One of the changes has been the abandonment of the long standing schools bcg programme because of the low risk of tb in that population. Bcg vaccination programme from july 2005 an improved targeted neonatal and other at risk based programme replaced the previous schools programme for older children 1999. However, bcg is not generally recommended for use in the united. The united kingdom has recently changed its bcg vaccination policy in response to the changing epidemiology of tuberculosis tb in children. Phe uk immunisation schedule green book chapter 11 phe. Introduction of menc into childhood vaccination schedule adult immunisation programme source. Principles of vaccination, pink book webinar series, june 6, 2018, immunity, vaccines, antigen, antibody, types of immunity active and passive, antibody for prevention of rsv, live attenuated vaccines viral and bacterial, inactive vaccines viral and attenuated, individual response to live vaccines, population response to live vaccines. The bcg vaccine can take 3 months to provide protection against tb disease. Bcg vaccination is carried out under the expanded programme of immunisation epi. Who should have it and why public health england, winter 201920. Immunisation public health royal college of nursing. Surveillance decision evidence tuberculosis guidance.
The most common form of tb in ireland affects the lungs, but it can affect other parts of the body such as the bones, joints and kidneys. International studies of the effectiveness of bcg vaccine have given widely varying. Public health england updated the uk immunisation schedule the green book chapter 11 in january 2020. Immunisation policy for the uk is available in immunisation against infectious diseases the green book. Phe uk immunisation schedule green book chapter 11 phedh. A recurring theme is the administration of bcg vaccines to infants of hivpositive mothers in whom full assessment of their hiv status had not been completed. Children less than five years who will have prolonged greater than three months or frequent travel to a high tb incidence country. Depending on the risk of acquiring tb, there may be benefits to vaccinating older children. Coordinated work will need to continue, however, to allow this number to be maintained and progressed.
Keep the vaccination area dry for 24 hours after receiving the vaccine, and keep the area clean until you cannot tell the vaccination area from the skin around it. Immunisation by nurses and other health professionals. The bcg vaccine should be considered only for very select persons who meet specific criteria and in consultation with a tb expert. Bcg vaccine fda prescribing information, side effects and uses. The green book recommendations around bcg vaccination of healthcare workers and laboratory staff that were available when nice guideline ng33 was developed were broadly aligned. However, the vaccine is 7080% effective against the most severe forms of the disease, such as tb meningitis in children. Uptake of the neonatal bcg vaccination is improving and at 89. The bcg vaccination is not part of the wa routine vaccination program. The bcg, an old vaccine but the only one against tuberculosis, is more effective than was thought, offering protection for at least 20 years, a new study. Design a survey of key informants across pcts using a standardised, structured questionnaire. Delayed administration of bcg has been reported to be associated with reduced vaccination coverage and equitability. Bcg vaccine has a documented protective effect against meningitis and disseminated tb in children.
More information for more information please see bcg vaccination information for parents. The technical instructions include a vaccination component, specifying how the civil surgeon has to conduct the vaccination assessment. Your doctor or a health care provider will administer this medicine. Bacillus calmetteguerin vaccine treatment summary bnf.
This gives good immunity to people who receive it without actually causing the disease. Nhs grampian has an efficient method for identifying infants at risk of exposure to tb. Tb is an infection caused by a bacterium called mycobacterium tuberculosis. The bcg vaccine is made from a weakened strain of tb bacteria. A general practitioner or specialist referral is required to attend this clinic. Bcg immunisation began in mid1950s as part of the ncip. Other changes to the immunisation schedule, such as the. The bcg immunisation programme has contributed significantly to the eradication of tb meningitis in. However, the green book recommendations are specifically to use a 26g, 10mm brown needle. Coordinated work will need to continue, however, to allow this number to.
Only medical or nursing staff who are trained in bcg vaccination procedures should administer bcg vaccine. Public health england gateway number 2019221 pdf, 54. Public health england has published updated information and guidance on tuberculosis in the green book immunisation against infectious disease. Updated chapter with the latest information about a licensed bcg vaccine now available in the uk.
Therefore bcg vaccine should ideally be given 3 months prior to travel to a high tb incidence country. Tuberculosis august 2018 administration of bcg vaccination in all cases, bcg vaccine must be administered strictly intradermally, normally into the lateral aspect of the left upper arm at the level of the insertion of the deltoid muscle just above the middle of the left upper arm as recommended by who. If your immigration medical examination is during this period, you are required to have the seasonal flu vaccine. A list of courses, conferences and study days of relevance to uk health professionals working, or wishing to. The recommendation from public health is to vaccinate those who may have an increased risk of exposure to tb or of developing tb. Vaccination with the bacillus calmetteguerin bcg is among the most important tb control strategies in iran 2. Due to the worldwide shortage of bcg vaccine, appointments are limited as the rch only has a limited amount of supply of vaccine.
