BCG vaccination in Korea, Japan, and Taiwan: Current status and future perspectives

The Bacille Calmette-Guérin (BCG) vaccine remains essential for preventing severe pediatric tuberculosis (TB). This review compares BCG policies in Korea, Japan, and Taiwan - three low-burden countries with differing strategies. Notably, Taiwan and Japan have delayed vaccination to 5-8 months specifically to mitigate osteitis risks, whereas Korea retains a schedule before four weeks. Despite these variations in timing and vaccine strains, all three nations maintain >95% coverage and have effectively eliminated severe pediatric TB. These outcomes suggest that varying delivery models can achieve comparable success. However, as epidemiological landscapes transition, the focus must shift toward enhanced safety surveillance and programmatic precision. Reassessing vaccination policies is crucial to minimize adverse events while maintaining protection against severe disease in low-burden settings.