IS BCG VACCINATION AGAINST TUBERCULOSIS STILL INDICATED

More than 70 years after the introduction of BCG vaccination into clin ical practice many questions remain to be answered. Major trials produ ced conflicting results regarding the degree of protection of this vac cine against tuberculosis. Several factors which may contribute to the inconsistent results of these trials, are discussed. In developing co untries continuation of routine BCG vaccination of infants is highly r ecommended considering the ease of administration, low cost, wide avai lability and safety on the one hand and the protection provided partic ularly against haematogenous spread of tuberculosis on the other hand. In developed countries the vaccine is reserved for high risk groups s ince the prevalence of tuberculosis in the general population declined dramatically during the past decades. However, as the incidence of tu berculosis in the Western world no longer decreases steeply and indeed increases again in some countries, and because (para-) medical person nel risks to be among the prime victims of this re-emergence of tuberc ulosis, rigorously sustained preventive measures to protect this profe ssional category deserve renewed interest. Among those, BCG vaccinatio n can be considered, especially in case of a high prevalence of multid rug-resistant tuberculosis, but also for the Belgian situation with a high degree of non-immune health care workers. Therefore, we believe t hat BCG vaccination still has a future.