Introduction - The mandatory BCG vaccination of all children was replaced in July 2007 by a strong recommendation for children at risk of tuberculosis. We present the first data on BCG vaccination coverage (VC) and epidemiological data on childhood tuberculosis, which allow us to assess the impact of the new vaccination guidelines. Methods - BCG VC was estimated based on a survey (February–March 2008) of infants followed by private practitioners, as well as on BCG sales data (2005–2007). Epidemiological data on tuberculosis were derived from mandatory reporting. Results - The BCG vaccination coverage among infants seen in private practice, born after the mandatory vaccination requirement was lifted and meeting at least one criterion for BCG vaccination, was 58% (68% in Île-de-France, 48% outside Île-de-France). BCG sales data showed that BCG vaccination coverage in Île-de-France had decreased overall by 37% between 2005 and 2007. Among children under two years of age, the number of tuberculosis cases remained stable in Île-de-France/French Guiana between 2006 and 2007 and increased outside these regions. Of the 83 cases in 2007, 46 met at least one vaccination eligibility criterion (55.4%), of whom 21 were vaccinated (45.7%). A single case of tuberculous meningitis was reported in 2007 in a child under 5 years of age. Conclusions - One year after the mandatory vaccination requirement was lifted, BCG vaccination coverage remains insufficient, although surveillance data do not yet indicate an impact on the number of childhood tuberculosis cases. Strengthening communication with vaccinating physicians appears to be a priority. (R.A.)