Tuberculin testing before BCG vaccination

Editor—The editorial by Bothamley et al is usefully provocative.¹ They begin by saying that the evidence base for the current recommendations is not clear. However, the evidence base for their idea is not clear either. The evidence on complications cited describes an age related effect for tuberculous skin lesions only in those over 15 years of age, and Bothamley et al do not say whether the increased frequency of this complication over that age is considered clinically significant.

Is age important or do the authors' conclusions also apply to children aged 10-14 (the age at which BCG is given to school children in the United Kingdom who live outside high prevalence areas such as the one in which Bothamley et al work) or even to adults as well?