BCG vaccination has shown consistently high efficacy against childhood TB. However, this evidence on its own is not sufficient to justify BCG vaccination on its present large scale.
To analyse cost-effectiveness of the vaccination, Christopher Dye (World Health Organization) and colleagues compared the costs and effects of BCG as an intervention against severe childhood tuberculosis in different regions of the world. They found that the 100 million doses of BCG vaccine given to children born every year prevent about 40 000 cases of severe TB during their first five years of life. BCG had its biggest effect, and is most cost effective, in southeast Asia, Africa, and the western Pacific region, where TB infection rates and BCG coverage are highest. The investigators found that, worldwide, the cost of vaccination is around US$200 per year of healthy life gained.
Dr Dye concludes: "BCG vaccination is highly cost-effective intervention against severe childhood tuberculosis; it should be retained in high-incidence countries as a strategy to supplement the chemotherapy of active tuberculosis."
See also accompanying Comment.
Contact: Dr Christopher Dye, Communicable Diseases Control, Prevention & Eradication, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland. T) 0041 22 791 2904 / +41 79 509 0621 (mobile) /+41 22 791 4566 (PA) email@example.com
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