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Region TB Incidence (per 100 000 per year) † TB Incidence (Count) ‡ Income group (World Bank) name id groupID Current BCG vaccination? BCG Recommendation Type Timing of 1st BCG? Multiple BCG? Multiple BCG in the past? BCG Strain Is TST done post BCG? Year of BCG coverage estimate BCG coverage (%) Year of changes to BCG schedule Details of changes Are there special groups that receive BCG? Is TST administered pre-BCG vaccination? Location of Administration of BCG Vaccine BCG Supply Company Were there shortages/stockouts of the vaccine? Is the BCG vaccination policy regularly assessed? Process of Assessment (if not regular) BCG Policy Link Is BCG Vaccination Recommended For HIV-Positive Babies? Datasource updated_in color Which year was vaccination introduced? Timing of old BCG #2 Timing of old BCG #3 Year booster BCG stopped Timing of BCG #2 Year BCG stopped? Details on special/high risk groups Why was the policy discontinued? (if applicable) What was the process of discontinuation? (if applicable) Additional Comments BCG Manufacturer How long has this BCG vaccine strain been used? Details of shortages/stockouts How often is the policy assessed? Timing of BCG #3
Latin America & Caribbean 12 13 High income Aruba AW
South Asia 189 61000 Low income Afghanistan AF Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth (up to 1 year of age) - First month of life No No Danish Statens Serum Institute 1331 No 2015 46% None None No No Left upper arm Green Signal Bio Pharma Ltd. Yes No BCG policy is reassessed when all epidemiological policies are reassessed. In Pashto: http://moph.gov.af/Content/Media/Documents/NationalTBGuideline309201291046938553325325.pdf No Questionnaire 2017 #7FCDBB
Sub-Saharan Africa 370 93000 Upper middle income Angola AO Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No No Serum Institute of India No 2007 90% None None No Questionnaire 2011 #7FCDBB 1979
21 3 Anguilla AI
Europe & Central Asia 19 550 Upper middle income Albania AL Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Europe & Central Asia 7 5 High income Andorra AD Past national BCG vaccination policy for all No Past national BCG vaccination policy for all Published data 2011 #C51B8A
Middle East & North Africa 2 140 High income United Arab Emirates AE Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Latin America & Caribbean 25 11000 Upper middle income Argentina AR Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No Yes Anlis Malbran No 2007 95% 1995 & 2007 1995: Ceased revaccination at 16 yrs, 2007: Ceased revaccintion at 6 yrs. No Questionnaire 2011 #7FCDBB Unknown 6 yrs 16 yrs 1995 & 2007
Europe & Central Asia 41 1200 Lower middle income Armenia AM Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Yes No Sofia, Bulgaria/ InterVac Ltd Toronto Canada No 2007 94% 2002 Approval of National BCG Calendar No Questionnaire 2011 #7FCDBB 1998 7 yrs, if no scar
East Asia & Pacific 8 5 Upper middle income American Samoa AS
Latin America & Caribbean 8 7 High income Antigua and Barbuda AG
East Asia & Pacific 6 1400 High income Australia AU Past national BCG vaccination policy for all No Past national BCG vaccination policy for all After infancy: School age No No 1980s Moved to selective vaccination of at risk groups Yes Questionnaire 2011 #C51B8A 1950s mid 1980s Aboriginal neonates, in high TB incidence, neonates born to families with leprosy and children and HCWs at high risk
Europe & Central Asia 8 650 High income Austria AT Past national BCG vaccination policy for all No Past national BCG vaccination policy for all At birth (up to 1 year of age) Yes Yes 1989 Almost 100% 1952, Dec. 31, 1989 1952: National mass vaccination BCG policy implemented; 1989/1990: Mass vaccination discontinued Yes No Right or left upper arm No No Questionnaire 2017 #C51B8A 1952 10 years 1990 High-risk groups (1 vaccination) Low TB incidence and partly due to severe side effects of the vaccination Expert panel Because of the high incidence of TB in Austria, BCG vaccination of all newborns was implemented in 1952. In the following decades, TB-incidence declined to few cases annually. During the last few years the BCG policy was in effect, several cases of side effects occurred, partly severe. So, the expert panel decided to stop the BCG vaccination programme as of December 31, 1989.
Europe & Central Asia 69 6800 Upper middle income Azerbaijan AZ Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all After birth, within 1 yr: 4-7 days Published data 2011 #7FCDBB
Sub-Saharan Africa 122 14000 Low income Burundi BI Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Europe & Central Asia 9 1100 High income Belgium BE BCG recommendation only for specific groups or none at all No BCG recommendation only for specific groups or none at all Mostly Pasteur Institute, Paris; also Statens Serum Institute Yes 1989, 1995, 2013 1989: Stopped vaccinations for healthcare or other at-risk workers, medical/nursing students; 1995: Targeted population reduced to TST negative persons, mostly children of parents from high-risk countries; 2013: BCG vaccine considered optional to 1. children of parents from high-risk countries < age of 5 2. persons working in healthcare 3. healthcare workers in contact with multi-drug resistant TB patients Yes Yes Upper arm RIVM (Netherlands), Merieux Institute (France), Sanofi Pasteur (France), and Statens Serum Institute (Denmark) Yes Yes No Questionnaire 2017 #17a308 Children and health care workers in prolonged exposure settings or at high risk RIVM (Netherlands), Merieux Institute (France), Sanofi Pasteur (France), and Statens Serum Institute (Denmark) 67 years (with Pasteur Institute Strain produced in Belgium) Post 1989, after national production was stopped, BCG was no more available on the market in Belgium and had to be imported. Due to shortages in manufacturers, BCG could not be imported from 2015-16. Currently, it is impossible to administer the BCG vaccine in Belgium. Every 10 years
Sub-Saharan Africa 60 6600 Low income Benin BJ Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
1 Bonaire, Saint Eustatius and Saba
Sub-Saharan Africa 52 9400 Low income Burkina Faso BF Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
South Asia 225 362000 Lower middle income Bangladesh BD Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth (up to 1 year of age) No No Serum Institute of India No 2015 99% None None No No Left upper arm Serum Institute of India No No BCG policy is reassessed by the monitoring system of the EPI program. http://nimc.portal.gov.bd/sites/default/files/files/nimc.portal.gov.bd/page/6c53bd88_ad69_4ccf_bbae_d45b70dbc0bf/005%20National%20Immunization%20Policy%20Bangladesh%202013.pdf Questionnaire 2017 #7FCDBB 1979 Serum Institute of India Since 1979 (38 years)
Europe & Central Asia 24 1700 Upper middle income Bulgaria BG Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No Yes Sl222 Sofia (BCG) BulBio-NCIPD Yes 2006 98% None None No Questionnaire 2011 #7FCDBB 1951 7 months 7, 11 & 17 yrs
