European survey of BCG vaccination policies and surveillance in children, 2005

In 2005, all 25 EU countries, as well as Andorra, Bulgaria, Norway, Romania and Switzerland, participated in a survey on BCG vaccination in children. BCG was recommended nationally for children under 12 months in 12 countries, in older children in five countries and in children at risk (from origin, contact or travel) in 10 countries. Seven countries did not use BCG systematically. Revaccination was practised in four countries. In countries with universal vaccination, BCG coverage was high (83.0% to 99.8%). TB cases commonly occurred in vaccinated children (at least 30%-98% in five countries using universal or high-risk approach). Disseminated infection due to BCG was rarely reported in recent years (0-1/100 000 vaccinated). There is a wide variation among BCG recommendations in Europe, and nearly half the countries surveyed were considering revisions, at a time when the European Centre for Disease Prevention and Control (ECDC) is advocating for harmonised vaccine strategies. Data on monitoring of BCG coverage in target groups is important but often lacking in Europe. Information on BCG status and eligibility should be collected routinely through TB case notification. The incidence of severe adverse effects of BCG in children should be monitored. Given lack of evidence to its efficacy, revaccination should be discontinued.