It is evident from follow-up studies of tuberculosis in the Netherlands (without BCG vaccination), Sweden (discontinuation of BCG vaccination since 1975) and in both parts of Germany (FRG discontinuation since 1975), as well as from the favourable tuberculosis situation in both parts of Germany (low tuberculosis incidence and very low infection risk) that general vaccination of babies is no longer warranted. For this reason the German Central Committee for Combatting Tuberculosis is considering in consultation with the Federal Bureau of Health to abstain from continuing to recommend general BCG vaccination of all newborn. BCG vaccination should be recommended only in enhanced-risk groups (children of foreign parents and children sharing their living quarters or household with a person suffering from acute, i.e. infectious tuberculosis).
For a long time the risk of importing tuberculosis via immigrants and asylum seekers from countries with a high infection prevalence has been a much-discussed problem. Statistically significant increases in tuberculosis incidence were first regitered in the USA in the wake of several immigration waves, and then the former colonial powers in Europe, France and the United Kingdom, were faced with the problem in the 50 s and 60 s. It was found that not only tuberculosis morbidity, but also the risk of infection and illness were much higher among immigrants from the former African colonies, the West Indies, Pakistan, and India than among the native Europeans, which gave rise to the utmost concern. The same reactions were incited by the first reports on the so-called "foreign-worker tuberculosis" from Switzerland in the early 60 s and not much later from the FRG. Although tuberculosis morbidity among foreign workers and their relatives remained twice as high as among the indigenous population, tuberculosis has continually gone down in Switzerland and the FRG in subsequent years. The initial concern that a relatively high rate of foreigners could have long-lasting epidemiological consequences was not confirmed.