BCG – A Must For All Babies
BCG is a live vaccine against Tuberculosis (TB). BCG stands for Bacillus Calmette-Guerin. It was named after two doctors who developed and introduced the vaccine in the 1920s. To date it remains the only available vaccination against TB. It is given to infants to help prevent the more serious forms of TB. The BCG Tuberculosis vaccine is a weakened form of the Tuberculosis bacterium. This weakened form of TB will not cause a Tuberculosis infection or disease since it is weak. It works by developing immunity against the Tuberculosis disease in the event of exposure to Tuberculosis germs.
What is Tuberculosis?
Tuberculosis is a highly infectious disease that usually affects the lungs, but can also affect the lymph glands, brain or even the bones of the body. In babies, Tuberculosis can lead to Tuberculosis Meningitis (tuberculosis infection of the meninges—membranes lining the skull and vertebral canal and enclose the brain and spinal cord), which causes the lining of the brain to swell. TB causes coughing, shortness of breath, weight loss, sweating and loss of appetite.
When should the vaccine be administered?
The vaccine is administered shortly after birth, during a baby’s stay at the hospital. However, there are exceptional circumstances under which the doctor may defer administering the vaccine. These include cases of babies who are unwell or of very low birth weight and cases of mothers who had TB and their babies are taking anti TB medication.
In what area of the body is the jab given?
In Kenya, the injection is given in the left forearm near the elbow joint. Should the scar not disappear, a repeat jab is given at the time of the next immunisation clinic. This indicates that the vaccine has not taken effect. There may be something wrong with the vaccine or the immune reaction of the baby.
If not administered early can it cause any complications?
Delay in giving the BCG vaccine will render the child susceptible to TB infection. Hence, a child should be vaccinated as soon as possible. If the child is more than 5 years old, a test should be done to ensure the child is not already infected, before the vaccine is given. If given to an infected child, the vaccine would be ineffective; the child must complete TB treatment first. Otherwise, the drugs will render the vaccine useless.
What are the dangers of missing a vaccine?
A child who is not vaccinated for TB is at risk of getting severe forms of TB, for example Tuberculosis Meningitis or Miliary TB, a form of TB that is accompanied by lesions resembling millet seed.
All of the infections in the standard baby immunisation schedule can develop into serious illnesses and potentially cause disability and/or death. If most children are immunised, the spread of the infection in the community is significantly reduced and even un-vaccinated children face a much lower risk of catching the illness. Diseases such as polio, for example, now occur in very rare cases.
If more people choose not to immunise their children, then the number of children at risk of catching a disease will increase and outbreaks of the disease will be rampant.
Can BCG be administered on a sick baby?
As a general rule, your child can receive all the standard immunisations unless he or she has a fever at the time the injection is due. The vaccines will not make the illness worse, but existing ailments could make it difficult to identify side-effects.
How does the jab work?
BCG is very effective in the prevention of serious forms of TB, like TB meningitis or miliary TB, which can often lead to death. This is especially important for children because they develop severe TB much more often than adults do. In the areas of the world with high rates of TB the risk of children developing severe TB is high enough to make the use of BCG worthwhile.
Can a baby develop TB after BCG?
BCG can prevent someone from getting TB about half the time although estimates vary widely. The protection BCG provides reduces with time. This means that many people develop active TB even though they received BCG. This is due to generally induced immunity that comes with advancing age. BCG however, gives life long immunity and does not require a booster.
What are some of the (side) effects of BCG?
Two to six weeks after the BCG Tuberculosis vaccine, a small spot may appear at the injection site. Do not cover the injection site. The spot should heal in a few days. Some babies develop fever (a slightly raised body temperature). To lower your baby’s temperature and relieve the discomfort you can give your baby a painkiller.
When should BCG NOT be given?
The vaccine should not be given if a baby has any of the following conditions:
o A low immune system
o A high fever*
o If she is already on cancer treatment
o HIV infected
o A skin condition such as eczema at the injection site*
*These are temporary conditions and the baby should be vaccinated after recovery from an ailments.
Dr. Kituyi Adelaide is a consultant pediatrician at Afya Royal Clinics. Uchumi Ngong Hyper, Mezzanine Floor, Ngong Road.
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