Tracking changes in national BCG vaccination policies and practices using the BCG World Atlas.
health policy
tuberculosis
vaccines
Journal
BMJ global health
ISSN: 2059-7908
Titre abrégé: BMJ Glob Health
Pays: England
ID NLM: 101685275
Informations de publication
Date de publication:
01 2022
01 2022
Historique:
received:
16
09
2021
accepted:
27
10
2021
entrez:
18
1
2022
pubmed:
19
1
2022
medline:
19
3
2022
Statut:
ppublish
Résumé
The BCG vaccine is a widely given vaccine against tuberculosis (TB), yet studies on effectiveness have shown considerable heterogeneity; as a result, BCG vaccine policies vary greatly across the globe and change across geography, and with time and disease burden. The recently updated third BCG World Atlas (www.bcgatlas.org) is a publicly available online database with information on BCG practices across 194 countries. This helpful resource has been used for over 10 years to support clinicians, TB researchers and TB vaccine development worldwide. Here, we summarise main findings from the third BCG Atlas' most recent update which included additional data collected around BCG strain type, vaccine stockouts and associated changes. Longitudinal analysis enables evaluation of changes in TB incidence over time, a method becoming more common in legislation interventions. A large number of countries in the BCG Atlas (156/194 countries) maintain universal neonatal BCG vaccination, of which 51 are considered low TB burden countries. We demonstrate the majority of countries who changed their national policy moved to targeted vaccination for high-risk groups, were in Europe and also had significant decreases in TB incidence both before and after policy change. Globally, the most common BCG strain continues to be the Danish strain, despite its worldwide manufacturing interruption in 2015. Substantial variation and disproportionality exists in which regions were most affected by stockouts between 2009 and 2019. Tracking and understanding the reasoning behind changes to national BCG practices and their impact on TB burden is critical for decision makers as they contemplate how to include BCG vaccination in future immunisation guidelines in low and high TB burden countries.
Identifiants
pubmed: 35039309
pii: bmjgh-2021-007462
doi: 10.1136/bmjgh-2021-007462
pmc: PMC8764994
pii:
doi:
Substances chimiques
BCG Vaccine
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Iran J Public Health. 2017 Jun;46(6):852-853
pubmed: 28828330
Med Hist. 2014 Oct;58(4):475-97
pubmed: 25284891
BMC Med. 2016 Sep 15;14(1):138
pubmed: 27633883
S Afr Med J. 2016 Apr;106(4):12-4
pubmed: 27303774
N Engl J Med. 2019 Dec 19;381(25):2429-2439
pubmed: 31661198
Int J Epidemiol. 2018 Feb 1;47(1):193-201
pubmed: 29025083
Eur Respir J. 2019 Jan 10;53(1):
pubmed: 30630851
Lancet Respir Med. 2016 Jul;4(7):e35
pubmed: 27396765
Arch Dis Child. 2007 Aug;92(8):726-9
pubmed: 17642487
PLoS Med. 2011 Mar;8(3):e1001012
pubmed: 21445325
Vaccine. 2016 Apr 12;34(17):2015-20
pubmed: 26947498
JAMA. 1994 Mar 2;271(9):698-702
pubmed: 8309034
Sci Rep. 2015 Oct 21;5:15443
pubmed: 26487098
Vaccine. 2018 Jan 25;36(4):498-506
pubmed: 29254839
Eur Respir J. 2014 Jan;43(1):24-35
pubmed: 24381321
Emerg Infect Dis. 2020 Mar;26(3):624-625
pubmed: 31922950
BMC Public Health. 2019 Nov 11;19(1):1504
pubmed: 31711446
Int J Epidemiol. 2017 Feb 1;46(1):348-355
pubmed: 27283160
PLoS One. 2020 Dec 17;15(12):e0243707
pubmed: 33332418
BMJ. 2015 Jun 09;350:h2750
pubmed: 26058820
J Epidemiol Glob Health. 2014 Sep;4(3):195-202
pubmed: 25107655
Euro Surveill. 2006;11(3):6-11
pubmed: 16567882
Tuberculosis (Edinb). 2009 Jul;89(4):248-51
pubmed: 19540166