Vaccination for tuberculosis
BCG (Bacille Calmette–Guérin) vaccine is a live vaccine made from an attenuated or weakened strain of the tuberculosis (TB) bacteria.
It does provide protection against progression to disease, specifically providing over 70% protection against severe disease, for example TB meningitis and disseminated disease in young children.
The vaccine is only useful if it is given before the child is infected with the TB bacteria. It is also highly protective against leprosy.
Who should be vaccinated
It is recommended for young children at high risk of contact with active TB or leprosy.
These include all of the following:
- Indigenous newborn babies
- children under five years old with no previous BCG vaccine who will be living in NT Indigenous communities
- children under five years who have a high probability of travelling to countries of high TB incidence for an extended period
- newborn babies whose parents have leprosy or who have an immediate family history of leprosy.
It should also be considered for:
- children between five and 16 who will be travelling to living in countries with a high incidence of TB for extended period - it should be given three months before travel
- healthcare workers who may be at high risk of exposure to drug resistant cases.
Who should not be vaccinated
You should not be vaccinated if any of the following apply:
- you are immune compromised including those with cancer of the bone marrow or lymphoid system
- you are on medications which suppress the immune system - for eg: corticosteroids, chemotherapy
- you have or suspect you have HIV infection
- if you have received the vaccination before
- you have a current or past history of TB
- if you have a Mantoux test result greater than or equal to 5mm or positive blood test for TB exposure
- any serious illness including malnutrition
- if you have been given an injectable live vaccine in the four weeks before, unless give at the same time
- if you are pregnant
- you should take precaution if you have generalised skin infections and conditions such as eczema, dermatitis and psoriasis or if you have a fever.
Testing before vaccination
Children over 6 months of age should have a Mantoux test prior to vaccination.
Infants less than 6 months of age who have been exposed or may have been exposed to TB should also have a Mantoux test.
How the vaccination is given
The vaccine is given by injection into the skin of the upper arm (usually left).
The person holding the child during the injection and the vaccine provider should wear eye protection.
After the injection
A small red papule forms and over 2 to 3 weeks forms an ulcer, which may crust. It may also discharge pus. There is no pain or tenderness around the site of injection, and there are no signs of general ill health.
The ulcer may persist for two to three months. Keloid (raised and overgrown scar) formation can occasionally happen.
The ulcer may be covered with dry sterile gauze if discharging pus, and should be kept as dry as possible. You should avoid using antiseptics and sticking plasters. The ulcer will eventually heal.
Adverse reactions are rare but need to be reported to the TB unit and the local immunisation coordinator.
You should seek medical advice if your child develops any of the following:
- fever higher than 38.5º C
- soreness, redness and swelling around the ulcer (larger than a 50 cent piece)
- swollen glands under the arms, around the neck or in the groin.