tuberculosis vaccination, BCG

In many countries across the world, vaccination against tuberculosis is routinely practiced. Bacillus Calmette-Guerin (BCG) vaccine is a live, weakened strain of Mycobacterium bovis (cow tuberculosis), which was introduced in 1922.

The efficacy of BCG is unknown. Earlier European trials showed up to 80 percent protection, but recent Indian trials showed little value. Even though tuberculosis is becoming a problem again in this country, BCG is still recommended only in selected tuberculin-negative individuals with unavoidable intense exposure to tuberculosis, such as children of mothers with active tuberculosis.

BCG may be useful in travelers anticipating close contact with people infected with tuberculosis, but an alternative approach is tuberculin skin-testing before and after travel, with administration of isoniazid in the event of skin-test conversion.

For any individuals facing travel with their children to areas of high tuberculosis prevalence, for example missionaries, I would recommend consultation with a pediatric infectious disease specialist before considering the vaccine.

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