'Ineffective' tuberculosis vaccinations in schools to be dropped

Jeremy Laurance
Tuesday 05 July 2005 19:00 EDT
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Professor Liam Donaldson, the Government's chief medical officer, will announce today that the BCG vaccination offered to all children between the ages of 10 and 14 is to be dropped because it is ineffective.

Evidence shows that tuberculosis is falling among the white population and that schoolchildren are at lowest risk, but it remains a risk among immigrant groups. The vaccination will continue to be offered to babies from high-risk groups whose parents were born abroad.

The move has the backing of specialists in the field who are lobbying for the £10m cost of the vaccination scheme to be ploughed back into services to improve TB control. Cases of tuberculosis have grown from 5,000 in 1987 to almost 7,000 last year, but they are concentrated among the homeless and communities with close links to parts of the world where tuberculosis is rife, especially in Africa and the Indian subcontinent.

Professor Peter Ormerod, of the British Thoracic Society, said: "All the scientific evidence shows that the schools BCG programme is given to people at extremely low risk of TB. Children born abroad or with parents born abroad are at higher risk and they are offered vaccination at birth, which will continue. If you are not in one of those groups, the chances of getting TB are one in 100,000."

Professor Ormerod, professor of respiratory medicine at Blackburn Royal Infirmary, said the BCG vaccine was only 75 per cent effective and gave protection for 10 to 15 years. For every 5,000 children vaccinated, one case of TB would be prevented over the following 15 years.

Some children suffered adverse reactions, including a BCG abscess which required treatment with anti- tuberculosis drugs, or a keloid scar - an unsightly disfigurement at the site of the injection.

Professor Ormerod said: "It is hugely cost-ineffective. If you are having to give 5,000 injections to prevent one case of disease, that is madness. The British Thoracic Society fully supports the decision to stop the school BCG programme, but we will lobby to have the money saved invested in TB services."

Tuberculosis is a global killer, claiming more than two million lives a year. In Britain, after decades of decline, the number of cases started to rise again in the mid-1980s. Although it is curable with drugs, the development of drug-resistant strains of TB in recent years has caused alarm. These cases are extremely difficult and costly to treat.

TB is not easy to catch, and in most cases requires prolonged close contact with an infected person. Once infected, the disease can lie dormant and may not emerge until years or decades later.

Professor Ormerod said most white victims of the disease were in their fifties or older who became infected decades ago. The proportion of the white population infected had fallen year on year.

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