Estonia considers targeted TB vaccination as cases fall

Estonia has entered the group of countries with low tuberculosis incidence, prompting preparations to replace universal vaccination of children with targeted protection for risk groups, ERR reports.

Under the current immunisation schedule, all newborns receive a tuberculosis vaccine between one and five days after birth. In June, the immunoprophylaxis expert committee decided to support preparations for switching to selective tuberculosis vaccination.

Maia-Triin Kanarbik, an adviser at the Ministry of Social Affairs’ public health department, said the World Health Organization recommends vaccinating all newborns in countries with a high rate of new tuberculosis cases. In countries with low incidence, vaccination can be limited to specific risk groups, she said.

“Estonia has entered the group of countries with low tuberculosis incidence, and incidence here has steadily declined,” Kanarbik said.

She added that several European countries, including Finland and Sweden, had successfully moved from vaccinating all young children against tuberculosis to a risk-based approach. Based on their experience, the change had not increased illness among children, she said.

Correspondence among ministry officials has indicated that the change is unlikely to take effect in Estonia before 2028. Kanarbik said the transition would be a complex process requiring extensive preparation, including defining the risk groups, ensuring smooth implementation, updating guidance and training healthcare workers.

Expert discussions have yet to begin, making it difficult to predict when universal vaccination will end. Until then, the Ministry of Social Affairs continues to recommend that all parents have their children vaccinated against tuberculosis.

Kanarbik said the proportion of drug-resistant cases remained high despite the decline in tuberculosis incidence, accounting for nearly 20 percent of all pulmonary tuberculosis cases.

According to the National Institute for Health Development, Estonia recorded 28 new tuberculosis cases in the first six months of this year. None of those newly diagnosed were under 14.

Including both new and recurrent cases, 86 people contracted tuberculosis last year and 88 in 2024. In 2011, the figure was 316.

Health Board data showed that 87.6 percent of newborns had received the tuberculosis vaccine as of 2025.