BCG vaccination and tuberculosis in Japan.
This paper summarizes Bacillus Calmette-Guerin (BCG) vaccination and revaccination policies in Japan, its cost-effectiveness, side effects, proposed selective vaccination strategy, and present tuberculosis situation in Japanese perspectives based on Medline database and other published reports. Universal BCG vaccination in infants and revaccination among children were not found economically justifiable. Overall tuberculosis incidence in Japan is higher than that of other developed countries. Trend of decline in tuberculosis incidence is similar to that of the countries where universal BCG vaccination has never been implemented. In the recent years, the number of tuberculosis group infection has been escalating. Since BCG revaccination program has already been discontinued, a consensus on universal BCG vaccination is also essential based on social, political, and economical factors. Side by side, more pragmatic strategies such as well-defined tuberculin test, selective vaccination policy based on tuberculosis incidence in each administrative zone, and early vaccination of high risk groups, should be formulated.
Department of General Medicine and Clinical Epidemiology, Kyoto University Graduate School of Medicine, Japan.
Mahbubur
M
Rahman
Osamu
O
Takahashi
Masashi
M
Goto
Tsuguya
T
Fukui
D000293:Adolescent; D000328:Adult; D016907:Adverse Drug Reaction Reporting Systems; D001500:BCG Vaccine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D019049:Developed Countries / Q000706:statistics & numerical data; D004196:Disease Outbreaks / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007267:Injections / Q000379:methods; D007564:Japan / Q000453:epidemiology; D032541:Mass Vaccination / Q000191:economics / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014376:Tuberculosis / Q000453:epidemiology*
D001500:BCG Vaccine