Middle East & North Africa 18 250 High income Bahrain BH
Latin America & Caribbean 18 71 High income Bahamas, The BS
Europe & Central Asia 37 1400 Upper middle income Bosnia and Herzegovina BA Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No Yes Pasteur's Institute Paris No 2008 97% 1996 Revaccination ceased, now only vaccinated at birth. No Yes Questionnaire 2011 #7FCDBB 1950 3 yrs 5, 7, 13 & 19 yrs 1996
Europe & Central Asia 55 5200 Upper middle income Belarus BY Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth (up to 1 year of age) No Yes Danish Yes 2015 98% 2016 Stopped revaccinations No No Left upper arm Mikrogen Russia No Yes http://www.rnpcpf.by/ru/organizacionno-metodicheskaya-rabota/normativno-pravovye-akty-po-slujbe.html?download=33%3A23.05.2012-622 No Questionnaire 2017 #7FCDBB 6 years 12 years 2016 Mikrogen Russia Every 5 years
Latin America & Caribbean 25 90 Upper middle income Belize BZ Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
North America High income Bermuda BM
Latin America & Caribbean 117 13000 Lower middle income Bolivia BO Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Latin America & Caribbean 41 84000 Upper middle income Brazil BR Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth (up to 1 year of age) - Between birth and 1 month of age No Yes BCG Moreau - Rio de Janeiro No 2016 86.90% 1927, 1968, 1994, 2006 1927: Began oral vaccines; 1968: Replaced oral vaccine with intra-dermal vaccines; 1994: Began revaccinations at 6 years of age; 2006: Stopped revaccinations Yes; According to 2011 data, No No Right upper arm Funda Yes No Ad hoc http://bvsms.saude.gov.br/bvs/publicacoes/manual_procedimentos_vacinacao.pdf [Portuguese] BCG information on pages 69 to 73 No Questionnaire 2017 #7FCDBB 1976 One revaccination between 6 years to adolescence 2006 Hansen's disease patients (receive one extra dose of BCG vaccine; interval of one month between the two doses) BCG vaccination for all children between birth to the first month of life. A second dose is given to those with Hansen's disease/leprosy. BCG is contraindicated in children with HIV, but not in children who have been exposed to HIV at birth, as there is no confirmation of infection. Vaccine coverage is assessed every 4 months and the National Immunization Program recommends that municipalities with low adopt measures to achieve adequate coverage. Funda 49 years In 2015, there were partial shortages in the months of January, March, April, May and September, and a total shortage in February. In 2016, there were partial shortages in June, July, Novermber, and December and a total shortage in August.
Latin America & Caribbean High income Barbados BB Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all After infancy: 5-6 yrs old Published data 2011 #7FCDBB
East Asia & Pacific 58 240 High income Brunei Darussalam BN
South Asia 155 1200 Lower middle income Bhutan BT Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth (up to 1 year of age) No Yes Japan BCG Laboratory Yes 2015 95% 2009 2009: Stopped revaccinations No No Right, left upper arm Japan No Yes Yes Questionnaire 2017 #7FCDBB 1979 2009 Tha vaccine is a live-freeze dried vaccine made from an attenuated strain of Mycobacterium bovis given in 0.05 mL doses. Japan BCG Laboratory Every 5-10 years; Epidemiological coverage survey is conducted to find out BCG coverage using WHO 30 cluster surveys
Sub-Saharan Africa 356 8000 Upper middle income Botswana BW Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Sub-Saharan Africa 391 19000 Low income Central African Republic CF Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
North America 5 1800 High income Canada CA BCG recommendation only for specific groups or none at all No BCG recommendation only for specific groups or none at all After birth, within 1 yr No 2011 data: No Tokyo 172 No 2011 data: 1960s-1970s 2011 data: Discontinuation of routine BCG vaccination in many provinces/territories Yes Yes Upper arm Japan BCG Laboratory Yes Yes https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-2-bacille-calmette-guerin-vaccine.html No Questionnaire 2017 #17a308 2011 data: 1933-1954 in some provinces/territories 2011 data: 1960s-70s except for Inuit and many on-reserve First Nations infants Infants residing among groups of persons in First Nations and Inuit communities or infants residing in populations with an annual risk of TB infection greater than 0.1%. Healthcare workers, laboratory workers, prison workers, those working in homeless shelters, etc. at high risk. The information provided in the questionnaire is from the Canadian Immunization Guide, which is published by the Public Health Agency of Canada. The implementation of BCG vaccine policies are the responsibility of the individual provinces and territories in Canada. Therefore, the specific policies implemented in an individual province or territory may vary from the guidance provided in the Canadian Immunization Guide. Japan BCG Laboratory Supply shortage of approximately 6 months was experienced in 2012 after Sanofi Pasteur ceased production. Canada contracted for supply with the Japan BCG Laboratory in August 2012 and no supply disruptions have been experienced since that time. Every 4 years
Europe & Central Asia 7 610 High income Switzerland CH Past national BCG vaccination policy for all No Past national BCG vaccination policy for all At birth (up to 1 year of age) No No Merieux Yes 1960s, 1970s, 1987, 1996 1960s: BCG vaccination for tuberculin-negative persons above the age of 12; newborns and infants only in 'high-risk' groups (ex. with TB cases in the family; 1970s: Revaccinations of BCG vaccine for tuberculin-negative children at age 10-12; 1987: Discontinued mass BCG vaccination; 1996: BCG vaccination only for specific groups Yes Yes Left upper arm Yes Yes http://www.tbinfo.ch/de/publikationen/handbuch-tuberkulose.html; https://www.bag.admin.ch/bag/fr/home/themen/mensch-gesundheit/uebertragbare-krankheiten/impfungen-prophylaxe/informationen-rund-ums-impfen/schweizerischer-impfplan.html No Questionnaire 2017 #C51B8A 1960s 1987 Infants at increased risk of exposure Combination of low BCG effectiveness, low number of disseminated cases and/or fatalities that could be prevented, and risk of BCG-it is Discussion among Public Health experts in TB, pulmonologists, and pediatricians Stockouts are on and off; latest stockout is since November 2016 Every 3-5 years (when TB guidelines are updated)
Latin America & Caribbean 16 3000 High income Chile CL Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth (up to 1 year of age) - Between Day 1 and day of discharge No Yes Statens Serum Institute No 2014 97.80% 2005 Stopped revaccinations No No Left upper arm PAHO (Fondo rotatorio de OPS) Yes No Ad hoc No Questionnaire 2017 #7FCDBB Between 1947 and 1949 6 years 12 years 2005 Serum Institute of India Ltd There was a shortage for a brief period during the end of 2015.
