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    BCG--anti-tuberculosis vaccine.

    Fajardo I; Koch-Weser D

    Chronicles. 1983 Jun; 3(1):11-4.

    Analyzes the anti-tuberculosis (BCG) vaccine controversy. The vaccine was highly controversial at the beginning due to difficulties in standardization, maintenance of efficacy, and in the methods of applying the vaccine. Nevertheless, BCG gained increasing acceptance and is used widely in France, Germany, Norway, Sweden and Japan. It is also 1 of the vaccines regularly employed in the worldwide immunization campaign of the World Health Organization. A number of well controlled prospective studies have been done in the last 50 years in several countries to determine the efficacy of BCG. The studies give contradictory results which may prove that under certain conditions, BCG has a clear protective effect against infection from human virulent tubercle bacilli. The 1982 evaluation after 10 years showed a 45% protective efficacy. On the basis of an extended review of BCG vaccination, it is recommended that the use of BCG be continued. However, there are situations where the effectiveness of BCG cannot be predicted with certainty, and it is recommended that every effort be made to identify local factors that may modify the outcome of BCG vaccination. The worldwide tuberculosis problem presents differing patterns in different countries, making a single recommendation for all situations unwise. The BCG program chosen should be based on the epidemiological situation in each country. The authors conclude that BCG vaccination, together with chemoprophylaxis and chemotherapy, can play an important role in controlling tuberculosis, which still constitutes 1 of the major world health problems. (summaries in SPA, POR, ARA)
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