08/07/2024
💉BCG Tuberculosis Vaccine💉
Pull up your sleeve and look at your upper arm; you’ll probably see a mark from a vaccine you got as a child. It was the BCG vaccine. Your little one may also have gotten the vaccine, which formed a huge bump, and you were wondering what was happening.
💉What is TB?💉
TB is a bacterial infection that usually affects the lungs but can also affect any part of the body. Infection with TB may not develop into TB disease. TB disease develops slowly in the body, and it takes several months for symptoms to appear. Most people who have TB infection will never develop TB disease. In these people, the TB bacteria remain inactive for a lifetime. In some people, usually those with weak immune systems, the bacteria may become active and cause TB disease.
The BCG vaccine does not prevent someone from being infected with the bacteria that causes TB, but it prevents the development of the disease.
It is more common for children to have TB, which affects more than one part of the body (miliary TB) and brain inflammation (meningitis). As TB tends to be more severe in children, it is recommended to have a BCG vaccine for your children.
💉What is the BCG vaccine?💉
The Bacillus Calmette–Guérin (BCG) vaccine contains a weakened strain of TB bacteria, which builds up immunity and encourages the body to fight severe TB if infected with it without causing the disease itself.
Because it is weakened, it doesn’t cause TB, but it helps your baby develop immunity against TB in case they ever come into contact with it. The BCG vaccination protects babies and young children against the more rare severe forms of TB, such as TB meningitis.
There are no blood products in the vaccine. All raw materials used to make the vaccine are from non-animal origins.
💉Is it effective?💉
The BCG vaccination is thought to protect up to 80% of people against the most severe forms of TB for at least 15 years, perhaps even up to 60 years.
💉Why is TB still a problem, then?💉
It was hoped that with the invention of the BCG vaccine, it would be possible to wipe out TB in the same way that smallpox has been eradicated. Unfortunately, this hasn’t happened due to the following:
🙉Several strains of TB bacteria have developed resistance to 1 or more anti-TB medications, making them much harder to treat and prevent.
🙉The BCG vaccination is effective against severe forms of the disease, such as TB meningitis in children, but it's not as effective against all forms of TB.
🙉HIV has led to an epidemic of TB cases because it weakens the immune system, making it more likely to develop a TB infection.
💉How is the vaccine given?💉
Your baby will be given the BCG vaccination in the upper part of the right arm. The vaccination is offered after birth while your baby is still in hospital, but it can be given at any time up to five years, preferably before 1 year.
💉Is the vaccine safe?💉
The BCG vaccine is safe for people allergic to latex, penicillin, dairy products, eggs, or nuts.
For HIV-exposed infants, the WHO recommends that BCG should continue to be given at birth to all infants regardless of HIV exposure due to the high TB rates in South Africa.
Worldwide, health authorities have approved this vaccine as safe and effective after extensive research and studies.
💉Who should not get the vaccine?💉
If the child did not receive the BCG at birth, some children should not get the BCG vaccine later because the vaccine could cause complications.
This includes:
🌗Children who have had TB before.
🌗They have a positive Mantoux (skin) test.
🌗They have symptomatic, severe HIV infection
🌗They have a condition or take medicines that weaken their immune system.
💉BCG vaccine shortage💉
Occasionally, there is a vaccine shortage due to international manufacturing and supply issues, and your child might not have received the vaccine at birth. You can take your child (up to 1 year) for the vaccine as soon as it is in stock again.
💉Is the live vaccine safe?💉
The BCG vaccine contains live bacteria that have been weakened (attenuated), so they stimulate the immune system but do not cause disease in healthy people.
Vaccination with BCG reduces the risk of TB and, therefore, also reduces the risk of TB being transmitted to people with a weakened immune system. You cannot catch TB from someone who has been vaccinated.
Children have been getting live vaccines for many years, and these vaccines are considered to be very safe for those who are healthy. One of the very first vaccines, the smallpox vaccine, was a live-virus vaccine. Due to widespread vaccination, the last natural case of smallpox occurred in 1977 (there was a case due to a laboratory accident in 1978), and the disease was declared to be eradicated worldwide in 1979.
💉My child has a huge bump or blister after the vaccine; what now?💉
Immediately after the injection, a raised blister may appear. A tiny spot can appear within two to six weeks of the injection. It may leave a small scar.
6-12 weeks later, the BCG starts ‘reacting’ and may start with a slight bump under the skin and usually develops into a pimple. Sometimes, the pimple becomes quite large and ‘puss-filled,’ and after some time, it pops. It is best to leave it alone, not cover or put anything on it. It’s a good thing if it reacts this way and indicates that the body is responding to it. It can take up to a year to settle.
Keep the area clean and dry, and bathe your child as usual. Carefully pat the area dry after washing. Use some gauze to clean the area if it starts to ooze. Do not cover the area. Do not apply ointment, antiseptic creams, or plasters.
If a significant bump (abscess/collection of pus) is more prominent than an R2 coin forms at the injection site, or there is tenderness and swelling of the glands under the arm, see your GP.
💉Why is there pus in the bump?💉
A fantastic explanation from Ria Coetzee from Pro Vaccination South Africa:
The macrophages (an immune cell that eats up anything that does not belong in the body) engulf the TB bacteria (visualise Pac-man eating). They break it up so that it is no longer harmful. Then, they present parts of bacteria to other immune cells to show what the foreign invader looks like (imagine a warrior displaying his enemy's blood or their head - sorry for the gruesome analogy).
With the vaccine, your immune cells try to eat it up, and when they can't, they kind of tightly pack around it (imagine a bunch of pillows piled in a heap on top of a few peanuts). They isolate it this way to contain it and keep it in place, to prevent it from moving and spreading - and this is what you see in the bump.
What comes out of the bump is pus (all the tightly packed white blood cells isolating the bacteria), and pus is just dead white blood cells. So what you see is dead white blood cells - which is evident that there was an immune response, and your immune system took notice of the invader. When immune cells come in contact with antigens, they create antibodies. That is why we vaccinate.
💉My child didn’t have the bump; was it not effective?💉
If your child did not have this reaction to the vaccine, it does not mean that they have not responded to it. People react differently to vaccines. There's no need to vaccinate with BCG a second time.
BCG can be a life-saving vaccine; now you know why!
Thank you to Nicky Thomson and Ria Coetzee from the Pro Vaccination South Africa page for help with the article. Visit their page for any vaccine-related questions.
Pic of our little cousin’s BCG vaccine mark.
