed2000

[BCG vaccination in the world].

BCG vaccination programme and BCG vaccination coverage in the world were summarized mainly based on the published informations from official organizations, such as World Health Organization (WHO), International Union Against Tuberculosis and Lung Disease (IUATLD) and Centers for Disease Control and Prevention (CDC). From this review, we can see how widely BCG has been used for the prevention of tuberculosis in the world. In most of the developing countries, especially in Africa, the Americas, and Pacific Region, BCG vaccination is carried out to newborn babies soon after birth by intradermal injection according to the recommendations from WHO, but some of the developing countries in Asia and Europe have their own modified BCG vaccination programmes. In economically developed countries, BCG vaccination programme has been established according to the tuberculosis status of each countries. Some countries have general vaccination policy, and other countries have selected vaccination policy, but there is no country where BCG vaccination is not carried out at all. Among G8 contries, as representatives of the economically developed countries, Japan, United Kingdom, France and Russian Federation have BCG general vaccination policy for the specified age group. In these 4 countries revaccination (s) of BCG are still carried out. In Germany, some provinces have general vaccination policy and some others have selected vaccination policy. In the United States of America, BCG vaccination is recommended to selected high risk infants and health care workers by CDC. There are many debates as for the efficacy and safety of BCG vaccination, and the development of new vaccine better than BCG has been actively discussed and some encouraging results in animal models have been reported from several laboratories. But, there is almost no possibility to be able to use a new vaccine in the routine practice within a couple of years. From the practical point of view, therefore, the operational researches for the better and more appropriate usage of BCG are equally important and more practical than the researches for the development of new vaccines.

BCG Vaccine↗
PubMed1966

Relation between pre-vaccination and post-vaccination tuberculin sensitivity. A contribution to the ecology of BCG vaccination.

BCG vaccination is commonly assessed in terms of post-vaccination sensitivity to tuberculin. If vaccination is followed by the development of a high degree of tuberculin sensitivity, it is assumed that the vaccination was successful. If, on the other hand, tuberculin sensitivity does not develop, it is assumed that the vaccination was unsuccessful. Both these assumptions equate post-vaccination tuberculin sensitivity with BCG-induced tuberculin sensitivity and disregard the possibility that environmental factors, such as the prevalence of low-grade naturally acquired tuberculin sensitivity, may affect the outcome of vaccination. Thus, while it seems reasonable to equate post-vaccination and BCG-induced tuberculin sensitivity in areas where low-grade sensitivity is uncommon, it might be unjustifiable to do so in areas where such sensitivity is prevalent.This paper analyses the relation between pre- and post-vaccination tuberculin sensitivity in a community with a high prevalence of naturally acquired low-grade tuberculin sensitivity. From this analysis it appears that post-vaccination tuberculin sensitivity may be only partly BCG-induced and cannot therefore be considered a reliable measure of the success of BCG vaccination in the presence of naturally acquired low-grade sensitivity. The author discusses the implications of this finding and concludes that a further evaluation of the protection afforded by BCG in areas where low-grade tuberculin sensitivity is prevalent is much needed.

Adolescent↗