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April 2, 1997

Modalities for Tuberculosis Control: Surveillance vs Vaccination-Reply

Author Affiliations

Brigham and Women's Hospital Boston, Mass

JAMA. 1997;277(13):1036. doi:10.1001/jama.1997.03540370026023

In Reply.  —Our analysis evaluated the likelihood that current national control policies would reach previously set goals for the elimination of TB in the United States. Evaluation of control policies in particular risk groups, such as health workers, is a logical next step, but it was not the purpose of the current study.The scenario1 described by Drs Reichman and Mangura has been published as a letter to the editor in reference to earlier work2 done by some of us. In our view, while BCG vaccination complicates surveillance, it does not preclude it. We believe BCG would be effective in preventing TB among health care workers, as discussed more fully in this earlier work2 and correspondence.3 Several decision analyses by others4,5 have similarly concluded that BCG vaccination is a reasonable option for TB prevention among health care workers. Although important, the ability to undertake future surveillance is