6 YEARS EXPERIENCE WITH THE DISCONTINUATION OF BCG VACCINATION .2. COST AND BENEFIT OF MASS BCG VACCINATION

In 1986 the compulsory mass BCG vaccination of infants born in a selec ted area of the Czech Republic was abolished. The observed annual risk of tuberculous infection in children aged 0-6 years was below 0.1% an d the annual risk of tuberculous disease 7/100 000. The increase of tu berculous cases among nonvaccinated children indicated a protective ef ficacy of BCG vaccine of 80%. A benefit analysis proved that the advan tages and disadvantages of BCG vaccination were in balance. The number of nonvaccinated children developing tuberculosis was so small that m ass application of BCG has been found to be redundant.The important ad vantage of not using the vaccination is the maintenance of the epidemi ological and diagnostic value of tuberculin tests. The tests in connec tion with preventive chemotherapy remain an important tool, enabling c ontrol of infected individuals.