The BCG (Bacillus Calmette-Guérin) vaccine protects against infection with mycobacterium tuberculosis (TB).
It is usually offered to babies at birth who are more likely to come into contact with someone with TB. The vaccine is usually offered while the baby is still in hospital, but it may be given later.
Questions and answers:
What is BCG vaccine?
BCG vaccine contains a weakened form of the bacteria (germs) that cause TB. The vaccine doesn't actually cause TB, but it helps your baby develop protection (immunity) against the disease in case he or she ever comes into contact with it.
Who is offered the vaccine?
The BCG vaccine is offered to those babies who are more likely than the general population to come into contact with someone with TB. This is because they either lived in an area with high rates of TB, or their parents or grandparents came from a country with high rates of TB. These include countries in South-East Asia, sub-Saharan Africa and some countries in Eastern Europe.
The vaccine is usually offered soon after birth, either while your baby is still in hospital or soon after you return home. However, it can be given at any time if necessary.
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What is TB?
TB is a serious infectious disease. TB can progress rapidly, particularly in young children and infants, and can lead to TB meningitis (swelling of the lining of the brain) in babies.
In young people and adults it usually affects the lungs, but it can also affect the lymph glands, brain, joints, kidneys or bones.
Most people in the UK country recover fully after treatment, but this usually takes several months.
How is TB spread?
TB is usually spread when people with infectious TB in their lungs or throat cough or sneeze. However, it usually takes close contact with an infectious person over a long period of time to catch the disease.
Not everyone with TB in their lungs is infectious. Once they are taking the right treatment, most people will become non-infectious after about two weeks.
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How common is TB?
TB is not a common disease. In Scotland, around 400 new cases of TB are diagnosed every year. Most of these cases occur in adults over the age of 25.
Cases of TB can be found all over the world. More information about this can be found below. With increasing numbers of people travelling around the world, the risk of people coming into contact with the disease or bringing it into this country.
What are the symptoms of TB?
TB can affect almost any part of the body, so the symptoms vary and may be different in a baby from those in an adult. However, as TB is infectious, it is important that you can recognise the signs and symptoms. You should get medical help if you, your baby or any other member of your family has:
- a persistent cough that lasts several weeks
- a fever and unusual sweats at night
- been losing weight for no obvious reason
- a general and unusual sense of tiredness and being unwell
- been coughing up blood.
How is the vaccine given?
The vaccine is injected just under the skin of the upper part of the left arm.
Are there any side effects?
Immediately after the vaccine is given, a raised blister will appear. This shows that the vaccine has been given properly.
Within two to six weeks, a small spot will appear. This may be quite sore for a few days, but it will gradually heal and may leave a small scar.
Occasionally your baby may develop a small sore where the vaccine was injected. If this is leaking and needs to be covered, use a dry dressing – never a waterproof plaster or creams – until a scab forms. It is better to leave the sore uncovered if possible and it is fine to leave it uncovered when bathing. This sore may take several months to heal completely.
If you are worried, or you think the sore has become infected, see your GP.
Is the vaccine safe?
Before they are allowed to be used, all medicines (including vaccines) are tested for safety and effectiveness. Once they are in use, the safety of vaccines continues to be monitored.
Are there any reasons why my baby shouldn’t have the BCG vaccination?
The BCG vaccine should be delayed if your baby has high fever.
The BCG vaccine should not be given if your baby:
- is having treatment for cancer or other serious conditions that weaken the immune system
- is HIV positive
- is suffering from a generalised septic skin condition - babies with eczema can be given the vaccine in an area without skin lesions (broken skin)
- lives in a household where an active TB case is suspected or confirmed
- has had a confirmed anaphylactic reaction (a severe allergic reaction) to an ingredient of the vaccine.
Do I need to know anything else?
Your baby can start their routine childhood immunisations for diphtheria, tetanus, pertussis (whooping cough), pneumococcal, polio, Haemophilus influenzae type b (Hib), rotavirus and meningococcal C (MenC) from 2 months of age, regardless of when they have their BCG vaccine.
However, your baby should not be given another vaccine in the same limb as the BCG vaccine for at least three months afterwards, otherwise the glands may swell.
You should also make sure that there is a record of the BCG vaccine in your child's Personal Child Health Record (Red Book).
Countries with high rates of TB
An up-to-date list of countries is available on the UK Government website (external link).
If you answer ‘yes’ to any of these questions your baby may need a BCG vaccine if they haven’t already had one:
- Are you, your family or your baby’s father or his family from a country with a high rate of TB? (If in doubt, talk to a health professional.)
- Will you and your baby be going to live in a country with a high rate of TB for more than three months in the near future?
- Will you and your baby be travelling frequently to countries with a high rate of TB in the near future?
- Is there anyone in your house, or anyone else who is likely to have long-term close contact with your baby, who either has TB, or has had it in the past, or comes from a country with a high rate of TB?
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