Bcg bcg vaccine is recommended for healthcare workers who may have close. Bcg vaccination is recommended for all babies up to 1 year old who. Mar 12, 2011 these children should be identified at suitable opportunities, tuberculin tested and vaccinated if negative see green book chapter 32 section on tuberculin testing prior to bcg vaccination. Aug 31, 2017 the bcg, an old vaccine but the only one against tuberculosis, is more effective than was thought, offering protection for at least 20 years, a new study shows. When used to protect against tb, it is injected into the skin. Because the bacteria in the vaccine is weak, it triggers the immune system to protect against the disease. Bcg vaccine ajv aj vaccines is the only licensed vaccine in the uk. Phe publications gateway number 2018326 pdf, 152kb, 16 pages this file may not be suitable for users of assistive technology. Rch runs an outpatient clinic once a week that provides bcg vaccine to infants less than 12 months. Public health guidelines are set out in the immunisation green book.
If the mantoux test is negative, refer to the green book for bcg immunisation guidance. Health professionals and immunisation practitioners can keep up to date with developments in the field and updates to the green book through regular vaccine update newsletters. Surveillance decision evidence tuberculosis guidance nice. However, chapter 32 of the green book was updated in august 2018 and the updated recommendations are much more restrictive in terms of when healthcare workers or. Children less than five years who will have prolonged greater than three months or frequent travel to a high tb incidence country newborn children of parents with hansens disease leprosy or a family history of hansens disease. This pgd is for the administration of bcg vaccine ajv by registered healthcare. Tb vaccine bcg effective for twice as long as previously. It uses a live tb germ that has been modified in the laboratory so that it will not cause disease in a healthy person. This was based on early studies with measles and smallpox vaccines, 1.
Jan, 2016 the green book recommendations around bcg vaccination of healthcare workers and laboratory staff that were available when nice guideline ng33 was developed were broadly aligned. Studies of the effectiveness of bcg vaccine range from no protection to 7080% protection. Tuberculosis the green book, public health england see useful. Bcg may still be available through private travel clinics. These children should be identified at suitable opportunities, tuberculin tested and vaccinated if negative see green book chapter 32 section on tuberculin testing prior to bcg vaccination. Sep 11, 20 the green book has the latest information on vaccines and vaccination procedures, for vaccine preventable infectious diseases in the uk.
The bacille calmetteguerin bcg vaccine has existed for 80 years and is one of the most widely used of all current vaccines, reading 80%of neonates and infants in countries where it is part of the national childhood immunization programme. Practice guidelines diagnosis of active and latent. Routine vaccination all staff should be up to date with their routine immunisations, e. A positive reaction to a tb skin test may be due to the bcg vaccine itself or due to infection with tb bacteria. Theres no evidence the bcg vaccine works for people over the age of 35. Results complete questionnaires were returned from 127 84% pcts. Bcg vaccination scar associated with better childhood.
Bcg, or bacille calmetteguerin, is a vaccine for tuberculosis tb disease. To see the most up to date version of this guideline, see the full guideline on the phe website. Bcg vaccine is available from state and territory tuberculosis services. Apr 15, 2016 vaccination with bcg may cause a false positive reaction to a tb skin test.
May 02, 2019 in nsw bcg vaccine is only recommended for. Bcg vaccination is recommended for newborn babies of parents with leprosy or with a family history of leprosy. Contraindicated bcg vaccination of at risk infants the bmj. General contraindications to vaccination public health england, august 2017. The main use of bcg is for vaccination against tuberculosis. Hepatitis b vaccination is recommended for workers who are at risk of injury from bloodcontaminated shar p instr uments, or of being deliberatel y injured or bitten by patients. Oct 20, 2015 although no harmful effects of the bacillus calmetteguerin bcg vaccination on the fetus have been observed, bcg vaccination should not be given during pregnancy due to theoretical concerns associated with a live vaccine. For advice on bcg vaccination in immunosuppressed individuals, consult chapter 32. Bcg vaccine is only available through local district health board dhb bcg vaccination programmes, to babies and children aged 05 that meet the following eligibility criteria as per the pharmac schedule.
The green book has the latest information on vaccines and vaccination procedures for all the vaccine preventable infectious diseases that may occur in the uk. Pack sizes of 1, 5, or 10 vials and pack size of 1 vial with one syringe and two injection needles one long for adding solvent and one short. Immunisation of healthcare and laboratory staff hepatitis b. Vaccination with bcg may cause a false positive reaction to a tb skin test. The bacillus calmetteguerin bcg vaccine bcg vaccine contains a live attenuated strain derived from m. Revised recommendations for the administration of more. The green book has the latest information on vaccines and vaccination procedures, for vaccine preventable infectious diseases in the uk. Children who were recent home contacts of a case of pulmonary tb became eligible for the bcg vaccine in 1949. It is less effective in preventing respiratory disease, which is. Immunisation of individuals with underlying medical. Does bcg have a role in tuberculosis control and prevention. Immunisations and chemotherapy cancer treatment cancer.
