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What Is a BCG Vaccine And When a Child Should Get It?

While the BCG vaccination is one of the oldest and most commonly used vaccines in the world, it is not routinely used in countries where tuberculosis is rare (TB). Only newborns, children, and adults under the age of 35 who are at risk of contracting tuberculosis (TB) and who are traveling to a country with a high TB incidence rate should have the vaccination.

What is the BCG vaccine?

Tuberculosis (TB) is caused by a bacterium called Mycobacterium tuberculosis. The BCG vaccine was developed in the early 1900s to protect against infection and it is one of the most widely administered vaccines, playing a major part in TB control programs in countries with high disease rates.

When a person with tuberculosis coughs or sneezes, tiny droplets are discharged into the air, and someone else breathes in these droplets, spreading the disease but it is not as contagious as measles or influenza. Before you develop tuberculosis, you must spend a long time in close contact with an infected individual.

Why is BCG vaccination prescribed for children?

The BCG vaccine provides persistent protection (up to 80%) against severe types of paediatric TB, such as TB meningitis when administered to newborns and young children. In adults, it may be less effective against TB that affects the lungs. The BCG vaccine can provide protection for up to 15 years.

The Bacille Calmette-Guérin (BCG) vaccine is administered to children under the age of five who are at a higher risk of contracting tuberculosis (TB). This could be for a child who lives with someone who has TB or has had TB in the past, or who lives with someone who has traveled to a country with high TB rates in the last five years, or who will be traveling to a place with high TB rates. For persons above the age of 35, there is minimal evidence that the BCG vaccine is effective.

How does a BCG vaccine work?

The BCG vaccine contains a weakened form of tuberculosis bacteria that creates immunity and assists the body to fight tuberculosis if it is infected but does not cause tuberculosis. While the BCG vaccine cannot prevent infection with the microorganisms that cause tuberculosis, it does help prevent serious TB disease in children.

The vaccination does not contain any blood components. All of the vaccine’s raw components are derived from non-animal sources. When used as a tuberculosis vaccine, it is administered intradermally (between the skin’s layers). Only one dose of the BCG vaccine should be administered in a lifetime.

When to give BCG vaccine?

The BCG vaccination should be given to your child within a few days of birth and up to six months of age, but they can be immunized at any age up to five years old. Only children with a negative TB test and who are constantly exposed to the disease should be evaluated for BCG vaccination.

People aged 16 to 35 who are at risk of TB exposure at work, such as healthcare or laboratory personnel who have direct contact with TB patients or possibly infectious clinical samples and materials, as well as those traveling to high-risk countries, should have the BCG vaccine.

What special precautions should be followed before your child receives the BCG vaccine?

There are several important checks to be done prior to your child receiving the BCG vaccination:

Has a fever

If your baby has a fever, you should delay the immunization until they are feeling better. However, if the child’s temperature is normal and they have a slight cough or cold, they can still get the vaccine.

Suspected TB exposure

If you suspect your child has been exposed to TB, it is important to first get a Mantoux (skin) test. If the test result is positive, it is most likely a latent TB infection in which case the BCG vaccine cannot be given. If the result is negative, your doctor may want a retest in a couple of weeks or they may consider it safe to get the BCG vaccination.

HIV infection

In HIV-uninfected newborns, the vaccine is safe and effective; nonetheless, immune responses to not only BCG but other childhood immunizations were altered in HIV-exposed, uninfected infants. BCG vaccination of HIV-exposed, uninfected newborns may also make them more susceptible to HIV infection, according to research.

Other Conditions

If your child has any of these conditions or takes medicines that weaken their immune system, they cannot get the BCG vaccine because it can cause complications:

  • malignant lymphoma
  • leukemia
  • has a reduction in the body’s resistance to infection
  • chronic granulomatous disease
  • is receiving cancer treatment 
  • suffers from any generalized skin condition

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What side effects may a BCG vaccine cause?

The BCG vaccine, like any vaccine, can have side effects, but they are rare and usually minor. Abscesses, bone inflammation, and anaphylaxis are more significant side effects that are not common.

Hardness at the injection site, followed by a raised blister, and sometimes a long-term scar is a highly common adverse effect (affecting 9 out of 10 persons).

Uncommon side effects (affecting up to one in every 100 people):

  • A throbbing headache and a fever.
  • Two to six weeks after injection, an ulcer may form at the injection site, which can be painful. It usually takes a few weeks to fully recover.
  • Swelling of lymph nodes in the armpit that is more than one centimeter in diameter.
  • An infected lymph node with an enlarged lymph node (lymphadenitis).

How to prevent them?

To minimize the effects of the BCG vaccination on your child, you can employ the following tips:

  • Make sure the child is hydrated before and after getting the vaccine.
  • Administer a mild pain relief after the vaccine.
  • Keep the vaccination site clean and dry.
  • If a sore appears, wrap it with gauze to allow air to circulate.
  • Avoid squeezing or scratching the spot.
  • Do not apply ointments, oils, or herbs to the area.
  • Do not cover the wound with sticking plaster.
  • The area should not be rubbed or massaged.

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