The effect of a policy of non-vaccination of schoolchildren on the incidence of tuberculosis in Oxfordshire

Abstract

We examined the effect of the decision in 1981 in Oxfordshire to cease routine vaccination of schoolchildren for tuberculosis. All notifications, laboratory and death certificate reports of tuberculosis between 1973 and 1989 were reviewed. Results showed that the incidence of tuberculosis in Oxfordshire continued to decline with an annual 5 per cent decrease. The incidence increased with age from a mean annual rate of 6.18 per 100,000 at age 0-10 to 19.90 per 100,000 at age 71-80. There was a higher incidence in the Asian population, with a mean annual rate of 79.6 per 100,000 compared with 7.35 per 100,000 in non-Asians. Four cases had occurred since 1981 in children who had not been immunized routinely at school. All four children had other risk factors in addition to not receiving BCG vaccine. We did not find a need to resume the routine vaccination programme. However, the findings demonstrated the need to be effective in contract-tracing and in vaccinating those most at risk.