The BCG (Bacillus Calmette-Guérin) vaccine protects against infection with mycobacterium tuberculosis (TB). Although TB is no longer common in the UK, it kills around two million people a year worldwide.
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 an altered form of the bacteria (germs) that cause TB. Because its form is altered it doesn’t cause TB, but it helps your baby develop protection against the disease in case he or she ever comes into contact with it.
What is TB?
TB is a serious infectious disease that 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 glands, brain or bones. Most people in the UK country recover fully after treatment, but this usually takes several months.
How is TB caught?
You can You can only catch TB from someone who is already infected and who is coughing. When they cough, a spray of tiny droplets is produced that contain the germs. If you breathe in the droplets you too can catch the disease.
Although these droplets can stay in the air for quite long periods of time, in general, it takes prolonged contact with an infected person for the disease to spread.
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How common is TB?
In the UK in the 1950s there were over 50,000 new cases of TB every year. Today, there are around 8,500 cases of TB in the UK each year, of which an average of 400-500 are from Scotland. While it’s unlikely that you will get infected, everybody should be aware of the symptoms of TB.
Most TB disease in Scotland occurs in older people who are likely to have caught it many years ago when TB was more common. However, TB is a widespread disease worldwide (see the Health Protection Agency's list of TB countries (external link)), and as increasing numbers of people travel round the world, living and working in countries with high rate of TB, the risk of people coming into contact with the disease or bringing it to the UK also increases.
What are the symptoms of TB?
TB can affect practically any part of the body, so the symptoms vary and the signs of the disease in a baby may be different from those in an adult. However, as TB is infectious, it is important that you can recognise the disease in someone else. You should contact a doctor if your baby, any other member of your family, or a friend has any of the following:
- a cough that lasts for more than three weeks
- a fever
- sweating, especially at night
- weight loss
- feeling tired
- coughing up blood.
Why is my baby being offered BCG?
In the UK, like many other countries, BCG is offered to 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 (external link). The vaccine is usually offered soon after the birth either in hospital or when you return home, but it can be given at any time.
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How is my baby immunised?
Your baby will be given the BCG vaccination in the upper part of the left arm.
Are there any possible side effects?
Immediately after the injection, a raised blister will appear. This shows that the injection has been given properly. Within two to six weeks of the injection a small spot will appear. This may be quite sore for a few days, but it should gradually heal if you don’t cover it. It may leave a small scar.
Occasionally, your baby may develop a shallow sore where they had the injection. If this is oozing fluid and needs to be covered, use a dry dressing – never a plaster – until a scab forms. This sore may take as long as several months to heal. If you are worried or you think the sore has become infected, see your doctor.
Are there any reasons why my baby shouldn’t have the BCG vaccination?
The BCG injection should not be given or should be delayed if your baby:
- has a high fever
- 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 immunised at a site free from skin lesions (broken skin)
- lives in a household where an active TB case is suspected and confirmed
- has had a confirmed anaphylactic (allergic) reaction to a component of the vaccine.
Do I need to know anything else?
Your baby can start their routine immunisations for diphtheria, tetanus, pertussis (whooping cough), polio, Haemophilus influenzae type b (Hib) and meningitis C at two months of age regardless of when they have their BCG. However, you should make sure that your baby is not given another injection in the same limb as the BCG for at least three months afterwards; otherwise the glands in that area may swell. Also make sure that there is a record of the BCG vaccination in your child’s Personal Child Health Record (your Red Book) for future reference.
Countries with high rates of TB
An up-to-date list of countries is available on Public Health England's website (external link).
If you answer ‘Yes’ to any of the following questions your baby may need to have a BCG vaccination if he or she hasn’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?
- Will you and your baby be going to live for more than three months in a country with a high rate of TB 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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