Madison Clarke
The Bacille Calmette-Guérin (BCG) vaccine is used to prevent tuberculosis (TB). It is recommended for people who are at high risk of developing TB, such as babies and children, travellers, and people in certain professions. The BCG vaccine is not routinely given in all countries, and it is important to consult a healthcare professional to determine if it is suitable for you.
| Characteristics | Values |
|---|---|
| Name | Bacille Calmette-Guérin (BCG) |
| Use | Vaccine for tuberculosis (TB) disease |
| Administration | Injection into the skin or upper part of the left arm |
| Number of doses | One |
| Side effects | Redness, swelling, mild pain, small ulcer, and scarring at the injection site |
| Serious side effects | Rare |
| Pregnancy | Not recommended during pregnancy |
| Efficacy | Reduced infections by 19-27% and reduced progression to active TB by 71% |
| Regions with high use | Countries with a high risk of TB, including Eastern Europe and sub-Saharan Africa |
| Regions with low use | United States, Netherlands |
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What You'll Learn
The Bacille Calmette-Guérin (BCG) vaccine
The BCG vaccine is injected into the skin and can cause redness, swelling, and mild pain at the injection site. It is recommended that only one dose is needed, and it should be administered after birth. It is on the World Health Organization's List of Essential Medicines.
The vaccine is particularly helpful in protecting babies and young children against more serious forms of TB, such as TB meningitis, and miliary TB disease. It prevents about 20% of children from getting infected, and among those who do get infected, it protects half from developing the disease. A systematic review and meta-analysis conducted in 2014 demonstrated that the BCG vaccine reduced infections by 19–27% and reduced progression to active tuberculosis by 71%.
The BCG vaccine is not suitable for everyone. It is not recommended for pregnant women, as there is insufficient evidence about its safety during pregnancy. It is also not recommended for babies with weakened immune systems, for example, if there is a family history of HIV or severe combined immunodeficiency (SCID).
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TB skin test reactivity
The Bacille Calmette-Guérin (BCG) vaccine is used to prevent tuberculosis (TB) disease. The TB skin test, also known as the Mantoux tuberculin skin test or TST, is a method of determining whether an individual is infected with TB bacteria. The test involves injecting a standardised solution made with purified protein derivative (PPD) under the skin. PPD is derived from tuberculin and is not a live bacterium, therefore it cannot make individuals sick.
In individuals who have been infected with TB, the immune system will recognise the PPD as it is derived from proteins excreted by M. tuberculosis. This recognition causes a T-cell-mediated delayed-type hypersensitivity reaction, which appears as a firm, red bump at the injection site within three days. The size of the bump is measured by a healthcare provider. A negative test, indicated by the absence or a very small bump, means that the individual does not have TB. A positive test, indicated by a bump of a certain size, means that the individual likely has TB germs in their body.
It is important to note that previous BCG vaccination can cause false-positive results in the TB skin test. This is because the BCG vaccine can cause tuberculin reactivity, especially during the first two years after administration. Therefore, individuals who have received the BCG vaccine and exhibit a positive TB skin test reaction should be further evaluated for latent TB infection or TB disease. TB blood tests are the preferred method for individuals who have received the BCG vaccine, as these tests are not affected by prior vaccination.
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BCG side effects
The Bacille Calmette-Guérin (BCG) vaccine is used to prevent tuberculosis (TB) disease. It is not generally used in the United States, but it is given to infants and small children in countries where TB is prevalent. The vaccine can cause a false positive TB skin test reaction.
When used as a treatment for early-stage bladder cancer, BCG is delivered directly into the bladder (intravesical) through a catheter. It is used to treat non-muscle-invasive bladder cancers and can slow tumour growth and reduce the chance of needing a cystectomy. It is typically administered weekly for six weeks, followed by maintenance therapy given once a week for three weeks at three, six, and 12-month marks.
