TB Vaccine: Pro & Con

The question of whether vaccination against tuberculosis should be extended in the U.S., long moot because of doctors' skepticism about the vaccine, is up for searching reexamination. Columbia University's Dr. H. McLeod Riggins declares that the U.S. has failed to put into full use "a scientifically proved vaccine" against TB because of "a false sense of security." Reason: the dramatic drop (of 76%) in the TB death rate since "wonder drugs" were found to treat the disease after 1945.

"Too many physicians," says Dr. Riggins, "overlook the fact that almost as many new TB cases (about 100,000 a year) are now being reported as before the wonder-drug age. To hasten the elimination of tuberculosis, we need to vaccinate infants, children and certain young adults in areas of high incidence as well as those individuals who are unavoidably exposed [i.e., doctors and nurses]."

The Drawbacks. A second strong plea for the vaccine is.made in BCG Vaccination Against Tuberculosis (Little, Brown; $7.50) by the University of Illinois' Dr. Sol Rosenthal. With the help of the Pasteur Institute's famed bacteriologist Dr. Camille Guerin, 84, TB Fighter Rosenthal records the disappointments attending early efforts to perfect a TB vaccine, then the surprising success of France's late Dr. Albert Calmette, with Guerin collaborating, in attenuating a strain of tubercle bacilli taken from human patients by growing them in cattle. The trouble was that the vaccine, now universally known as BCG (for Bacillus of Calmette and Guerin), got a bad name early. The first enthusiasts made exaggerated claims for it, and in the late 1920s, virulent tubercle bacilli were accidentally substituted for BCG in Luebeck, Germany, and 72 children died.

U.S. objections to BCG are based on doubts of its safety and effectiveness, plus the complaint that it invalidates the tuberculin skin test.* Dr. Carroll Palmer of the U.S. Public Health Service found that among 50,000 young people in Puerto Rico, the vaccine cut TB by only 33%.

The Advantages. Advocates of BCG argue that even a small contribution toward reducing TB is worthwhile, point out that the vaccine was shown in Britain to be 80% effective in cutting down TB among exposed adolescents, a rate comparable to that of most other vaccines now in general use. They feel that the value of the tuberculin test has been exaggerated, that X rays and sputum tests are more important and more reliable. BCG vaccine is not perfectly standardized, but the University of Illinois' Research Foundation has pioneered a freeze-drying process by which the vaccine probably can be shipped anywhere and stored as long as four years (it used to deteriorate in ten days).

Around the world, more than 100 million people have been vaccinated with BCG and in most countries health authorities are satisfied that it has done much good--always in combination with other methods of TB control. In 1949 the U.S.'s National Tuberculosis Association urged a wide vaccination program, much the same as the one now advocated by Dr. Riggins, but little was done about it.

*In which the skin is scratched with a needle dipped in an extract from killed TB bacilli. A skin reaction indicates a past or present TB infection.

This file is automatically generated by a robot program, so reader's discretion is required.