[Vaccine prophylaxis of tuberculosis: implication and problems]

The paper presents data on vaccine prophylaxis in Russia. A sophisticated analysis of the data available in the literature on approaches to vaccination against tuberculosis in different countries of the world is provided. The results of the studies made by Russian investigators to develop different regimes of BCG re-administrations an their frequencies are given. The fact that it is necessary to change a tuberculosis prophylaxis calendar under the present conditions, by keeping in mind the age of a child and the epidemic situation in the country's region, has been established. A particular section is dedicated to the problem associated with the occurrence of complications in response to tuberculosis vaccine. Based on the Federal Center data on complications due to BCG/ BCG-M, the authors provide information on the incidence and pattern of complications occurring in Russia. As compared with 1995, the incidence of postvaccination complications slightly changed (21.1 in 100,000 in 1995 versus 20.3 in 2002-2003). In the children inoculated at a maternity hospital, postvaccination lymphadenitis was observed 2 times more frequently than in those vaccinated at a polyclini (77.1 and 37% of cases, respectively) and cold abscesses were 3.3 times less frequently than those inoculated at the polyclinic (19.1 and 63% of cases, respectively). The study has ascertained main reasons for the higher incidence of severe complications as BCG ostitis.