BCG treatment for bladder cancer can cause various side effects, including:
- Lower back pain
- Abdominal pain
- Pain when urinating
- Urinary tract infection
- Blood in the urine
- Kidney problems
- Fatigue
- Nausea
- Vomiting
- High fever
- Signs of infection
Most side effects typically resolve within 48 to 72 hours. However, if symptoms persist or become severe, individuals are advised to contact their healthcare provider for guidance and medication to manage the side effects.
Pregnant women should not receive the BCG vaccination or treatment, although no harmful effects on the fetus have been observed. Doctors also recommend that individuals undergoing BCG treatment for bladder cancer avoid becoming pregnant or making someone pregnant during the treatment course.
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BCG for pregnant women
The Bacille Calmette-Guérin (BCG) vaccine is a vaccine for tuberculosis (TB) disease. It is the only vaccine licensed against tuberculosis, which is an ongoing pandemic. Tuberculosis elimination is a goal of the World Health Organization (WHO).
The BCG vaccine is not generally used in the United States, although many people born outside the US have been vaccinated with it. It is commonly administered to infants and small children in countries where TB is prevalent. The vaccine protects children from getting severe forms of active TB disease, such as TB meningitis and miliary TB disease.
The BCG vaccine is not recommended for pregnant women. While no harmful effects on the fetus have been observed, there is insufficient evidence about the safety of BCG vaccination during pregnancy. Animal reproduction studies have shown an adverse effect on the fetus, and there is a lack of well-controlled studies in humans. Therefore, the potential risks outweigh the potential benefits, and it is classified as FDA Pregnancy Category C.
However, there have been studies on the influence of BCG immunization on tuberculin reactivity in healthy pregnant women. One study performed tuberculin testing on 840 healthy Chilean women in their third trimester of pregnancy, with 807 having been immunized with one or more doses of BCG. The study found that healthy, BCG-immunized pregnant women may have positive tuberculin reactions without an increased risk for tuberculosis. This highlights the need to consider the incidence of tuberculosis and the BCG immunization status when developing policy recommendations for diagnosing and treating Mycobacterium tuberculosis infection in pregnant women.
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BCG for healthcare workers
The Bacille Calmette-Guérin (BCG) vaccine is a vaccine for tuberculosis (TB) disease. It is not generally used in the United States, but it is given to infants and small children in countries where TB is prevalent. The BCG vaccine protects children from severe forms of active TB disease, such as TB meningitis and miliary TB disease.
The BCG vaccine has also been studied for its potential to protect against COVID-19 in healthcare workers. Several clinical trials have been conducted to evaluate the effectiveness of the BCG vaccine in reducing the impact of COVID-19 among healthcare workers. These trials suggested a potential association between BCG vaccination and protection against COVID-19 infection and respiratory infections in healthcare workers.
However, it is important to note that the BCG vaccine can cause a false positive TB skin test reaction. As a result, TB blood tests (interferon-gamma release assay or IGRA) are recommended for individuals who have received the BCG vaccine.
When considering BCG vaccination for healthcare workers, it should be done on an individual basis in specific settings. These settings include places where there is ongoing transmission of drug-resistant TB strains to healthcare workers, or where comprehensive TB infection control precautions have been unsuccessful. Healthcare workers should be counselled regarding the risks and benefits associated with both BCG vaccination and the treatment of latent TB infection.
Pregnant women should not receive the BCG vaccination, although no harmful effects on the fetus have been observed, further studies are needed to confirm its safety.
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Frequently asked questions
The name of the TB vaccine is the Bacille Calmette-Guérin (BCG) vaccine.
The BCG vaccine is a vaccine for TB disease. It is not commonly administered in the United States.
The BCG vaccine is recommended for people at high risk of developing TB, including those staying for extended periods in countries with a high risk of TB. It is also recommended for babies and young children in countries where TB is prevalent.
The BCG vaccine is given as an injection into the skin, typically in the upper part of the left arm. It is usually only given once, but may be repeated if there is not a good response.
Common side effects include redness, swelling, and mild pain at the injection site. Serious side effects are rare, but people with immunosuppression may experience more severe reactions. The BCG vaccine is not recommended for pregnant women, as there is insufficient evidence about its safety during pregnancy.