East Asia & Pacific 67 918000 Upper middle income China CN Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No Yes No Questionnaire 2011 #7FCDBB
Sub-Saharan Africa 159 36000 Lower middle income Cote d'Ivoire CI Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Sub-Saharan Africa 212 49000 Lower middle income Cameroon CM Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No No No No Yes Questionnaire 2011 #7FCDBB
Sub-Saharan Africa 324 250000 Low income Congo, Dem. Rep. CD Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Sub-Saharan Africa 379 18000 Lower middle income Congo, Rep. CG Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No No Serum Institute of India No 2008 90% None No Yes Questionnaire 2011 #7FCDBB
8 2 Cook Islands CK
Latin America & Caribbean 31 15000 Upper middle income Colombia CO Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No No Pasteur 1173 No 2000 80-90% None No No Questionnaire 2011 #7FCDBB 1960
Sub-Saharan Africa 35 270 Low income Comoros KM Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Sub-Saharan Africa 139 720 Lower middle income Cape Verde CV Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Latin America & Caribbean 11 530 Upper middle income Costa Rica CR Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Latin America & Caribbean 7 800 Upper middle income Cuba CU Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Latin America & Caribbean 4 6 High income Curacao
Latin America & Caribbean 13 8 High income Cayman Islands KY
Europe & Central Asia 6 72 High income Cyprus CY
Europe & Central Asia 5 550 High income Czech Republic CZ Past national BCG vaccination policy for all No Past national BCG vaccination policy for all At birth (up to 1 year of age) - Before 6 weeks of age No Yes Moreau No 2014 80% (of targeted) 1986-93, 1994, 2001, 2009, 2010, 2015 1986-93: Stopped universal BCG vaccination in 3 regions; 1994: Russian vaccine replaced by Behring Danish strain; 2001: Stopped vaccination of special groups (i.e. healthcare workers at risk); 2009: Stopped revaccinations; 2010: Changed from universal vaccination to selective vaccination upon request (voluntary); 2015: Danish SSI BCG replaced by Polish BCG, Biomed Lublin Yes No Left upper arm Polish BCG, Biomed Lublin Yes Yes https://www.zakonyprolidi.cz/cs/2006-537 No Questionnaire 2017 #C51B8A 1953 11 years 2009 2010 Infants at increased risk of TB 1. High reactogenity and low efficacy/effectiveness of the vaccine 2. Low TB incidence Lengthy process with discussions and debates between advocates and opponents of stopping universal vaccination Polish BCG, Biomed Lublin 2 years Due to the shortages and stock-outs of BCG SSI, CR had to switch to Polish BCG. Every year (along with assessment of vaccine coverage)
Europe & Central Asia 8 6500 High income Germany DE Past national BCG vaccination policy for all No Past national BCG vaccination policy for all At birth No No Kopenhagen 1331, Chiron-Behring, Germany Yes DK DK 1951 & 1975 Histories different for West and East Germany (East: 1951, revacc of TST neg at age 15years, also used different strains, more info in questionnaire...1975- move to vaccinate high risk kids only No Questionnaire 2011 #C51B8A 1961 1998
Middle East & North Africa 378 3400 Lower middle income Djibouti DJ Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Latin America & Caribbean 11 8 Upper middle income Dominica DM Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all After birth, within 1 yr: 3 months Published data 2011 #7FCDBB
Europe & Central Asia 6 340 High income Denmark DK Past national BCG vaccination policy for all No Past national BCG vaccination policy for all At birth (up to 1 year of age) No No Danish Statens Serum Institute No 1970 >80% 1927, 1946, 1980s, 1986, 1990 1927: BCG vaccine first introduced to Denmark; 1946: Mandatory universal vaccination; 1980s: Universal vaccination discontinuation begins; 1986: Last county in Denmark discontinues universal vaccination; 1990: BCG vaccination removed as official reccommendation for childhood vaccination Yes No Left upper arm Yes Yes N/A Questionnaire 2017 #C51B8A 1946 1986 Children travelling for long periods of time high TB burden countries, or living in Denmark in families with TB, or healthcare workers working specifically with TB patients (or in a TB lab) Cost benefit - the BCG vaccine would only prevent very few cases per year Cost benefit calculations 90 years (since 1927) ~ 5 years
Latin America & Caribbean 60 6300 Upper middle income Dominican Republic DO Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Middle East & North Africa 75 30000 Upper middle income Algeria DZ Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth or within 4 wks Published data 2011 #7FCDBB
Latin America & Caribbean 52 8400 Upper middle income Ecuador EC Past national BCG vaccination policy for all No Past national BCG vaccination policy for all Published data 2011 #C51B8A
Middle East & North Africa 15 13000 Lower middle income Egypt EG Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Sub-Saharan Africa 65 3400 Low income Eritrea ER Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Europe & Central Asia 12 5500 High income Spain ES Past national BCG vaccination policy for all No Past national BCG vaccination policy for all At birth No No Danesa (Danish) No 1991 1981 Systematic BCG vaccination ceased Yes No Questionnaire 2011 #C51B8A 1965 1981 Newborns in Basque contry (Pa
Europe & Central Asia 18 240 High income Estonia EE Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No Yes Danish No 2007 ~90% 2004 Ceased revaccination at 7 yrs No Questionnaire 2011 #7FCDBB Unknown 7 yrs 2003
Sub-Saharan Africa 192 191000 Low income Ethiopia ET Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth (up to 1 year of age) - <45 days No No Danish Statens Serum Institute No 2016 69% None None No No Right upper arm No UKN Yes Questionnaire 2017 #7FCDBB Early 1980s
Europe & Central Asia 6 310 High income Finland FI Past national BCG vaccination policy for all No Past national BCG vaccination policy for all At birth No Yes Danish Statens Serum Institute No 2006 98% 1971, 1978, 1990, 2002 & 2006 1971: Gothenburg BCG; 1978: Glaxo-Evans strain; 1990:TST and revaccintion of schoolchildren stopped 2002: Danish SSI, 2006: Ceased mass BCG vaccination, start target selected groups Yes Questionnaire 2011 #C51B8A 1941 schoolage (if TST negative) 1990 2006 kids of immigrant families (from high inc countries), kids living with relative with TB, kids in high inc coutries for prolongeed stay, kids whose families request BCG, older kids from high inc countries who have yet to start school.
