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Last Updated: Wednesday, 6 July, 2005, 11:49 GMT 12:49 UK
School 'TB jabs' to be scrapped
TB bacterium
One third of the world's population is though to carry the TB bacterium
UK school children will no longer be routinely immunised against tuberculosis, the government has announced.

Currently, all children aged between 10 and 14 are offered the BCG vaccination.

But experts now believe the jab is pointless for most children, who are at very low risk of the disease anyway.

Chief Medical Officer Sir Liam Donaldson said the BCG jab would be reserved for youngsters from high risk groups whose parents were born abroad.

Scrapped

The new programme will be introduced from September this year.

The World Health Organization estimates one person is infected with TB every second. It kills two million people annually, mainly in poorer nations.

Although cases of TB have grown in recent years in the UK, these have mainly been concentrated in immigrant groups and the homeless.

It is appropriate to concentrate resources where they are most needed
Dr John Moore-Gillon, chair of the British Thoracic Society joint TB committee and president of the British Lung Foundation

In England, there were more than 6,000 people diagnosed with the disease in 2002 - up 25% over the last decade.

There are also around 350 deaths from TB each year in England.

But TB rates in the white population have been falling, and evidence suggests that schoolchildren are at lowest risk.

Financial saving

Experts believe if you are not in one of the high risk groups, your chances of getting TB are one in 100,000.

The BCG vaccine is thought to offer protection for around 15 years.

However, it is not effective for everyone. In the UK, only around two thirds of those who receive the vaccination are believed to be protected. Some trials have suggested protection could be as low as 30%.

Therefore, for every 5,000 children vaccinated, one case of TB would be prevented over the following 15 years.

HIGH RISK GROUPS WHO WILL BE OFFERED BCG
All babies living in areas where the incidence of TB is 40/100,000 or greater
Babies whose parents or grandparents have lived in a country with a TB prevalence of 40/100,000 or higher
Unvaccinated new immigrants from countries with a high TB prevalence

Experts say that is hugely cost-ineffective.

The British Thoracic Society said it supported the decision to stop the school BCG programme.

Dr John Moore-Gillon, chair of the British Thoracic Society joint TB committee and president of the British Lung Foundation, said: "We understand the rationale behind the government's decision to stop the universal BCG vaccination programme.

"It is appropriate to concentrate resources where they are most needed - shifting the focus to areas where TB is particularly prevalent such as in London and other major inner cities, and to population groups at particularly high risk of TB."

But Dr Moore-Gillon said a selective vaccination programme would need to be properly resourced so that those in high risk groups and areas continued to be protected from the disease.

"It is vital that every single penny of the funds freed up from abolition of universal BCG vaccination is diverted directly into other aspects of TB control, such as our network of TB nurses.

"We would be very concerned if it just became lost in the general public health budget," he said.

Sir Liam Donaldson said: "The changes that we are implementing mean that we will target those children who are most likely to catch the disease earlier than they would have been identified through the schools programme."

The Department of Health said the changes were not about cutting costs, but were better attuned to the current patterns of TB.

It also said that parents could still ask for their child to be vaccinated even if they did not fit the criteria for receiving the jab.

Conservative health spokesman Andrew Murrison warned that a postcode approach to vaccination was fraught with difficulty, given movement of people and the difficulty of identifying at-risk groups within otherwise low-risk populations.


BBC NEWS: VIDEO AND AUDIO
Alarming rise of TB in England



SEE ALSO:
Tuberculosis
08 Feb 03 |  Medical notes


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