BCG Vaccination

(BCG Jab, Injection, Inoculation)

BCG vaccination, (also called a jab, injection or immunisation) has been shown to give 70%-80% protection against TB (Tuberculosis). The vaccine is given in a single dose following a ‘negative’ mantoux test.

The vaccine contains a weak form of the disease.

Local policy differs regarding the vaccination of babies. Some babies considered “at risk” will be given the vaccine at birth. This includes those born into families with members from high-risk countries, those babies who will be traveling to high-risk countries and those babies living in households were persons of a high risk are also living. Advice should be taken from a health professional.

Advice on this page this follows current UK recommendations. The Mantoux Test has replaced the Heaf Test that was previously used in the UK.

Mantoux test

The BCG vaccination should never be given to a person who has a “positive” tuberculin skin test. A “strong” positive test might indicate that you will need to visit a chest clinic for further assessment.

A Mantoux Test is done before having the BCG vaccination in all persons over the age of 6 years or earlier if the child has been “at risk” of TB. Routine vaccination is no longer carried out in schools – however, a new improved immunisation programme targets those at greatest risk to the disease.

The Mantoux test is given “intradermally” into the lower left forearm. The tuberculin test is injected into the arm at skin level. After the injection some people experience mild itching or swelling but this usually goes within a week.

You will need to avoid itching the injection site, keeping it clean and dry – water won’t hurt it so you can bath or shower - but try not to scrub it! Don’t put a bandage on the site and don’t use any lotions or creams on the injection site.

When planning your vaccine schedule, the test can be given at the same as other “inactive” vaccines. If you need “live” vaccines you should have these four weeks before or after the test as they can “suppress” the result.

The results are read 48 to 78 hours later and you should ideally make this appointment when you make one for the Mantoux Test.

When the test is read, the injection site is measured and recorded. If it measures less than 6mm the test is “negative” and you will be offered the BCG vaccination. If the test reads more than 6mm your doctor or nurse will advise you on the next course of action.

On the Day of BCG Vaccination – What can you expect?

You will only be given the vaccination only if you have had a “NEGATIVE MANTOUX TEST”. On the day of vaccination you should inform your doctor or practice nurse if you are suffering from a fever, have a skin infection or think you might be sensitive to any of the components in the vaccine.

BCG vaccination is given as a single injection to the upper left arm. If you put your hand on your hip so the arm is at a 45 degree angle, this will help the nurse administering it.

As the injection is given, your skin will be stretched slightly and the vaccine injected “intradermally” just under the skin. Intradermal means that the needle is usually visible under the skin as the injection is given. The injection is given slowly and after it is done you will see a small raised area known as a “blanched bleb” on the skin.

After the vaccination a small red spot usually develops within 2-6 weeks. After a few weeks the spot usually becomes scaly, crusting and with slight bruising. This will eventually heal to form a round flat scar. It is better if you leave the injection site uncovered as this will aid in the healing. In some cases a small shallow ulcer appears. In the rare situation that a reaction occurs medical advice should be sought from your doctor or practice nurse as soon as possible.

No other vaccinations should be given in the same arm as the BCG injection for up to 3 months. If other ‘live’ vaccines such as Yellow Fever are required, they should be given at the same time as the BCG vaccination or 4 weeks before or after its administration.

Resources for TB

The DOH has provided answers to many common concerns about the jab

NHS Immunisation Information Service has produced multi-lingual fact sheets about TB and other vaccine preventable diseases

Amazon has a collection of books covering history and medical treatment of TB including Timebomb: The Global Epidemic of Multi-drug-resistant Tuberculosis

Health Protection Agency provides excellent information and reports on Tuberculosis with latest health reports and epidemiological data from the UK and abroad.