East Asia & Pacific 51 450 Upper middle income Fiji FJ Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Yes Published data 2011 #7FCDBB 6 yrs
Europe & Central Asia 8 5300 High income France FR Past national BCG vaccination policy for all No Past national BCG vaccination policy for all At birth (up to 1 year of age) - Between Day 1 and day of discharge No Yes Statens Serum Institute No 2013 2004, 2006, 2007 2004: Stopped revaccinations of children and adults of certain professions; 2004: Routine tuberculin tests stopped; 2006: Multipuncture (Monovax) replaced by BCG ID (BCG SSI); 2007: Compulsory vaccination suspended and replaced by targeted vaccination of high-risk children Yes Yes Left upper arm Sanofi Pasteur Yes No Ad hoc http://social-sante.gouv.fr/IMG/pdf/Calendrier_vaccinal_2015.pdf No Questionnaire 2017 #C51B8A 1950 No defined ages - second dose recommended as long as TST is negative 2004 2007 1. Health and social professionals 2. Children at risk (mainly with a family history of TB and whose parents originate from a high incidence TB country The main reason was the decrease of TB incidence, with national levels below 10 cases/100,000 population since the beginning of 2000 1. Two main situational analyses done by French public health and academic institutions 2. Meetings between ethics committees 3. National meeting in November 2006 between institutions, stakeholders, partners, etc. concerned by BCG vaccination discussing pros and cons 4. Advisory committee (Conseil sup_rieur d'hygi The policy of immediate BCG vaccination is still under discussion. The policy might change to recommendation of BCG vaccination after one month of age later in 2017. Statens Serum Institute (curreng shortage causing temporary shift to Biomed Lublin on a provisional basis) 9 years Currently experiencing shortage of BCG SSI. Therefore, the vaccine has been temporarily replaced by BCG Biomed Lublin, Polish vaccine (Moreau strain)
Europe & Central Asia High income Faroe Islands FO
East Asia & Pacific 124 130 Lower middle income Micronesia, Fed. Sts. FM Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Sub-Saharan Africa 465 8000 Upper middle income Gabon GA Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Europe & Central Asia 10 6600 High income United Kingdom GB Past national BCG vaccination policy for all No Past national BCG vaccination policy for all After infancy: 12 or 13 yrs old No No Evans Medical/Medeva /Changed from Glaxo to Staten in 2005 No 2007/2004 75% 2005 2005: vaccination of adolescents stopped only babies from families at risk get BCG Yes Questionnaire 2011 #C51B8A 1953 2005 HCW dep on occupation, if TST - and No BCG history receive BCG
Europe & Central Asia 99 4000 Upper middle income Georgia GE Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all After birth, within 1 yr: 2-5 days Published data 2011 #7FCDBB
Sub-Saharan Africa 160 44000 Lower middle income Ghana GH Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Europe & Central Asia High income Gibraltar GI
Sub-Saharan Africa 177 22000 Low income Guinea GN Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Sub-Saharan Africa 174 3500 Low income Gambia, The GM Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No No Russian Strain Serum Institute India No 2006 99% None None No Questionnaire 2011 #7FCDBB 1979
Sub-Saharan Africa 373 6900 Low income Guinea-Bissau GW Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Sub-Saharan Africa 172 1500 Upper middle income Equatorial Guinea GQ Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Europe & Central Asia 5 490 High income Greece GR Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all After infancy: 6 yrs old Published data 2011 #7FCDBB
Latin America & Caribbean 5 6 Upper middle income Grenada GD
Europe & Central Asia 164 92 High income Greenland GL Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No No Danish SSI No 2006 97% 1990 & 1996 Discontinuation of BCG vaccination in 1990 and reintroduction in 1996 Questionnaire 2011 #7FCDBB 1955
Latin America & Caribbean 25 4200 Lower middle income Guatemala GT Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
East Asia & Pacific 51 87 High income Guam GU
Latin America & Caribbean 93 710 Upper middle income Guyana GY Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
East Asia & Pacific 71 5200 High income Hong Kong HK Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth (up to 1 year of age) - first day No Yes Currently Russian strain, previously Statens Serum Institute No 2015 99% 2000 2000: Stopped revaccinations No No Left upper arm Sofia, Bulgaria No stockout, but had to switch from SSI to Sofia because could not further the supply from SSI No Ad hoc http://www.fhs.gov.hk/english/health_info/child/14828.html No Questionnaire 2017 #7FCDBB 1952, 1960s 6-12 years 2000 Sofia, Bulgaria 1 year
Latin America & Caribbean 43 3500 Lower middle income Honduras HN Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Europe & Central Asia 13 560 High income Croatia HR Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth (up to 1 year of age) No Yes Moreau, Brazilian strain No 2015 98.60% 2004-05, 2005, 2014 2004-5: Stopped revaccinations at the age of 8; 2005: Stopped TST at age of 2; 2014: Stopped revaccinations at the age of 13 Yes No Left upper arm Medoka Yes Yes www.hzjz.hr No Questionnaire 2017 #7FCDBB 1948 8 years 13 years 2014 Laboratory healthcare workers The country is currently considering stopping universal BCG vaccination and changing to targeted BCG vaccination. BIOmed Lublin 2 years 1-2 months in 2015 Every 2 years
Latin America & Caribbean 194 21000 Low income Haiti HT Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all After birth, within 1 yr No No Intervax Bulgarie No 2007 70% None No No Questionnaire 2011 #7FCDBB
Europe & Central Asia 9 920 High income Hungary HU Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No No Danish, Statens Serum Institute No 100% None None No Questionnaire 2011 #7FCDBB 1953
East Asia & Pacific 395 1020000 Lower middle income Indonesia ID Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth (up to 1 year of age) - 0-2 months No No Pasteur Institute (Paris) No 2015 92.2%% None None No No Right upper arm No No A national TB expert gives assistance to Minister of Health if there is need for any change to the policy. http://pppl.depkes.go.id/_asset/_regulasi/92_PMK%20No.%2042%20ttg%20Penyelenggaraan%20Imunisasi.pdf No Questionnaire 2017 #7FCDBB 1999 Biofarma
Europe & Central Asia High income Isle of Man Past national BCG vaccination policy for all No Past national BCG vaccination policy for all Yes Questionnaire 2011 #C51B8A 1950s 2005 Infants with a parent or grandparent who have active TB or who were born in a country with high TB incidence
South Asia 217 2840000 Lower middle income India IN Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No No BCGVL Chennai strain, BCG laboratory Guindy, Chennai, India No 2006 99% 1948, 1949, 1951, 1978 & 1985 1948: BCG intro as pilot project, 1949: Immunization program in schools, 51-59 Mass immunization campaigns. 1978: extended program of immunization to be given at birth or within 1st mo, 1985: universal immunization program BCG vaccine policy continued as earlier No Questionnaire 2011 #7FCDBB 1948
Europe & Central Asia 7 340 High income Ireland IE Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No Yes Danish SSI 1331 No 2007 94% 1996 & 2001 1996: stopped boosters, 2002: changed from evans BCG copenhagen 1077 to Danish SSI 1331 No Questionnaire 2011 #7FCDBB 1950s 11-12 yrs 1996
Middle East & North Africa 16 13000 Upper middle income Iran, Islamic Rep. IR Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth (up to 1 year of age) No Yes Pasteur Institute 1173-P2 No 2016 99.50% 1947, 1984, 1999 1947: Local BCG vaccine production and usage in the country; 1984: Beginning of Expanded Program of Immunization (EPI) calling for routine BCG vaccination and revaccinations of BCG introduced; 1999: Revaccinations stopped No No Left upper arm No Yes UNK No Questionnaire 2017 #7FCDBB 1984 6 years 1999 Pasteur Institute of Iran 32 years 5 years
Middle East & North Africa 43 16000 Upper middle income Iraq IQ Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Europe & Central Asia 2 8 High income Iceland IS
Middle East & North Africa 4 320 High income Israel IL Past national BCG vaccination policy for all No Past national BCG vaccination policy for all At birth No No Unsure No 1982 >90% 1982 Ceasing routine newborn vaccination Yes No Questionnaire 2011 #C51B8A 1955 newborns and children with high risk for example, babies from families that immigrated from endemic countries
Europe & Central Asia 6 3500 High income Italy IT BCG recommendation only for specific groups or none at all No BCG recommendation only for specific groups or none at all 2011 data: At six years of age 2011 data: No 2011 data: Yes Yes 1970, 2001 1970: Compulsory BCG vaccination was introduced for selected groups of people; 2001: Selected groups of people requiring BCG vaccination was reduced; Stopped vaccination at 6 and 9 years of age (never systematically done) Yes Yes BCG is unavailable in the country for the past few years. This happened around a time when BCG vaccination was already an obsolete practice in Italy. No Ad hoc http://www.trovanorme.salute.gov.it/norme/dettaglioAtto?id=12113 No Questionnaire 2017 #17a308 2011 data: 1970 (not national, only provincial) 2011 data: 9 years 2011 data: 2001 (not national, only provincial) 1. PPD-negative infants and children under the age of 5 who are household or close contacts of a sputum-positive pulmonary TB case, if there is potent risk of transmission 2. PPD-negative healthcare workers, medical students, nursing students or anyone working in a health facility who have a high risk of exposure to multidrug-resistant cases or who cannot receive any prevantative treatment if PPD-conversion occurs due to clinical contraindications. BCG mass vaccination has never been performed in Italy, but, since the 1940s, vaccination campaigns were promoted in some areas of the country. No information about the type of vaccine and mode of administration are included in national policies. Theoretically, more than one type of vaccine can be used in different parts of the country. When the national health system was reformed in 2008 (legislative decree no. 81/2008), a number of previous policies were implicitly abrogated, including the one concerning BCG vaccination (2001), although this remains a matter of debate.
