The Health Information and Quality Authority has advised the Minister for Health that Ireland's BCG vaccination scheme change from a universal programme to a selective one.
Selective vaccination would focus on those who are at higher risk.
One in eight newborns would continue to be eligible for the vaccine.
The move would reduce the number of vaccinated infants from around 61,000 to 8,000 a year, reducing the cost by over €1m.
The focus would be on infants born in, or whose parents are from, a country with a high incidence of TB; those in contact with patients with active respiratory TB and members of an at-risk group, such as the Traveller community.
HIQA says it would avoid unnecessary side effects in those with a limited capacity to benefit from vaccination.
It has now made the recommendation to Leo Varadkar after it published a health technology assessment report in September, followed by a six-week public consultation programme.
HIQA says that the change would have to be supported by a clear commitment to enhanced systematic and comprehensive TB control measures.
Only Ireland and Portugal continue to have universal vaccination BCG programmes.
The incidence of TB has been declining in Ireland.
HIQA says that notwithstanding ongoing issues with the supply of the BCG vaccine, parents should continue to get their children vaccinated until such time as the policy is changed.
The HSE is to conduct a review of the resources and timeframe required for any policy change in relation to BCG vaccination.
The Department of Health said today that when this has been completed, it will assess the existing policy, in light of the HIQA and HSE studies.
Until then, existing BCG policy will remain unchanged.