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BCG vaccine contains live attenuated Bacillus Calmette-Guérin (BCG) strain of Mycobacterium bovis. The vaccine will not prevent a person becoming infected with tuberculosis. However, when BCG vaccine is given just after birth, 7 out of 10 of infants and young children will be protected from developing severe forms of TB, e.g. meningeal TB (affecting the brain) and miliary TB (widespread).
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Infants and children at risk of TB can catch-up their missed BCG vaccine any time before their 5th birthday.
No special considerations are required for lyophilised vaccine, store as per cold chain between 2°C to 8°C and protect from light.
The diluent may be stored with the lyophilised vaccine or separately in a cool place. Once the vaccine has been reconstituted protect from light, store at 4°C and discard if not used within 4 hours.
The best time to administer the BCG vaccine is when the infant is between a few days old and six months of age.
Only BCG endorsed, authorised vaccinators may administer the BCG vaccine.
The vaccine is given as an intradermal injection over the left deltoid muscle. No further vaccinations should be administered into the left arm for at least three months.
BCG vaccine can be administered concurrently with other vaccines, including all National Immunisation Schedule vaccines. Separate syringes and different injection sites should be used.
Other live injected vaccine e.g. MMR or varicella vaccines, can be administered on the same day as BCG vaccine. When not injected on the same day as BCG vaccine, other live vaccines must be delayed until four weeks after the BCG. Inactivated/sub-unit vaccines can be given at any time interval before or after the BCG vaccine.
BCG vaccine can be administered at any time before or after rotavirus vaccine because the BCG vaccine is an injectable live vaccine and rotavirus is an oral live vaccine.
Re-vaccination with BCG vaccine is not recommended in New Zealand.
BCG immunisation will not prevent tuberculosis infection. However, when the BCG immunisation has been given just after birth 70% of infants and young children will be protected from developing severe forms of TB i.e. meningeal TB (infection of the membranes covering the brain) and miliary TB.
The effectiveness of the BCG vaccine has been determined over time through observation that those who had received the BCG immunisation could still get pulmonary TB lesions but they were less likely to spread and cause serious forms of tuberculosis disease. The duration of immunity against TB after BCG is not known. However, studies suggest that it wanes with increasing age and could be non-existent 10-20 years after immunisation.
There is no blood test that can identify if a person is protected against TB after receiving a BCG.
A tuberculin skin test (TST or Mantoux test) indicates an immune response following a BCG immunisation but does not necessarily indicate a person has protection against the disease. The size of a TST response is not indicative of the degree of protection after a BCG. Studies have identified animals with a negative TST that were protected from TB and cases where administration of a TST boosted/increased a subsequent TST result but the animal was not protected from TB.