Latin America & Caribbean 5 130 Upper middle income Jamaica JM Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth or within 6 wks Published data 2011 #7FCDBB
Middle East & North Africa 7 530 Upper middle income Jordan JO Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all 1st contact(infants & school age) Published data 2011 #7FCDBB
East Asia & Pacific 17 21000 High income Japan JP Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all After birth, within 1 yr No Yes Tokyo 172, Japan BCG Laboratory No 2006 98.10% 1942, 1948, 1967, 1974 & 2005 1942: Introduced to primary school graduates, 1948: If TST is negative BCG is repeated every year from ages 0-18 yrs, 1967: Intradermal method was replaced with nulti-puncture method, 1974: Change age of first vaccination to within 4 yrs & Restrict revaccination to primary school and junior school entrants who are TST negative (age of 7 and 13, if negative of TST.). 2005: Restrict to those aged less than 6 months, without preceeding TST No Questionnaire 2011 #7FCDBB 1942-1951 6-13 yrs (every year if TST negative) 2003
Europe & Central Asia 89 16000 Upper middle income Kazakhstan KZ Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Yes Published data 2011 #7FCDBB 6 yrs 12 yrs
Sub-Saharan Africa 233 107000 Lower middle income Kenya KE Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No Statens Serum Institute No 80% No Questionnaire 2011 #7FCDBB
Europe & Central Asia 144 8500 Lower middle income Kyrgyz Republic KG Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
East Asia & Pacific 380 59000 Lower middle income Cambodia KH Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth (up to 1 year of age) - First day of birth No No No No No Left upper arm No Questionnaire 2017 #7FCDBB
East Asia & Pacific 551 620 Lower middle income Kiribati KI Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Latin America & Caribbean 5 3 High income St. Kitts and Nevis KN Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth or within 4 wks Published data 2011 #7FCDBB
East Asia & Pacific 80 40000 High income Korea, Rep. KR Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No Yes Danish No 2006 85% 2007 Revaccination ceased No Questionnaire 2011 #7FCDBB 1970s 8 yrs 2007
Europe & Central Asia Lower middle income Kosovo
Middle East & North Africa 22 860 High income Kuwait KW Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth (up to 1 year of age) - 3 months No Yes Tokyo 172 2005 Changed age of vaccination from 4 years to 3 months; Stopped revaccinations No Left upper arm Japan BCG Laboratory No Yes Questionnaire 2017 #7FCDBB 8 14 2005 Japan BCG Laboratory Every 5 years
East Asia & Pacific 182 12000 Lower middle income Lao PDR LA Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Middle East & North Africa 13 750 Upper middle income Lebanon LB BCG recommendation only for specific groups or none at all No BCG recommendation only for specific groups or none at all No Questionnaire 2011 #17a308
Sub-Saharan Africa 308 14000 Low income Liberia LR Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Middle East & North Africa 40 2500 Upper middle income Libya LY Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Latin America & Caribbean 9 16 Upper middle income St. Lucia LC Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all After birth, within 1 yr: 6 weeks Published data 2011 #7FCDBB
Europe & Central Asia High income Liechtenstein LI
South Asia 65 13000 Lower middle income Sri Lanka LK Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Sub-Saharan Africa 788 17000 Lower middle income Lesotho LS Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Europe & Central Asia 56 1600 High income Lithuania LT Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Europe & Central Asia 6 34 High income Luxembourg LU Past national BCG vaccination policy for all No Past national BCG vaccination policy for all Published data 2011 #C51B8A
Europe & Central Asia 41 800 High income Latvia LV Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth (up to 1 year of age) - Between 2-5 days No Yes BCG Moreau substrain No 2016 96.10% 1974, 1990s, 1991, 2005, 2010 1974: Stopped revaccinations at 12 years of age; 1990s: Stopped revaccinations at age of 7 and 14-15 years; 1991: Changed from Moscow strain to Merieux; 2005: Switched to Danish SSI strain; 2010: Age of BCG vaccine administration changed from 4-5 days to 2-5 days No No Left upper arm Local wholesaler Yes No https://likumi.lv/doc.php?id=11215 No Questionnaire 2017 #7FCDBB 1940s (Non-systematic vaccination began in the 1920s); According to 2011 data, 1962 7 years Between 12 and 15 years 1993 Biomed Lublin, Poland 2 years Shortage of SSI BCG vaccine in 2015 that lasted 4 months
East Asia & Pacific 72 430 High income Macao, China MO
Latin America & Caribbean High income St. Martin (french part)
Middle East & North Africa 107 37000 Lower middle income Morocco MA Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Europe & Central Asia High income Monaco MC
Europe & Central Asia 152 6200 Lower middle income Moldova MD Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all After birth, within 1 yr: 3-5 days Yes Published data 2011 #7FCDBB 6-7 yrs
Sub-Saharan Africa 236 57000 Low income Madagascar MG Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
South Asia 53 190 Upper middle income Maldives MV Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Latin America & Caribbean 21 27000 Upper middle income Mexico MX Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No Yes Danish RT-1331, Staten Serum Institute, Copenhague Yes 1994-2007 95% 1998, 2004-2005, 2005, 2007 1998: Revaccination ceased for school age children. 2004-2005: Mosku strain used. 2005: Tokyo strain 172 (Japan Institute) used by National Health Services because of different logistic problems to obtain Danish strain.2007: NTP deevelopped w No Yes Questionnaire 2011 #7FCDBB 1951 6 yrs (school age) 1998
East Asia & Pacific 344 180 Upper middle income Marshall Islands, Rep. MH Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth (up to 1 year of age) - Up to 11 months No No Freeze-dried Glutamate BCG Vaccine (Japan) No 2016 100% No changes No No Left upper arm UNICEF No No No known process No Questionnaire 2017 #7FCDBB 2004 Japan BCG Laboratory 10 years
Europe & Central Asia 13 270 Upper middle income Macedonia, FYR MK Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Yes Yes Toronto Canada No 2007 95.36% 2008 Revaccination at 14 yrs stopped No Questionnaire 2011 #7FCDBB 1950 14 yrs 7 yrs
Sub-Saharan Africa 57 10000 Low income Mali ML Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Middle East & North Africa 9 37 High income Malta MT Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all After infancy: School age Published data 2011 #7FCDBB
East Asia & Pacific 365 197000 Lower middle income Myanmar MM Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all After birth, within 1 yr: 6, 10, 14 weeks Published data 2011 #7FCDBB
