Fewer tuberculosis cases prompt Estonia to rethink universal vaccination
Estonia's declining tuberculosis rate has prompted the Social Affairs Ministry to prepare to replace universal newborn vaccination with targeted TB shots for at-risk children.
Under the current national immunization schedule, all newborns in Estonia are vaccinated against tuberculosis (TB) within five days of birth.
In June, however, the ministry's Immunoprophylaxis Expert Committee backed launching preparations to move from universal to targeted vaccination.
Department of Public Health adviser Maia-Triin Kanarbik said that the World Health Organization (WHO) recommends vaccinating all newborns in countries with a high incidence of TB, while low-incidence countries can limit vaccination to defined risk groups.
"Estonia is now among those countries with low tuberculosis incidence, and the incidence here has been steadily declining," she said.
Kanarbik noted that several European countries including Finland and Sweden have shifted from universal early childhood TB vaccination to risk-based vaccination without increasing TB cases among children.
According to the adviser, preparations will include defining risk groups, updating guidelines, training healthcare workers and establishing procedures for the new system.
While ministry communications have indicated the change is unlikely to take effect before 2028, Kanarbik said that with experts yet to discuss the necessary details, it's still too early to predict when universal TB vaccination will end.
Until then, the Social Affairs Ministry continues to recommend TB vaccination for all children.
"Although TB incidence in Estonia has declined, the share of drug-resistant cases remains high, accounting for nearly 20 percent of all pulmonary TB cases," the official noted.
TB vaccine coverage down
A Health Board handbook for new parents describes tuberculosis as "a serious disease that requires long-term treatment and can affect the lungs and other organs. In young children, it can even cause severe meningitis," or inflammation of the tissues surrounding the brain and spinal cord.
Estonia recorded 28 new tuberculosis cases in the first six months of 2026, according to the National Institute for Health Development (TAI), with no initial cases among children under 14.
Including recurrent cases, 86 people were diagnosed with TB last year and 88 in 2024, down significantly from 316 in 2011.
According to Health Board figures, TB vaccine coverage among the country's newborns stood at 87.6 percent in 2025, down significantly from over 98 percent in 2011.
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Editor: Karin Koppel, Aili Vahtla
