The Health Information and Quality Authority has suggested Ireland move away from a national BCG vaccination programme in favour of a selective one.
It says this would reduce the number vaccinated against TB from 61,000 a year to around 8,000 and would be more clinically cost-effective.
HIQA said it would also significantly reduce the number of children experiencing significant side effects.
It said selective vaccination will continue to protect those at higher risk, while avoiding unnecessary side effects in those with a limited capacity to benefit from vaccination.
HIQA Director of Health Technology Assessments Dr Máirín Ryan said falling TB incidence has decreased the potential benefit of BCG vaccination for most children.
The authority has published a new Health Technology Assessment of the vaccination programme and is seeking public consultation on it over the next six weeks.
It says Ireland meets the WHO criteria for ending universal vaccination and moving to selective vaccination.