BCG VACCINE

Bacille Calmette-Guérin vaccine (BCG) is a live vaccine recommended by WHO for administration at birth in an attempt to prevent disseminated and other life-threatening manifestations of M. tuberculosis.

BCG vaccination is not routinely recommended in the USA and is rarely indicated. It is used as a prevention strategy only in selected situations involving individuals who meet specific criteria

Prior BCG vaccination is not a contraindication to tuberculin testing.

A positive skin test in an asymptomatic child with a negative chest x-ray and a history of BCG immunization represents latent TB and ant tuberculosis therapy should be initiated.

• Immunization with BCG should be considered for an infant or child with a negative tuberculin skin test only if the following circumstances are present:
  • The child is exposed continually to an untreated or ineffectively treated patient who has infectious pulmonary TB, and the child cannot be separated from the presence of the infectious patient or given long-term primary preventive therapy; or
  • The child is exposed continually to a patient who has infectious pulmonary TB caused by M. tuberculosis strains resistant to isoniazid and rifampin, and the child cannot be separated from the presence of the infectious patient.
• Per ACIP, BCG vaccination of health care workers should be considered on an individual basis in the following high-risk situations:
  • A high percentage of TB patients are infected with M. tuberculosis strains resistant to both isoniazid and rifampin
  • Transmission of such drug-resistant M. tuberculosis strains to health care workers and subsequent infection are likely
  • Comprehensive TB infection-control precautions have been implemented and have not been successful
• BCG vaccination is not recommended for HIV-infected children or adults in the USA.
  • Per WHO, BCG vaccination is recommended for asymptomatic HIV-infected children who are at high risk for infection with M. tuberculosis (i.e., in countries in which the prevalence of TB is high), but should not be used in symptomatic patients.

BCG vaccine is not recommended during pregnancy

Dr Assad