Bacille Calmette-Guérin vaccination for the prevention of tuberculosis in health care workers.

For 60 years vaccination with bacille Calmette-Guérin (BCG) has been used for the prevention of tuberculosis in health care workers. In 1988 the U.S. Advisory Committee on Immunization Practices removed the category of health care worker from the list of persons for whom vaccination with BCG should be considered. Nosocomial epidemics of tuberculosis, especially those caused by multidrug-resistant strains, have led to the reconsideration of vaccination with BCG for this population. We review the available studies of the efficacy of BCG vaccine in health care workers. Although the studies had too many methodological flaws to be combined in a quantitative meta-analysis, they suggest that vaccination with BCG is effective in reducing the incidence of tuberculosis among health care workers.