Vaccination of young children against tuberculosis
Health Council of the Netherlands, Gezondheidsraad
Record ID 32011000144
The Minister of Health, Welfare and Sport asked the Health Council of the Netherlands to advise on the question to what extent the current BCG vaccination programme remains feasible. In order to answer this question, a number of experts were added to the Health Council’s National Immunisation Programme Committee. Additionally, expertise available in this specific area was extensively consulted, particularly of the Dutch KNCV Tuberculosis Foundation.
The current BCG vaccination strategy calls for immunisation of children with one or two parents from a country where the incidence of tuberculosis exceeds 50 cases per 100,000 inhabitants. These children receive notice around the age of six months. Children from these groups who were not born in the Netherlands or not immunised may receive catch-up vaccinations up to the age of 12 years. This policy satisfies all seven criteria for inclusion of vaccination in a public programme. This is an effective and possibly cost-saving intervention. The Committee therefore advises the Minister to continue the current strategy. Continuation of the current policy involves the immunisation of risk-group children where incidence in the land of origin exceeds 50/100,000. This also implies that 24 Vaccinatie van kinderen tegen tuberculose children from some EU states and Suriname should be eligible. These children did not always receive notice in the past. In total, this involves an estimated 24,000 infants each year.The Committee is of the opinion that from an administrative perspective, BCG vaccination should come under the NIP in order to optimally reach the target group and better document the immunisation rate. We already have efficient collaboration between Regional Coordination Programmes and Child Health Care Centres to reach the target group. This could also be utilised for BCG vaccination. From a care quality perspective, the Committee recommends to concentrate organisation, implementation and execution of BCG vaccination, e.g. at the Municipal Health Service tuberculosis units. The Committee recommends to ask organisations involved with immunisation to draft a joint proposal for practical organisation and collaboration.In conclusion, the Committee recommends that the Netherlands also contribute to medical research of a novel and improved vaccine. Around the world tuberculosis is a serious, very common infectious disease. The disease is in principle curable but resistance is becoming an increasing problem. High-level vaccination control programmes are currently not feasible, seeing BCG vaccine efficacy is highest in the prevention of severe complications of tuberculosis in children. Even though an alternative to BCG will not become available in the near future, various new vaccine candidates have shown promising results in preclinical studies.
English language abstract:
An English language summary is available
- BCG Vaccine
- Immunization Programs
Health Council of the Netherlands Gezondheidsraad
Postbus 16052, 2500 BB Den Haag, The Netherlands. Tel: +31 70 340 7520;Fax: +31 70 340 7523
Health Council of the Netherlands(GR)