This chapter has been completely updated to reflect the latest evidence on contraindications and special considerations for vaccination. Safety and immunogenicity of early bcg vaccination in. Bcg vaccine for percutaneous use is an attenuated, live culture preparation of the bacillus of calmette and guerin bcg strain of mycobacterium bovis. This section is part 1 of the phe uk immunisation schedule. Bcg vaccination is only recommended on the nhs for babies, children and adults under the age of 35 who are at risk of catching tuberculosis tb. More striking evidence bcg vaccine might protect against covid19 study shows countries with vaccination programmes have far fewer cases mon, apr 6, 2020, 15. Bcg vaccine does not contain thiomersal or any other preservatives. Children over 6 months of age or with prior tb exposure are required to have a tuberculin skin test before they can have the bcg vaccine. Bcg vaccine can be administered after birth intradermally.
This includes administering vaccinations included in the childhood immunisation programme and those recommended for adults, including travel vaccines and the annual influenza vaccination. Bcg is used in many countries with a high prevalence of tb to prevent childhood tuberculous meningitis and miliary disease. One of the greatest triumphs of immunology has been the development of vaccines against certain infectious agents. Antibody titres for hepatitis b should be check ed one to four. Although parental consent is required, acceptance has been high and close to 100% of children has been vaccinated in the last decade table 7. Please read the fact sheet on unregistered bcg before requesting a bcg vaccination. Some highrisk women should be considered for bcg vaccination in pregnancy. To improve the uptake of bcg vaccination, identify eligible groups in line with the department of healths green book. May 21, 2014 bcg vaccine contains a live attenuated strain derived from m. Further information about the bcg vaccination can be found here and here. The other change has been the targeting of those infants and children at increased risk of tb, particularly in.
The bcg vaccine is no longer offered to everyone in the uk. If you have an immigration medical examination completed between april 1 and september 30, when it is not the. For purposes of the immigration medical examination, the flu season starts on october 1 and ends on march 31 each year. Newborn children of parents with hansens disease leprosy or a family history of hansens disease.
Objective assess the current bcg vaccination policies and delivery pathways for immunisation in primary care trusts pcts in england since the 2005 change in recommendations. Safety and immunogenicity of early bcg vaccination in infants. Revised recommendations for the administration of more than. What bcg vaccine ajv looks like and contents of the pack bcg vaccine ajv consists of a powder and solvent for suspension for injection 28 x 105 bacteria0. Since the last edition of immunisation against infectious disease the green book, the immunisation programme has seen a number of changes, to both the vaccination schedule and to peoples attitudes to vaccination. Use a short 10 mm 2627 gauge needle with a short bevel. Immunisation of individuals with underlying medical conditions. The efficacy of bacille calmetteguerin bcg against pulmonary tuberculosis tb in infants and adults varies from 0 to 80% in different studies. The vaccine is 70 to 80% effective against the most severe forms of tb, such as tb. Bcg vaccine does not contain thiomersal or any other.
Since bcg has never been cloned and has been grown under different conditions and in different laboratories, genetic differences have developed between the. Bcg vaccine and vaccinator endorsement ministry of health nz. Bcg was given to all newborns between 1955 and 1982. In the 1960s a selective bcg vaccination programme was introduced. As a precaution, if an individual has a history of severe i. The civil surgeon records the results of the medical examination, including the results of the vaccination assessment, on uscis form i693, report of medical examination and vaccination record. The bcg vaccination is not part of the wa routine vaccination program it is only given in restricted circumstances. Bacille calmetteguerin bcg was developed by calmette and guerin, at the pasteur institute lille using in vitro attenuation by repeated passage of an isolate of m. Immunisation of healthcare and laboratory staff hepatitis b hepatitis b vaccination is recommended for workers who are at risk of injury from bloodcontaminated shar p instr uments, or of being deliberatel y injured or bitten by patients. Bcg vaccination can cause a false positive mantoux test, although a very highgrade reading is usually due to active disease the most controversial aspect of bcg is the variable efficacy found in different clinical trials, which appears to depend on geography. For many years, immunisation against infectious disease the green book has contained a recommendation that when two live vaccines are required in the same individual, then the vaccines should either be given on the same day, or separated by an interval of at least four weeks. Immunisation of healthcare and laboratory staff health and safety at work under the health and safety at work act hswa 1974, employers, employees.1490 891 1185 1475 1067 15 1091 1364 688 753 388 538 1366 513 1203 1557 114 55 55 409 76 599 791 1458 1374 824 1095 1137 1005 242 660 827 119