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GD Gothi, Kul Bhushan, SS Nair & GVJ Baily: Proceed 19th Natl TB & Chest Dis Workers Conf, New Delhi, 1964, 138-62.

In the BCG Mass Campaign low outputs and coverages of BCG vaccination done after tuberculin test were due to slowness of the campaign because of two visits to an area, the fear of two pricks and tuberculin tested absenting themselves from reading of the test. It was thought that if BCG vaccination could be given without prior tuberculin test and without causing any complications then the speed of work and outputs could be more than doubled and coverages improved appreciably. For this, the following three studies were carried out: In the first study 1,891 persons belonging to a rural population were randomly divided into four groups (i) those tuberculin tested and vaccinated, (ii) tested but not vaccinated, (iii) not tested but vaccinated, and (iv) neither tested nor vaccinated. Induration site of tuberculin test and vaccination were read on the 3rd, 6th and 90th day. Later on, another tuberculin test was done on the 90th day and read 3 days later. Both axillae were examined on 0, 14th and 90th day and X-ray pictures were taken on 0 day, 90th day and after one year. Tuberculin indurations on 3rd day were compared with BCG induration on 3rd, 6th, 14th and 90th day. Majority of tuberculin reactors had large BCG indurations upto 14th day. By 90th day very few persons have large indurations left. Among non-reactors also large BCG reactions were seen in 25%-53% of the persons. There were no differences as regards to the size of lymph nodes (regional reactions) between reactors and non-reactors; neither was there any evidence of exacerbation of existing disease nor any flaring up of dormant foci (Primary complex) in the form of new disease as shown by X-ray.

In the second study out of 1,520 persons from 4 villages, 1,186 were both tuberculin tested and simultaneously vaccinated. Examination of local reactions daily from one to nine days, on 19th and the 29th day, confirmed the findings of first study with regard to the local reactions. In this study neither axillae were examined nor X-ray pictures taken. In the third study, influence on acceptability of direct BCG vaccination due to large local reactions was tested. Twelve villages in Gubbi taluk of Tumkur district were taken in pairs. Vaccination of 2nd village of each pair was done after 1-4 weeks of the vaccination in lst village to observe the influence of BCG reaction on the people. Vaccinations were given to 5363 (64.2%) persons from the total registered population with Madras liquid vaccine. The large local reactions showed no adverse effect on the acceptability of BCG vaccination in the neighbouring villages, rather a slight improvement in BCG vaccination coverages with time was seen.