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
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- 1. 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).
- 2. 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. <MJA full text>
- 3. Ritz N, Connell TG, Curtis N. To BCG or not to BCG? Preventing travel-associated tuberculosis in children. Vaccine 2008; 26: 5905-5910.
- 4. 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.
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