Abstract
The current epidemiological situation of tuberculosis in France makes it necessary to re-assess the relevancy of the current BCG policy. It is close to the thresholds proposed internationally to consider the discontinuation of vaccination programs using BCG. Both the literature, specially experiences from European countries, and the analysis carried out on French data are in favour of an extremely limited impact of BCG revaccination of tuberculino-negative children. From these same sources, it can be anticipated that interruption of all BCG activities would result in an increase in tuberculosis incidence, affecting mainly high risks populations. The importance of this increase depends on the hypothesis made on BCG effectiveness. The National Technical Committees on Vaccination and Infectious Diseases have recommended in June 2002 the discontinuation of BCG revaccination and systematic tuberculin testing and should issued a definitive statement on November 2002. The decision regarding primo-vaccination needs, as a pre-requisite, a risk-benefit analysis taking into consideration adverse aspects of BCG vaccination, and an analysis of the feasibility and acceptability of various potential modifications in the population targeted by the BCG.
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