Fourie P B
S Afr Med J. 1987 Sep 5;72(5):323-6.
BCG vaccination for newborns has been compulsory by law in the RSA since 1973. From limited published information, it appears that coverage has now reached more than 80%. However, the effectiveness of the vaccinations in terms of disease prevention in the young is unknown. Small studies indicate protection of approximately 60% against all forms of tuberculosis in infants, but this figure is not generalisable. It is pointed out that the contribution of BCG vaccination to an overall decline of tuberculosis rates is minimal and should not be considered as a measurement of success of the EPI. The prevalence and risk of infection in southern African children is such that a policy of reduction or withdrawal of BCG vaccination from some sections of the community is not feasible. The current strategy of compulsory BCG vaccination at birth, followed by repeat vaccination 3 months later in children without evidence of reactivity at the vaccination site, as well as revaccination at school entry and school leaving, is both adequate and necessary. A standardised immunisation data recording format and full exchange of information at all decision-making levels between the EPI and the tuberculosis control programme is called for.
自1973年起，在南非共和国，新生儿接种卡介苗已成为法律规定的强制要求。从有限的已发表信息来看，目前接种覆盖率似乎已超过80%。然而，这些疫苗在预防儿童疾病方面的有效性尚不清楚。小型研究表明，卡介苗对婴儿各种形式结核病的保护率约为60%，但这一数字无法推广。有人指出，卡介苗接种对结核病总体发病率下降的贡献极小，不应被视为扩大免疫规划成功与否的衡量标准。由于南部非洲儿童的感染患病率和风险情况，在部分社区实施减少或停止卡介苗接种的政策是不可行的。目前在出生时强制接种卡介苗，随后对接种部位无反应迹象的儿童在3个月后进行复种，以及在入学和离校时进行补种的策略既充分又必要。需要一种标准化的免疫数据记录格式，并要求扩大免疫规划与结核病控制规划在所有决策层面充分交流信息。
