A public consultation on proposed changes to the BCG vaccination begins today.
HIQA has said it is examining the clinical and cost effectiveness of changes as well as looking at organisational and ethical issues.
It is looking at whether the vaccination is still beneficial for all given the low number of cases of TB.
The plans would see the number of infants getting the vaccination fall from around 61,000 to 8,000 per year, as only those most at risk would get the shot.
The public consultation will last until October 21.
HIQA Director of Health Technology Assessments, Dr Mairin Ryan, said the risk of acquiring TB has fallen.
"The incidents of TB has fallen substantially over the last number of years. Therefore the risk of acquiring TB infection has also fallen," she said.
"Now we're at a point where it males sense to switch from universal vaccination of all children to selected vaccination of just those who are at higher risk of acquiring TB infection."
She added the highest risk populations were infants born to parents where there is a high risk of TB, which she said included most of the developing world, and Traveller children.