Uptake of neonatal BCG vaccination in England: performance of the current policy recommendations

Area of Science:

• Public Health
• Immunization Practices
• Epidemiology

Background:

• BCG uptake in infants in England lacked recent measurement since 2005.
• Challenges in defining accurate denominators hindered previous uptake estimations.

Purpose of the Study:

• To estimate Bacillus Calmette-Guérin (BCG) vaccination uptake among infants in England between 2006 and 2008.
• To compare BCG uptake rates between universal and selective infant vaccination policies.
• To assess the impact of vaccination setting (postnatal wards vs. community) on BCG uptake.

Main Methods:

• Estimated BCG uptake by dividing administered infant doses by live birth denominators.
• Differentiated denominators based on universal (all live births) or selective (ethnic minority/Eastern European live births) vaccination policies.
• Analyzed uptake data from primary care trusts across England for the period 2006-2008.

Main Results:

• Weighted average BCG uptake was 68% (95% CI 65% to 71%).
• Universal vaccination policies showed slightly higher uptake (72%) compared to selective policies (66%).
• Vaccination in postnatal wards resulted in 13% higher uptake than in community settings.

Conclusions:

• Infant BCG vaccination coverage in England was estimated at 68% between 2006-2008.
• Universal vaccination strategies and postnatal ward delivery models appear to enhance BCG uptake.
• Findings highlight the importance of policy and setting in optimizing infant immunization coverage.