Estonia mulls ending universal TB vaccination for newborns
Estonia is preparing to switch from universal newborn tuberculosis vaccination to targeted immunization for at-risk children as TB incidence falls. The change is unlikely to take effect before 2028.
Estonia's Social Affairs Ministry is moving ahead with plans to replace the current practice of vaccinating all newborns against tuberculosis with a more selective approach that would cover only children in risk groups. Under the existing immunization schedule, every baby born in Estonia receives the TB vaccine within five days of birth.
In June, the ministry's Immunoprophylaxis Expert Committee gave its backing to the start of preparatory work for this shift. Public health adviser Maia-Triin Kanarbik explained that the World Health Organization recommends universal vaccination in countries with high TB incidence, while low-incidence countries may restrict vaccination to defined risk groups. Estonia now qualifies as a low-incidence country, and its rate continues to decline.
Kanarbik noted that several European countries, including Finland and Sweden, have already made a similar transition without seeing a rise in childhood TB cases. The preparation phase will involve identifying risk groups, updating clinical guidelines, training healthcare staff, and establishing procedures for the new system.
Although ministry communications have suggested that the change is not expected before 2028, Kanarbik said it is still too early to predict the exact date, as experts have yet to discuss essential details. Until the current policy is revised, the ministry continues to recommend TB vaccination for all children.
The adviser also warned that drug-resistant tuberculosis remains a concern, accounting for nearly 20% of all pulmonary TB cases in Estonia, even as overall incidence falls.
According to the National Institute for Health Development, the country recorded 28 new TB cases in the first six months of 2026, none of them initial cases among children under 14. Including recurrent cases, 86 people were diagnosed with the disease last year and 88 in 2024, compared with 316 in 2011.
Health Board data show that TB vaccination coverage among newborns stood at 87.6% in 2025, a noticeable drop from more than 98% in 2011.
