Infants born in Australia to mothers from countries with a high prevalence of tuberculosis: to BCG or not to BCG?

To the Editor: Gwee and colleagues recently reported a lack of parental knowledge of the potential need for BCG vaccination of Australian-born infants before overseas travel to tuberculosis (TB)-endemic countries.1 We believe this study highlights the need to examine BCG program delivery across Australia but does not, as they suggest, provide data on which to recommend BCG vaccination for all infants born to mothers from high-TB-prevalence countries. Policy regarding BCG use should be informed by a better understanding of TB epidemiology and disease acquisition in young Australian children and the benefits and risks of vaccination. Only limited data on mode of disease acquisition in children are available from small case series.2