BCG

What is Tuberculosis?

Tuberculosis (TB) occurs most commonly in children less than 5 years. While TB involving the lungs is the predominant form of TB in children, TB involving other organs (extra pulmonary TB) is also common.

Spread of the TB germs through the blood to other vital organs e.g. brain, lungs, can be life-threatening. E India accounts for 26% of TB cases in the world. TB of the brain, which is the most dangerous form of childhood TB, has the highest incidence in children <5 years of age. E BCG vaccine is very effective in preventing the serious forms of TB in children.

What is the BCG vaccine, who should receive it and what is its schedule?

BCG stands for (Bacille Calmette Guerin vaccine), a vaccine made from weakened TB germs. It is given to all newborns (with very few exceptions) on the left upper arm within the layers of the skin (intradermal). The vaccine should to be given to newborn babies at discharge from the hospital or within 2 weeks after birth. If missed in the neonatal period, it can be given up to 5 years of age. There is no need for a second dose .

What are the series of changes that occur following BCG vaccination?

After vaccination, a series of changes occur. The injected site usually shows no visible change for several days. Subsequently, a small, elevated spot may appear at the site of the injection, which turns into a blister, which sometimes oozes fluid before becoming a crusty scab, followed by formation of a small scar at the site of the vaccination. The ulcer at vaccination site may persist for a few weeks before formation of the final scar. The entire process may take 6 weeks to 3 months. No treatment is required for this condition. The area should be left uncovered.

How safe is the BCG vaccine?

BCG is a safe vaccine. Common side effects include prolonged pus formation at site of vaccination and delayed healing. Rarely, a swelling may occur in the left armpit which is an enlargement of the gland due to BCG vaccination. Usually, it last for a few months and disappears without any treatment. Very occasionally, the swelling may become soft, in which case the pus may need to be removed.

Who should not receive the BCG vaccine?

In children with weakened immunity, because the germs contained in the vaccine may spread all over the body, a condition which may be dangerous. Symptomatic Infants, born to HIV positive mothers , Mothers treated with drugs in pregnancy, which weaken the immune system

Family history of unexplained deaths in the first year of life, till the infant is investigated for any diseases causing weakened immune system