BCG immunisation in England and Wales: a survey of policy and practice in schoolchildren and neonates.

OBJECTIVE To determine the policy and practice of district health authorities in England and Wales for BCG immunisation in schoolchildren and neonates. DESIGN Self completion postal questionnaire survey. PARTICIPANTS District immunisation coordinators. SETTING 199 district health authorities in England and Wales. RESULTS Questionnaires were received from 186 districts, a response rate of 94%. Considerable uniformity was observed in many aspects of BCG immunisation policy and practice but some important variations were found. 15 districts no longer carry out a routine schools programme. 148 districts offer BCG to selected groups of neonates and five to all neonates, but 31 districts do not offer BCG to this age group. The recommended action in response to different levels of tuberculin sensitivity in schoolchildren and neonates varied among districts. CONCLUSIONS Despite the recommendations of the Joint Committee on Vaccination and Immunisation some districts do not offer BCG immunisation to neonates at high risk of tuberculosis and there are important variations in other aspects of BCG policy.