by Overview of BCG & Tuberculosis
Tuberculosis (TB) is a significant health concern, especially for children under five, with both pulmonary and extra-pulmonary forms being prevalent. The spread of TB germs to vital organs like the brain and lungs can be life-threatening. India, accounting for 26% of global TB cases, sees the highest incidence of brain TB in young children. The Bacille Calmette-Guerin (BCG) vaccine, included in the Universal Immunization Programme, is crucial for protecting children against severe TB forms. Medical practitioners in high-incidence countries like India recommend administering the BCG vaccine at birth, with some cases extending to children aged one to five years, to ensure better health outcomes.
What is the BCG vaccine, who should receive it, and what is its schedule?
The Bacille Calmette-Guerin (BCG) vaccine is derived from weakened TB germs and is used to protect against tuberculosis. It is typically administered to all newborns, with very few exceptions, by injecting it intradermally into the left upper arm. The ideal time for vaccination is at hospital discharge or within the first two weeks after birth. If not given during the neonatal period, it can still be administered up to the age of five years. Only one dose is necessary, with no need for a second dose.
Who should avoid the BCG vaccine?
Certain children should not receive the BCG vaccine due to potential complications. This includes those who:
- Have previously had TB
- Have a positive Mantoux (skin) test
- Have an HIV infection
- Have a condition or are taking medications that weaken their immune system.
What changes occur after BCG vaccination?
Following BCG vaccination, a series of changes typically occur at the injection site. Initially, there may be no visible change for several days. Then, a small, raised spot often appears, which can develop into a blister that sometimes oozes fluid. This blister eventually forms a crusty scab and, later, a small scar. The ulcer at the vaccination site may persist for a few weeks before the final scar forms. The entire process can take anywhere from 6 weeks to 3 months. No treatment is necessary, and the area should be left uncovered.
How safe is the BCG vaccine?
The BCG vaccine is generally safe. Common side effects include prolonged pus formation at the injection site and delayed healing. Occasionally, a swelling may develop in the left armpit due to gland enlargement from the vaccine. This swelling typically lasts for a few months and resolves without treatment. In rare cases, the swelling may become soft, requiring pus removal.
Cost of BCG Vaccine?
BCG vaccine is given at birth and later may cost between 100-1000 INR.
When to see a doctor
Rare side effects can occur with the BCG vaccine. If you experience any of the following, consult your GP:
- A large abscess (pus collection) at the injection site.
- Tenderness and swelling under the left arm, which may indicate an infection of the axillary lymph nodes.
- Noticeable scarring at the injection site, known as keloid scarring.
