[Tuberculosis prevention needs adaptation to conditions of Central European countries]

Area of Science:

• Pediatrics
• Epidemiology
• Public Health

Context:

• Mandatory BCG vaccination policies are being re-evaluated in regions with favorable tuberculosis (TB) epidemiology.
• In Czechia, 160,000 children remain unvaccinated.
• The annual risk of tuberculous infection in unvaccinated children aged 0-6 years is low, at 0.05%.

Purpose:

• To analyze the cost-effectiveness of neonatal BCG vaccination in a low-incidence setting.
• To evaluate the transition rate from tuberculous infection to disease in children.
• To determine optimal vaccination strategies considering epidemiological data and adverse effects.

Summary:

• A cost-effectiveness analysis of BCG vaccination initiated in 1986 indicated that vaccination prevented 1 death per 100,000 vaccinated newborns.
• The transition rate from infection to disease over a 6-year period was 15-20%.
• Adverse effects of BCG vaccination were noted, and the overall cost of vaccination exceeded the cost of prevented tuberculosis deaths.

Impact:

• Findings suggest that reconsidering neonatal BCG vaccination and potentially vaccinating older children may be a more appropriate strategy in specific epidemiological contexts.
• This study informs public health policy regarding childhood vaccination programs for tuberculosis.
• The research highlights the importance of ongoing evaluation of vaccination efficacy and cost-benefit in relation to disease prevalence.