[Vaccine prophylaxis of tuberculosis: implication and problems]

Area of Science:

• Immunology
• Public Health
• Epidemiology

Background:

• Tuberculosis remains a significant global health challenge.
• Vaccine prophylaxis, particularly BCG, is a cornerstone of tuberculosis control strategies worldwide.
• Understanding vaccination effectiveness and complication patterns is crucial for optimizing public health interventions.

Purpose of the Study:

• To analyze current data on tuberculosis vaccine (BCG) prophylaxis in Russia.
• To review global approaches to BCG vaccination and compare them with Russian research.
• To investigate the incidence, patterns, and causes of complications following BCG vaccination in Russia.

Main Methods:

• Literature review of global tuberculosis vaccination strategies.
• Analysis of Russian research on BCG re-administration regimens and frequencies.
• Examination of data on BCG/BCG-M vaccine complications from the Federal Center in Russia.
• Comparative analysis of complication rates based on vaccination setting (maternity hospital vs. polyclinic).

Main Results:

• The incidence of post-BCG vaccination complications in Russia showed a slight decrease between 1995 and 2002-2003 (21.1 vs. 20.3 per 100,000).
• Postvaccination lymphadenitis occurred twice as frequently in infants vaccinated at maternity hospitals compared to those vaccinated at polyclinics.
• Cold abscesses were less frequent in children vaccinated at polyclinics (63%) than in those vaccinated at maternity hospitals (19.1%).
• BCG osteitis was identified as a primary reason for severe post-vaccination complications.

Conclusions:

• Tuberculosis prophylaxis calendars require modification to account for child's age and regional epidemic situations.
• Vaccination site significantly influences the type and frequency of BCG vaccine complications.
• Further investigation into the causes of severe complications like BCG osteitis is warranted.