BCG vaccination in Korea, Japan, and Taiwan: Current status and future perspectives

초록

The Bacille Calmette-Gu & eacute;rin (BCG) vaccine remains essential for preventing severe pediatric tuberculosis (TB). This review compares BCG policies in Korea, Japan, and Taiwan - three low-burden countries with differing strategies. Notably, Taiwan and Japan have delayed vaccination to 5-8 months specifically to mitigate osteitis risks, whereas Korea retains a schedule before four weeks. Despite these variations in timing and vaccine strains, all three nations maintain >95% coverage and have effectively eliminated severe pediatric TB. These outcomes suggest that varying delivery models can achieve comparable success. However, as epidemiological landscapes transition, the focus must shift toward enhanced safety surveillance and programmatic precision. Reassessing vaccination policies is crucial to minimize adverse events while maintaining protection against severe disease in low-burden settings. PLAIN LANGUAGE SUMMARY BCG is a vaccine that protects infants and children from dangerous forms of tuberculosis (TB), such as TB meningitis. Korea, Japan, and Taiwan all continue to give BCG shots to babies, but each country does it in a different way. Korea offers two types of BCG - one through a skin injection and another using a small stamping device. Japan only uses the stamp method, while Taiwan uses only the injection method. Taiwan and Japan now delay the vaccine until babies are 5-8 months old to lower the risk of rare but serious side effects like bone infections. Korea still gives the shot shortly after birth. All three countries use different systems to check for vaccine side effects, with Taiwan having the most advanced tracking system. Overall, this review shows that different ways of giving BCG - such as when it is given, how it is given, and how side effects are monitored - can help improve vaccine safety, while keeping serious TB in children rare in these countries.

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