Paul Fine, professor of communicable diseases epidemiology at the London School of Hygiene & Tropical Medicine, said that a new policy of using the BCG vaccine only on infants and adults in high-risk communities would bring Britain into line with much of the rest of the world.
Fine said that the pattern of TB had changed enormously since the BCG vaccination programme against TB began in the 1950s. He added that the annual risk of infection in the UK had fallen from 20 per 1000 people in 1950 to less than one per 1000 today. And the number of cases identified in people born in the UK had reached an all-time low in 2003.
Fine said: “It is wise to re-examine processes which were introduced some time ago and examine the cost/benefit ratio. It’s clear the BCG programme is no longer worth the cost and uses resources which could be shifted to tackle more pressing health problems.”
“The disease has become restricted to identifiable segments of the population, particularly immigrant communities, and that is where work should be concentrated,” he added. Fine said that policy makers were reluctant to end the programme then because of fears that the increase in HIV infection and TB internationally might increase the risk of TB in the UK. He added: “This feared increase hasn’t happened and it’s clear the risk of TB among immigrant populations declines over time after they have settled in the UK and that the imported disease hasn’t led to increases in the disease among the indigenous population.”
The new policy, which starts this autumn, means that BCG vaccination will be offered to infants in communities with an average incidence of TB of at least 40 per 100,000 and to unvaccinated people who come to the UK from countries where the incidence exceeds 40 per 100,000. Fine stressed: “BCG vaccination will continue to have an important role in protecting children in high risk populations from TB.
MEDICA.de; Source: London School of Hygiene & Tropical Medicine (LSHT)