Volume 200 - Issue 3
Infants born in Australia to mothers from countries with a high prevalence of tuberculosis: to BCG or not to BCG?
Authors: Amanda Gwee, Ranmali Rodrigo, Dan Casalaz, Nicole Ritz and Nigel Curtis
Med J Aust 2014; 200 (3): 149-150. || doi: 10.5694/mja13.11367
Published online: 17 February 2014
Published online: 17 February 2014
Study highlights a need to examine BCG vaccination program delivery across Australia
In reply: Our suggestion that routine BCG vaccination be considered for all infants born to mothers from countries with a high prevalence of tuberculosis (TB) was based on the finding that the current arbitrary system, relying on parents seeking out a BCG vaccination service, is unreliable. We found that 73% of such infants met the criteria for BCG vaccination according to the Australian immunisation guidelines,1 but almost 90% of mothers were unaware of the need for this vaccine. Moreover, the surveyed women had 47 other children who had already travelled to high-TB-prevalence countries for 1 month or longer, of whom more than half (26) had not had the BCG vaccine.2
An assessment of health and economic outcomes associated with routine BCG vaccination for these infants would be informative. Early routine BCG vaccination of eligible infants would reduce both the risk of children acquiring TB3 and the costs related to obtaining a referral, a clinic appointment and, in some cases, a tuberculin skin test before vaccination.4
With current migration trends, there are increasing numbers of infants travelling to high-TB-prevalence countries. A more systematic approach to BCG vaccination of these infants at risk of travel-related TB is needed.
Competing interests
No relevant disclosures.
References
- Australian Technical Advisory Group on Immunisation. Vaccine-preventable diseases: tuberculosis. In: The Australian immunisation handbook. 10th ed. Canberra: Australian Government Department of Health and Ageing, 2013. http://www.health.gov.au/internet/immunise/publishing.nsf/Content/handbook10-4-20 (accessed Dec 2013).
- Gwee A, Rodrigo R, Casalaz D, et al. Infants born in Australia to mothers from countries with a high prevalence of tuberculosis: to BCG or not to BCG? Med J Aust 2013; 199: 324-326. i1142869
- Ritz N, Connell TG, Curtis N. To BCG or not to BCG? Preventing travel-associated tuberculosis in children. Vaccine 2008; 26: 5905-5910. CBBJHIHJ
- Ritz N, Tebruegge M, Camacho-Badilla K, et al. To TST or not to TST: is tuberculin skin testing necessary before BCG immunisation in children? Vaccine 2012; 30: 1434-1436. i1142876