Selective Vaccination Strategy with BCG: Are We Identifying All Eligible Newborns?

Date of submission: 05-02-2021 | Date of acceptance: 03-05-2021 | Published: 03-10-2021

Abstract

Introduction: In Portugal, a selective BCG vaccination strategy was adopted in January 2017. The efficacy of this strategy relies on the precise identification of high-risk groups. We designed a study to evaluate the implementation of the Portuguese guideline on BCG vaccination in the area of our hospital.

Methods: Retrospective cohort study of a sample of children born in our hospital from January 2017 to June 2018. Data was collected through a telephone questionnaire.

Results: There were 233 children included in the study. Of them, 46 (19.7%) were eligible for BCG immunization, most (82.6%) because they had a parent, cohabitant or frequent contact from a high-risk country. Of these eligible children, 21 (45.7%) had not been identified and were therefore unvaccinated. From the total sample, there were 38 vaccinated children, of which 47.4% were referred during the first month of age (age range of 0-20 months).  

Discussion: We identified 45.7% of unreferred high-risk children, a quarter of which with risk factors not often enquired - close contacts with substance abuse or HIV infection. About half of the parents denied or didn´t recall being asked about the criteria in our maternity or in further routine health consultations.

Conclusions: The risk identification must be improved because a significant number of unreferred children was found. There is still a failure to reassess the risk in all routine visits and probably not all the risk criteria are excluded.