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BCG vaccine is a live bacterial vaccine given for protection against tuberculosis, mainly severe forms of childhood
tuberculosis. It stands for Bacillus Calmette Gurrain, the strain of bovine tuberculosis used in the vaccine & attenuated by
French scientists Calmette & Gurrain.
BCG is given anytime from birth to 15 days of life along with the zero dose of oral polio vaccine. It is to be given to all
children as part of EPI schedule as recommended by Govt. of India.
Storage and Preparation
BCG vaccine is available as a lyophilized powder in an ampoule. Diluent used is buffered saline that is available separately.
It is available in a multidose ampoule containing 20 doses. BCG vaccine stocks can be stored frozen in freezer
compartment. Working stock can be stored in the chiller compartment. Even diluents should be stored in the refrigerator's
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treatment is required & only observation is required. It will usually disappear on its own in the next few months time. If the
glands are bigger than 15mm, soft, fluctuating with signs of inflammation or softening, painful and matted or if already an
abscess has formed with or without discharge, treatment is definitely required. One can either remove the entire gland
surgically or try a course of anti-tuberculous drugs in form of Isoniazid 5 mg/kg/day & Rifampicin 10mg/kg/day on empty
stomach for a period of 3-6 months.
BCG not given at birth
BCG should be given as early as possible in life, before child comes in contact with tuberculosis. It can be given up to 5
years of age. If it is given beyond 6 months it is preferable to do a prior Mantoux test to see if the patient is already
sensitized to tuberculosis. If patient is already sensitized as shown by positive MT, BCG is not necessary. If prior MT is not
done, at least check for accelerated reaction to BCG in first week after vaccination which may suggest presence of
tuberculosis in the child.
BCG and developed countries
In developed countries like USA, very few cases of tuberculosis occur. As BCG does not prevent primary complex or the
adult type of tuberculosis no benefit will be derived by routine BCG vaccination in such countries. In fact BCG can interfere
with interpretation of Mantoux test done subsequently. Hence BCG is not recommended in USA routinely. With the spread of
HIV, incidence of tuberculosis is rising in USA. Under such circumstances they may have to reconsider about routine BCG
vaccination.
No BCG scar post vaccination
Formation of scar is neither necessary nor is the only indication of success of BCG vaccine. However it is the only simple &
convenient way of determining success of BCG vaccine. It may take 3-6 months for the scar to form. If no scar is visible at
all after 6 months one needs to do Mantoux test. If negative, one should give repeat BCG.
Can BCG be given with other vaccines?
BCG can be given with other vaccines. In fact, BCG is given along with zero dose of OPV & 1st Dose of Hepatitis B vaccineat
birth. As measles can depress cell mediated immunity & as BCG induces cell mediated immunity BCG should not be given
along with measles or MMR