Ten Years' Experience with the Discontinuation of the Bacillus Calmette-Guérin Vaccination in the Czech Republic.

Abstract

Bacillus Calmette-Guérin (BCG) vaccination programs were introduced in Czechoslovakia more than 60 years ago under a quite different epidemiological situation than that of today. Compulsory mass BCG vaccination was abolished in November 2010 and changed to a selective vaccination program for infants at high risk of contracting tuberculosis (TB). This work sets out to ascertain the risk of TB and nontuberculous mycobacterial (NTM) infection in the 10-year period following the change to the vaccination program and to compare this with the same period of time when mass BCG vaccination was compulsory. Descriptive study. Statistical analysis of the incidence of tuberculosis and non-tuberculous mycobacteriosis as reported in the TB register in years 2001-2020. The incidence trend of TB in children in both monitored time periods is identical and statistically significantly decreasing (P < 0.001). In the first monitored period, the incidence trend of NTM cervical lymphadenitis in children is degressive and is not statistically significant (P = 0.561). However, in the second monitored period, the trend increases and is statistically significant (P < 0.001); in every compared 2-consecutive year period, there is an increase of 8%. These findings indicate that the change from mass BCG vaccination to selective vaccination of high-risk newborns and the abolishment of BCG revaccination can be recommended, so long as a keen eye is kept on NTM caused lymphadenitis.