An assessment of the value of BCG vaccination in England and Wales.

The scheme for BCG vaccination at about age 13 years in England and Wales was introduced in 1953. The coverage of the scheme is now 75%, and the efficacy of BCG has been 75-80% throughout, but the incidence of tuberculosis in young white adults has been decreasing steeply since 1950. The benefits of the scheme have consequently been decreasing equally rapidly in recent years. Discontinuation of the scheme would lead to some additional cases of tuberculosis but would not greatly increase the very small current risk of tuberculosis developing in the unvaccinated 13-years old.