European policies on tuberculosis prevention in healthcare workers: Which role for BCG? A systematic review

Publié le 18 octobre 2017 • Catégorie(s) : En accès libre, Vaccination • Mot(s) clef(s) : tuberculose

Auteur    Marco Bo
Auteur    Carla Maria Zotti
Volume    12
Numéro    11
Pages    2753-2764
Publication    Human Vaccines & Immunotherapeutics
ISSN    2164-554X
Date    Nov 2016
Résumé    National recommendations regarding the immunization of healthcare workers (HCWs) against tuberculosis differ throughout Europe. We searched multiple sources to identify legal acts, guidelines or papers addressing European national policies on BCG immunization for HCWs. For each policy, we reviewed the criteria used to recommend immunization, their level of evidence, the evidence supporting them and the actions required in cases of refusal. Four legal acts, 15 policies and 6 papers from 14 European countries met the inclusion criteria. Among European national agencies, 5 only recommend the immunization of HCWs employed in high-risk sectors, highlighting the lack of evidence of Bacillus Calmette-Guerin (BCG) efficacy in HCWs; 5 recommend BCG vaccination for all previously unvaccinated Mantoux-negative HCWs, underlining that some studies provide arguments of some BCG efficacy in HCWs; and four do not recommend the vaccine. Different interpretations of existing evidence on BCG efficacy and the demographics of HCWs may have influenced national policies.