The immunization for tuberculosis is the Bacillus Calmette-Guérin (BCG) vaccine, named after its inventors, Albert Calmette and Camille Guérin. While it is one of the most widely used vaccines globally, its primary purpose is to protect children against severe forms of tuberculosis, such as TB meningitis. In countries with a low TB prevalence, it is not administered to the general population but is reserved for individuals at higher risk.
Locating a BCG Vaccine Provider
In nations with low tuberculosis rates, like the United States, the BCG vaccine is not part of the routine immunization schedule, making it necessary to seek out specific providers. Public health departments at the county or state level are the primary administrators for individuals who meet the eligibility criteria. Health care providers can consult with their local or state TB control program for assistance in obtaining the vaccine.
Travel medicine clinics are another common source for the BCG vaccine. These specialized facilities cater to individuals planning to travel to parts of the world where tuberculosis is widespread. They can assess a traveler’s need for the vaccine based on their destination, length of stay, and planned activities.
Some hospitals and specialized medical centers may also offer the BCG vaccine. These are larger institutions with dedicated infectious disease departments or international health programs. Accessing the vaccine through a hospital often requires a referral and a consultation with a specialist to confirm the necessity of the immunization.
Eligibility for the BCG Vaccine
Vaccination is recommended only for specific groups of people who are at a heightened risk of exposure. Public health authorities have established clear criteria to determine who should receive the vaccine.
The main candidates for the BCG vaccine are infants and young children who have a negative TB test result but face continuous exposure to the disease. This applies to a child living in a household with an adult who has an active case of tuberculosis. It is also considered for children who will be exposed to adults with multidrug-resistant TB, where preventive antibiotic treatments for the child may not be an option.
Certain healthcare workers may also be considered for vaccination after consulting with a TB expert. This applies to professionals working in environments where transmission of multidrug-resistant TB is a known risk. The decision is made on a case-by-case basis, weighing the individual’s risk of exposure against the vaccine’s variable effectiveness in adults.
Travelers planning extended stays in countries with high rates of TB may be advised to get the vaccine. This is particularly relevant for children under 16 who will be living among the local population for more than three months. A consultation with a travel medicine specialist is important to assess the specific risks associated with the travel itinerary.
The Administration and Aftercare Process
The BCG vaccine is administered through a single intradermal injection, which means it is delivered into the top layer of the skin. The preferred site for the injection is the upper arm. Immediately after the injection, a small, raised white bleb will appear on the skin, which fades within about half an hour.
A distinct local skin reaction is expected to develop at the injection site, usually beginning within one to six weeks. A small red blister or sore will form, which may be a few millimeters in diameter. This area might become a small, weeping sore that can take up to three months to fully heal, which is a normal part of the body’s immune response.
Aftercare involves keeping the vaccination site clean and dry, allowing air to circulate around it as much as possible. It is not necessary to cover the site with a large plaster unless it is weeping, in which case a breathable gauze dressing is recommended. The site should not be scratched, squeezed, or have any creams or ointments applied, and the healing process culminates in a small, permanent, flat scar.