BCG VACCINATION PRACTICES IN VICTORIA

To determine the patterns of usage of bacille Calmette-Guerin (BCG) va ccine in Victoria and assess whether the vaccine was being administere d to those in high-risk groups, as identified by the National Health a nd Medical Research Council, an audit of BCG vaccine unit sales and ex penditure, over the past four years was conducted. A postal survey cov ering all registered Victorian BCG vaccinators inquired about BCG vacc ination practices during 1993. Vaccine sales and expenditure had nearl y doubled since 1991. The number of registered vaccinators had also in creased. The survey response rate was 77 per cent, (228 of 295). Half of the vaccinators were working in general practice, 11 per cent of va ccinators used no set guideline for client selection, 69 per cent vacc inated fewer than 25 people in 1993, 26 per cent had vaccinated neonat es (mainly southeast Asian), with few of these vaccinations being carr ied out in maternity hospitals. Tertiary students and ethnic groups we re the most commonly vaccinated groups. Only small amounts of BCG were being given to people outside risk groups, mainly travellers and anxi ous public. There has been significant increase in numbers of register ed vaccinators and use of BCG with much wastage. Application of guidel ines was inconsistent and coverage of high-risk groups varied. Despite some selection for vaccination by personal choice, little vaccine app eared to be used in nonrecommended groups. Subsequent changes in pract ice have resulted, including publicising and clarifying guidelines, re duction in the number of vaccinators, vaccinator upgrading courses, an d restructuring of the vaccine ordering system.