[Update on the BGC vaccine. Indications for use in Europe and in developing countries]

BCG vaccination is one of the tuberculosis control means. Since 1921, more than 3 thousand millions doses of BCG vaccine have been administered in 172 countries in the world. Vaccine, technical and side effects are today well known but we do not know nearly anything about the ideal age for initial vaccination and about the need, or not, of repeated vaccinations. Especially, its effectiveness is debated. Recent meta-analysises conclude to the protecting effectiveness of BCG in countries with a high annual risk of infection. The main rates of protection, from 60 to 90%, are obtained against tuberculous meningitis and miliary tuberculosis. So, the BCG vaccine is indicated in developing countries where the prevalence rate of tuberculosis is high. Administered in the first days of life, with a strict observance of the rules of preparation, of administration and of the conservation of the vaccine, this vaccination is the best prophylaxis of severe and disabled forms of tuberculosis. In these countries, the monitoring of the vaccine effectiveness by tuberculin skin tests and repeated BCG vaccinations do not seem to be useful. Spared money could be allowed to the screening and the treatment of cases.