An audit of BCG immunisation and tuberculin skin testing in Scotland. Scottish BCG Study Group.

BACKGROUND

BCG vaccination of all tuberculin-negative schoolchildren has been undertaken in the United Kingdom since 1954. In light of the ten-fold decline in tuberculosis, mass vaccination may no longer be justified. Since most tuberculosis cases now occur among identifiable high-risk groups, restriction of vaccination to these groups may be more appropriate. Before such changes can be recommended, further information is required on current practice within Scotland.

OBJECTIVE

To determine current BCG vaccination practice within Scotland, in order to inform planning of future immunisation services.

DESIGN

Postal questionnaire survey.

SETTING AND SUBJECTS

The questionnaires were posted to the Consultant in Public Health Medicine responsible for Communicable Disease Control in each of the fifteen Scottish Health Boards.

RESULTS

Completed questionnaires were returned by all 15 Health Boards. Marked variations were reported in the vaccination of both schoolchildren and high-risk groups. Six (40%) Health Boards immunised all tuberculin-negative children, whereas the remainder excluded those with evidence of previous BCG vaccination. All Health Boards immunised contacts of tuberculosis cases, 11 offered it to healthcare workers and 11 to immigrants from countries with a high prevalence of tuberculosis. However, only 7 offered it to the offspring of high-risk ethnic groups, 5 to students and 4 to animal workers.

CONCLUSION

There are marked variations in current BCG vaccination practice. Greater efforts are required to ensure that high-risk groups receive vaccination.