The tuberculosis vaccine has been removed from the National Immunisation Schedule, and will only start being administered to newborns whose parents have lived in high-risk countries, Superintendent of Public Health Ray Busuttil announced this afternoon.
The schedule has also been revised to add the vaccine against the human papilloma virus (HPV) for girls aged 12.
Dr Busuttil explained that the National Immunisation Schedule was frequently reviewed – this was the 10th revision to be announced in the past 25 years – to keep up with the latest developments.
Often, revisions either added new vaccines – as was the case with the MMR vaccine some 20 years back – or changed the ages in which the vaccines are administered.
On rare occasions, however, vaccines have been removed from the schedule: this was the case with the smallpox vaccine shortly after the disease was declared eradicated in 1979.
Tuberculosis may not have been eradicated yet, but international research shows that the vaccine’s efficacy is limited – and that it varies widely depending on the prevalence of the disease in any given population. Moreover, health promotion director Charmaine Gauci explained, the vaccine does not protect against pulmonary tuberculosis in adults.
The vaccine remained effective in protecting newborns and young children from meningeal and disseminated tuberculosis. However, Dr Gauci added, the evidence suggested that administering the vaccine selectively to high-risk children appeared to be more beneficial than administering it universally.
Under the new policy, the vaccine will be administered to children whose parents lived in high-risk countries – where the incidence of tuberculosis exceeds 40 cases per 100,000 people. In Malta, therefore, the vaccine will be mainly administered to children of immigrants from sub-Saharan Africa, although those whose parents have lived in high-risk countries will also be eligible for it.
In Malta, the prevalence of tuberculosis is of 7.5 cases per 100,000 people. Most cases affecting native Maltese stem from a reactivation of the infection in elderly people, who may have become infected with the bacterium before the vaccination programme began in 1951.
HPV vaccine for 12-year-old girls
The human papilloma virus is typically transmitted through sexual contact, and some types may cause genital warts. But HPV infections are also the cause of nearly all cases of cervical cancer, which is the second most common and the fifth deadliest cancer for women worldwide.
The incidence of cervical cancer in Malta is actually low when compared to most European countries, Dr Busuttil explained.
But he emphasised that there was no particular difference between the sexual behaviour of the Maltese and that of their European counterparts, which could lead to a future increase in the prevalence of the cancer.
As a result, the health authorities felt it best to administer the vaccine and keep the incidence low, rather than “miss the boat” and wait for it to go up, Dr Busuttil pointed out.
The HPV vaccine has already started to be administered to girls born in 2000 and in 2001, and will continue to be administered to 12-year-old girls every year. Around 2,000 doses a year will be required.
The National Immunisation Schedule also includes the MMR vaccine, which prevents measles, mumps and rubella, the Hepatitis B vaccine and the so-called “5-in-1” DTaP-Hib-IPV vaccine, which protects against diphtheria, tetanus, pertussis (whooping cough), polio and Hib disease.