摘要：Background: bacille Calmette-Guérin (BCG)immunisation programs in Australia are funded andoperated by the individual states and territories. Inrecent years BCG vaccine shortages have requireduse of unregistered products. We aimed to evaluateBCG immunisation programs in Australia, withparticular reference to program implementationand national consistency.Methods: Between September and November2015, 12 key stakeholders, representing Australianstates and territories, completed surveys. Weanalysed BCG vaccination coverage data fromthe Australian Childhood Immunisation Register(ACIR), and data on adverse events followingimmunisation (AEFI) with BCG vaccine from theTherapeutic Goods Administration’s Adverse DrugReactions System, for 2001 to 2014.Results: Access to BCG vaccination variesbetween jurisdictions, with some states providingthis only in major city locations. Analysis of ACIRdata suggests significant differences in vaccinedelivery between jurisdictions, but varying levelsof under-reporting to the ACIR were alsoacknowledged. The rate of BCG AEFI appearedto increase between 2011 and 2014; however,these data need to be interpreted with cautiondue to small numbers, likely under-reporting ofboth numerator (AEFI) and denominator (vaccinedoses administered), and the general increasein reporting of AEFI related to other vaccines inchildren over this period.Conclusions: BCG immunisation programs aim toprevent severe forms of tuberculosis in young childrenwho live in or travel to high burden settings.A range of factors, particularly inconsistent vaccinesupply are leading to low, variable and inequitablevaccine delivery across Australian jurisdictions.Improved BCG vaccination uptake and AEFI dataquality are required for accurate monitoring ofprogram delivery and vaccine safety – this is particularlyimportant given the current need to useunregistered vaccines. Improved and consistentaccess to BCG vaccine is suggested to optimiseequity for at-risk children Australia-wide.