Europe & Central Asia 21 130 Upper middle income Montenegro Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No Yes Pasteur Torlak Belgrade 1173P2 No 2005 >95% 1985, 1997, 2002 & 2005 Before 1985: boosters at 2, 7 and 14 if TST negative, 1985: boosters at 7 and 14 if TST negative, 1997: booster at 10 yr no TST, 2002 booster before 1 yr if no BCG scar 2005: 1 BCG at birth only or within 1 yr No Questionnaire 2011 #7FCDBB 1927 ( but not mass BCG) 10 yrs 2, 7 & 14 yrs 1997
East Asia & Pacific 428 13000 Lower middle income Mongolia MN Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No Yes 2007 SI India, 2003-2006 Intervax Toronto 1997-2003 Japan BCG 1992 France before 1992 Russia BCG No 2007 98.60% 1986, 1993, 2002 & 2006 1986: BCG at birth and ages 8 and 18 yrs, 1993: Changed revaccination age from 18 yrs to 15 yrs, 2002: Ceased revaccination at 15 yrs, 2006: Ceased revaccination at 8 yrs (now only at birth) No Questionnaire 2011 #7FCDBB 1948 8 yrs 15 &18 yrs 1974-2006
East Asia & Pacific 58 32 High income Northern Mariana Islands MP
Sub-Saharan Africa 551 154000 Low income Mozambique MZ Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Sub-Saharan Africa 107 4300 Lower middle income Mauritania MR Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Montserrat MS
Sub-Saharan Africa 22 280 Upper middle income Mauritius MU Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Sub-Saharan Africa 193 33000 Low income Malawi MW Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
East Asia & Pacific 89 27000 Upper middle income Malaysia MY Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Sub-Saharan Africa 489 12000 Upper middle income Namibia NA Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
East Asia & Pacific 24 64 High income New Caledonia NC
Sub-Saharan Africa 95 19000 Low income Niger NE Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Sub-Saharan Africa 322 586000 Lower middle income Nigeria NG Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Yes SSI No 2005 85% None No Questionnaire 2011 #7FCDBB 1991 5 yrs (but not yet incorporated into the immunization schedule
Latin America & Caribbean 51 3100 Lower middle income Nicaragua NI Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
8 Niue NU
Europe & Central Asia 6 980 High income Netherlands NL BCG recommendation only for specific groups or none at all No BCG recommendation only for specific groups or none at all Bulgarian strain No 1979, 2005, 2016 1979: Discontinuation of vaccination healthcare; 1979: Selective vaccination of children born in the Netherlands with one or both parents born in high-incidence countries; 2005: Selective vaccination limited to children born in the Netherlands with one or both parents born in a country with a WHO estimated TB incidence >50/100 000; 2016: Change from BCG SSI (Denmark) to BCG Bulbio (Intervax, Bulgaria); Yes No Left upper arm BCG Bulbio from Intervax No Yes No Questionnaire 2017 #17a308 1. BCG vaccination of children with one or both parents originating from TB high-incidence countries (>50/100,000) 2. Vaccination of immigrant or refugee children <12 years of age who have no sign of a BCG vaccination in the past (no scar) and with a negative tuberculin skin test 3. Long term travelers and expatriates to TB high-incidence countries BCG Bulbio from Intervax <1 year Every 10 years
Europe & Central Asia 6 330 High income Norway NO Past national BCG vaccination policy for all No Past national BCG vaccination policy for all At birth No No SSI DK No Unkown 2009 BCG Vaccination no longer part of National Vaccination program Yes No Questionnaire 2011 #C51B8A 2009 Newborns with parents from high prevalence countries & health professional students
South Asia 156 44000 Low income Nepal NP Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all After birth, within 1 yr No No DK No 2006 No Questionnaire 2011 #7FCDBB
East Asia & Pacific 113 12 High income Nauru NR
East Asia & Pacific 7 340 High income New Zealand NZ Past national BCG vaccination policy for all No Past national BCG vaccination policy for all At birth for high risk infants No No Danish 1331, Statens Serum Institute No 1948 & 1963 1948: BCG Immunisation was first introduced for 13 yr olds 1963-1990: Phased out vaccination Yes Questionnaire 2011 #C51B8A 1976 work in clinical capacity with known TB pts, work in mycobacteria lab, plan travel or work in healthcare in high incidemnce countries, are likely to be exposed to MDR-TB
Middle East & North Africa 8 380 High income Oman OM Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
South Asia 270 510000 Lower middle income Pakistan PK Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No No Japaneece strain, Japaneece BCG Lab, Japan No 2008 95% 2007 & 2008 2007:DANISH STRAIN 1331, STATENS SERUM INSTITUTE INTERRAX Ltd. TORONTO CANADA USED UP TO YEAR 2007, DANISH STRAIN 1331, STATENS SERUM INSTITUTE USED UP TO 2008, JAPANEECE STRAIN, JAPANEECE BCG LAB, JAPAN USED SINCE 2008 No Questionnaire 2011 #7FCDBB 1978
Latin America & Caribbean 50 2000 Upper middle income Panama PA Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Latin America & Caribbean 119 37000 Upper middle income Peru PE Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No No Danish, SSI No Unknown 80% No Yes Questionnaire 2011 #7FCDBB 1945
East Asia & Pacific 322 324000 Lower middle income Philippines PH Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Yes Published data 2011 #7FCDBB
East Asia & Pacific 76 16 Upper middle income Palau PW
East Asia & Pacific 432 33000 Lower middle income Papua New Guinea PG Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Europe & Central Asia 19 7200 High income Poland PL Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No Yes BCG SSI No (was done in past) 2006 93.70% 2005 2005: single BCG at birth only, ceased revaccination at 7 yrs, followed by TST and BCG if negative No Questionnaire 2011 #7FCDBB 1955 7 yrs 2005
Latin America & Caribbean 2 60 High income Puerto Rico PR
East Asia & Pacific 561 141000 Low income Korea, Dem. Rep. KP
Europe & Central Asia 23 2400 High income Portugal PT Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Latin America & Caribbean 41 2700 Upper middle income Paraguay PY Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Middle East & North Africa 1 51 Lower middle income West Bank and Gaza PS Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Questionnaire 2011 #7FCDBB
East Asia & Pacific 19 53 High income French Polynesia PF
Middle East & North Africa 34 760 High income Qatar QA Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Europe & Central Asia 84 16000 Upper middle income Romania RO Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No Yes Romanian BCG substrain Catacuzino Institute No 2007 >90% 1992-1993 Ceased revaccination No Questionnaire 2011 #7FCDBB 1928 7 yrs 14 & 18/21 yrs 1992-1993
Europe & Central Asia 80 115000 Upper middle income Russian Federation RU Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Yes Published data 2011 #7FCDBB 7-14 yrs
