No BCG vaccines for children since 2015 amid 'massive global shortage'

Doctor warns Ireland cannot take success in slashing TB infection rates for granted.

Children in Ireland have not received the BCG vaccine against tuberculosis since 2015, as a global shortage continues to impact decisions around vaccination.

Now, a clinic for TB contact tracing is opening in Limerick, as a senior doctor warns Ireland cannot take success in slashing infection rates for granted.

Consultant in public health medicine in the HSE Mid-West Dr Marie Casey said: “The BCG vaccine has not been available in Ireland since 2015. People often don’t realise this.” 

There is “a massive global shortage” of the vaccine, she said.

“Before the pandemic, there were shortages and it was being prioritised for countries with a high burden of disease so Ireland tapered off for a while to see what would happen with supply,” she said.

“Since then it has been referred to Niac [National Immunisation Advisory Committee], who are reviewing it again and looking at whether we need to reinstitute the BCG vaccine or what groups should be vaccinated.” 

She said prior to the pandemic, there was a review of the epidemiology in Ireland but the process was interrupted and was not completed.

The HSE cannot recommence this without instruction from the Department of Health, she said.

“In some countries they only vaccinate high-risk populations,” Dr Casey said, including across the UK. “The shortage is a major global issue really.” 

The Mid-West saw 21 TB cases last year and over 200 since 2012.

The Mid-West MyContact Clinic, a collaboration between Public Health Mid-West and St John’s Hospital, will operate twice weekly.

“The main focus we have now is to keep the numbers low here,” Dr Casey said. “Globally TB is still very much an issue. You have one in four people in the world infected with TB.” 

The World Health Organisation said 1.6m people died from TB in 2021, the second most deadly infectious disease after covid-19.

“We work really actively in Ireland to suppress it, and we’ve had success in that. But you can’t take that for granted," said Dr Casey, adding early treatment and contact tracing helped reduce case numbers and deaths.

“We have just moved our contract tracing clinic into St John’s,” she said. “That’s where we undertake the contact tracing, the screening of contacts and treatment of them if required. The cases of TB will be managed in Nenagh, UHL and hospitals in the group.” 

This preventative service also covers people with latent TB when someone is infected but neither symptomatic nor infectious.

TB has a tragic history in Ireland, with CSO data showing 6,471 people died from this in 1916.

Also known as the white plague or consumption, TB, which can cause bloody sputum, is believed to have influenced vampire folklore.

March 24 is World TB Day.

Update: On Tuesday, March 21, the HSE published on update on progress around use of the BCG vaccine, following guidance from the chief medical officer Professor Breda Smyth.

“Under the auspices of the National TB Advisory Committee the HSE is now forming a group of experts to consider the NIAC guidance and produce a plan to implement a selective BCG vaccination programme, in a safe and timely manner,” a spokeswoman said.

She added: “The absence of BCG in Ireland since 2015 has not led to an increase in TB cases in young children, and the overall incidence of TB continues to decline.” Last year there were 222 cases nationally.