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BCG vaccination and tuberculosis in Japan
Mahbubur Rahman1, Osamu Takahashi, Masashi Goto
1Department of General Medicine and Clinical Epidemiology, Kyoto University Graduate School of Medicine, Japan.
Journal of Epidemiology
|May 17, 2003
Summary
Japan
Area of Science:
- Public Health
- Vaccinology
- Epidemiology
Background:
- Japan's Bacillus Calmette-Guerin (BCG) vaccination policies require re-evaluation.
- Tuberculosis incidence in Japan remains higher than in other developed nations.
Purpose of the Study:
- To analyze the cost-effectiveness and impact of BCG vaccination and revaccination policies in Japan.
- To propose alternative strategies for tuberculosis control in the current Japanese context.
Main Methods:
- Review of Medline database and published reports on BCG vaccination policies and tuberculosis trends in Japan.
- Analysis of economic justification for universal infant and childhood BCG revaccination.
Main Results:
- Universal BCG vaccination and revaccination were not found to be economically justifiable.
- Tuberculosis incidence decline in Japan mirrors countries without universal BCG vaccination.
- Escalating numbers of tuberculosis group infections are a recent concern.
Conclusions:
- A consensus on universal BCG vaccination, considering social, political, and economic factors, is essential.
- Pragmatic strategies including tuberculin testing and selective vaccination based on regional incidence are recommended.
- Early vaccination for high-risk groups should be prioritized.