Sub-Saharan Africa 56 6600 Low income Rwanda RW Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No No Intervax Ltd Toronto No 2007 95% 1980 Policy changed from before 1 year to at birth No Questionnaire 2011 #7FCDBB 1956
Middle East & North Africa 12 3800 High income Saudi Arabia SA Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No No Pasteur-Japan No 2005 98% None No Questionnaire 2011 #7FCDBB 1968
Sub-Saharan Africa 88 35000 Lower middle income Sudan SD Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No No Danish No 2006 77% None Yes Questionnaire 2011 #7FCDBB 1976 some medical students in Universities (but not naional policy)
Sub-Saharan Africa 139 21000 Low income Senegal SN Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No No Pasteur Institute No 2016 85% None None Yes No Left upper arm No www.sante.gouv.sn Yes Questionnaire 2017 #7FCDBB 1986 Healthcare workers, medical students, military Vaccination is recommended at birth but, in practice, it is very difficult to administer the BCG vaccine in rural areas. 30 years (since 1986)
East Asia & Pacific 44 2500 High income Singapore SG Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No Yes Danish strain 1331, SSI No 2003 97% 2001 Revaccination ceased for school children (12-16 yrs old, TST non-reactors) No Questionnaire 2011 #7FCDBB mid 1950s 12 or 16 yrs 2001
East Asia & Pacific 89 520 Lower middle income Solomon Islands SB Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Sub-Saharan Africa 307 20000 Low income Sierra Leone SL Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No No Statens Serum Institute No 2007 90% None No No Questionnaire 2011 #7FCDBB 1990
Latin America & Caribbean 43 2700 Lower middle income El Salvador SV Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth (up to 1 year of age) No Pasteur Institute No 2016 85.40% No No Left upper arm Serum Institute of India Yes Yes No Questionnaire 2017 #7FCDBB 1970 BCG vaccine is contraindicated in children weighing less than 2500 grams, children of HIV positive mother, children who have their immunity compromised by congenital immunodeficiency, AIDS leukemis, lymphoma, immune response suppressed by steroids, antimetabolites or radiation. Serum Institute of India > 10 years 3 months in 2014 Every year
Europe & Central Asia 3 1 High income San Marino SM
Sub-Saharan Africa 274 30000 Low income Somalia SO Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Europe & Central Asia 21 1900 Upper middle income Serbia Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No Yes Pasteur Torlak Belgrade 1173P2 No 2005 >95% 1985, 1997, 2002 & 2005 Before 1985: boosters at 2, 7 and 14 if TST negative, 1985: boosters at 7 and 14 if TST negative, 1997: booster at 10 yr no TST, 2002 booster before 1 yr if no BCG scar 2005: 1 BCG at birth only or within 1 yr No Questionnaire 2011 #7FCDBB 1927 ( but not mass BCG) 10 yrs 2, 7 & 14 yrs 1997
Sub-Saharan Africa 146 18000 Low income South Sudan
Sub-Saharan Africa 97 180 Lower middle income Sao Tome and Principe ST Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Latin America & Caribbean 33 180 Upper middle income Suriname SR
Europe & Central Asia 7 350 High income Slovak Republic SK Past national BCG vaccination policy for all No Past national BCG vaccination policy for all At birth (up to one year of age) No Yes BB-NCIPD Ltd. Bulgaria Yes 2011 90% 1953, 1980, 1992, 2001, 2012 1953-80: Prague BCG; 1980-1992: Moscow vaccine lyophilized; 1992-2000: Behring 500; 2001: Stopped revaccinations; 2001-2004: Glaxo 1077 BCG vaccine aventis, SSI Copenhagen 1331 (2004); 2012: Mandatory neonatal BCG vaccination cancelled Yes No Left arm BB-NCIPD Ltd. Bulgaria Yes No No Questionnaire 2017 #C51B8A 1953 11 years; Accroding to 2011 data, 7 years According to 2011 data: 14 years 2001 2012 Healthcare workers, marginalized populations such as Roma community without access to water Incidence of TB was less than 10 per 100 000 Mission of WHO and European Centre for Disease Prevention and Control (ECDC) In January 2012, the government of Slovakia decided to stop mandatory BCG vaccinations in view of the low incidence and notification of TB in the country. Since then, there has been a major debate for and against this decision. This is of greater relevance in view of the increase in TB among children in specific subpopulations (particularly the Roma people). Statens Serum Institute 2 years SSI is not regularly supplied, switched to BB in 2015
Europe & Central Asia 7 150 High income Slovenia SI Past national BCG vaccination policy for all No Past national BCG vaccination policy for all After birth, within 1 yr No Yes Danish SSI No 1996 96% 1997 & 2005 1997: Ceased revaccination at 14 & 15 yrs. 2005: Stop nonselective BCG vaccination No Questionnaire 2011 #C51B8A 1947 14-15 yrs 1947-1996 2005
Europe & Central Asia 9 900 High income Sweden SE Past national BCG vaccination policy for all No Past national BCG vaccination policy for all After birth (up to 1 year of age) - 6 months No Yes Danish Statens Serum Institute No 2016 26.4% (98.1% of high-risk group) 1975, 1965, 1986 & 1993 1965: Stopped revaccinations at 7 years of age; 1975: General vaccination of newborns replaced by selective vaccination of at-risk groups; 1986: Stopped revaccinations at 15 years of age; 1979: Stopped boosters for military conscripts; 1975: Stopped mass mandatory vaccination and targeted only at-risk groups; 1993: Vaccination of at-risk groups postponed to 6 months after birth (however, infants with immediate risk of exposure are still vaccinated at birth) Yes Yes Left upper arm Japan BCG Laboratory Yes No As needed Only in Swedish: https://www.folkhalsomyndigheten.se/pagefiles/20439/rekommendationer-for-preventiva-insatser-mot-tuberkulos-halsokontroll-smittsparning-vaccination-2012-3-16.pdf No Questionnaire 2017 #C51B8A 1940 7 years 14-15 years 1986 1975 Healthcare workers and medical students when starting work/studies (once and only if negative TST) Low national incidence of TB Investigations showed that there was a higher risk of adverse events of the BCG vaccination than being infected with TB Danish Statens Serum Institute 2 years Statens Serum Institute was not able to deliver
Sub-Saharan Africa 565 7300 Lower middle income Swaziland SZ Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Latin America & Caribbean 6 2 High income Sint Maarten (Dutch part)
Sub-Saharan Africa 10 9 High income Seychelles SC Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Middle East & North Africa 20 3600 Lower middle income Syrian Arab Republic SY Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Latin America & Caribbean 7 2 High income Turks and Caicos Islands TC
Sub-Saharan Africa 152 21000 Low income Chad TD Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Sub-Saharan Africa 52 3800 Low income Togo TG Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
East Asia & Pacific 172 117000 Upper middle income Thailand TH Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No Yes Tokyo, Thai Red Cross No 2003 99% 1987 & 1991 1987: changed strain from Danish to Tokyo (same manufacturer), 1987-1991: 2 doses of BCG at birth, and 7 yrs (before and after they only used 1 bcg at birth No Questionnaire 2011 #7FCDBB 1977
Europe & Central Asia 87 7400 Lower middle income Tajikistan TJ Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth (up to 1 year of age) - By 3-5 days No Yes An attentuated strain - Micobacterium bovis Tokyo 172-1 substrain No 2015 98% 1992 1992: Stopped revaccinations No No Left upper arm UNICEF through Scan Global Logistic No No Ad hoc - If there is a change, it is due to WHO recommendation No Questionnaire 2011 data: Published data 2017 #7FCDBB 1992 Japan BCG Laboratory > 10 years
Europe & Central Asia 70 3800 Upper middle income Turkmenistan TM Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all After birth, within 1 yr: 3-5 days Yes Published data 2011 #7FCDBB 6-7 yrs 15 yrs
East Asia & Pacific 498 5900 Lower middle income Timor-Leste TL Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all After birth, within 1 yr Published data 2011 #7FCDBB
East Asia & Pacific 15 16 Lower middle income Tonga TO Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Latin America & Caribbean 17 230 High income Trinidad and Tobago TT
Middle East & North Africa 37 4200 Lower middle income Tunisia TN Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth (up to 1 year of age) No Yes Pasteur 1173 P2 Yes 2016 >95% 1928, Before 1996, 1996 1928: First BCG vaccination (oral route); Before 1996: Vaccination at birth, 1 revaccination at 12 years and another at 18 years; 1996: Only one revaccination at 6 years No Left upper arm Yes No Questionnaire 2017 #7FCDBB 12 years 18 years Pasteur Institute of Tunisia 60 years
Europe & Central Asia 18 14000 Upper middle income Turkey TR Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all After birth, within 1 yr No Yes Serum Institute of India No 2007 94% 1997 & 2006 1997: Ceased revaccination at ages 14 and 20. 2006: Ceased revaccination at age 7 No No Questionnaire 2011 #7FCDBB 1952 7 yrs 14 & 20 yrs 1997: stopped boosters at 14 & 20 yrs, 2006: stopped boosters at 7 yrs
East Asia & Pacific 232 23 Upper middle income Tuvalu TV
East Asia & Pacific High income Taiwan TW Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth (up to 1 year of age) - Between 5-8 months No Yes Tokyo 172 No 2014 98.40% 1953, 1958, 1965, 1979, 1997, 2016 1953: Strain shifted to Pasteur Institute; 1958: Strain shifted to new Pasteur strain; 1965: Vaccination of newborns and infants (previous vaccination target was school children with negative TST); 1979: BCG production using Tokyo 172 strain; 1997: Stopped revaccinations; 2016: Delay vaccination time to 5-8 months after bith or less than 1 year old No No Left upper arm Taiwan CDC and Japan Laboratory No No Ad hoc - Monitor vaccine coverage rate and adverse reactions closely and reassess http://www.cdc.gov.tw/english/list.aspx?treeid=E79C7A9E1E9B1CDF&nowtreeid=9ACA97F87D31282D No; According to 2011 data, Yes Questionnaire 2017 #7FCDBB 2011 data: 1951 12 years 24 years 1997 Japan BCG Laboratory 37 years
Sub-Saharan Africa 306 164000 Low income Tanzania TZ Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth (up to 1 year of age) - First day of birth preferably No No Statens Serum Institute No 2016 100% None None No No Left upper arm Statens Serum Institute No No The BCG policy is reassessed when the Immunization policy is reassessed. Not available online Yes Questionnaire 2017 #7FCDBB 1975 Statens Serum Institute
Sub-Saharan Africa 202 79000 Low income Uganda UG Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth (up to 1 year of age) No No Intervax Toronto, Canada No 2015 85% None None No No No Yes No Questionnaire 2017 #7FCDBB 1987 BCG vaccine is not recommended for infants with primary immunodeficiencies. Every 5 years
Europe & Central Asia 91 41000 Lower middle income Ukraine UA Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all After birth (up to 1 year of age) - Between 3-5 days of birth Yes Bulgaria National Center of Infectious and Parasitic Diseases Yes 2016 15-45%% 2015 2015: Second revaccination of vaccine was discontinued No Yes Left upper arm Canada Intervax Yes Yes No Questionnaire 2017 #7FCDBB > 40 years ago 7 yrs The policy of revaccination of the BCG vaccine at 7 years of age is currently under thorough revision and may be discontinued in the near future. Bulgaria Intervax 2 years Major stockout of the vaccine during 2015-16 Every 5 years
Latin America & Caribbean 30 1000 High income Uruguay UY Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No Yes Pasteur No 2007 99.90% 1993 & 2008 1993: Revaccination stopped for school age, 2008: National BCG production discontinued No Questionnaire 2011 #7FCDBB 1980 6-12 yrs 1980-1993
North America 3 10000 High income United States of America US BCG recommendation only for specific groups or none at all No BCG recommendation only for specific groups or none at all No No None None No Questionnaire 2011 #17a308
Europe & Central Asia 79 24000 Lower middle income mexico UZ Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Yes Yes BCG Serum Institute India Yes 2008 97.50% 1997 & 2009 1997: Ceased revaccination at 12, 15, 20, 25 & 30 yrs, and replaced with revaccination at 7 & 14 yrs. 2009: BCG strain changed, used to use BCG vaccine produced in Uzbekistan. No Yes Questionnaire 2011 #7FCDBB 1937 12 yrs 15 yrs, 20 yrs, 25 yrs & 30 yrs 1997 7 yrs 14 yrs
Latin America & Caribbean 7 8 Upper middle income St. Vincent and the Grenadines VC Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth or within 4 wks Published data 2011 #7FCDBB
Latin America & Caribbean 29 8900 Upper middle income Venezuela VE Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Latin America & Caribbean High income Virgin Islands (British) VG
Latin America & Caribbean 8 8 High income Virgin Islands (U.S.) VI
East Asia & Pacific 137 128000 Lower middle income Vietnam VN Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No No Pasteur Institute Ho Chi Minh City, Vietnam No 2007 93.70% None No No Questionnaire 2011 #7FCDBB 1985
East Asia & Pacific 63 170 Lower middle income Vanuatu VU Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Wallis and Futuna Islands WF
East Asia & Pacific 11 22 Lower middle income Samoa WS Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Middle East & North Africa 48 13000 Lower middle income Yemen, Rep. YE Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Sub-Saharan Africa 834 454000 Upper middle income South Africa ZA Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No Yes Danish 1331, Statens Serum Institute, Denmark No 2006 90.5% (98% for Western Cape) 2000 2000: stop Tokyo 1572 percutaneous, start Danish intradermal No Questionnaire 2011 #7FCDBB 1973
Sub-Saharan Africa 391 63000 Lower middle income Zambia ZM Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth No Yes No No Questionnaire 2011 #7FCDBB
Sub-Saharan Africa 242 38000 Low income Zimbabwe ZW Current national BCG vaccination policy for all Yes Current national BCG vaccination policy for all At birth Published data 2011 #7FCDBB
Mayotte YT
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