What is the BCG Vaccine Used For?

Bacillus Calmette-Guerin (BCG) vaccines help to prevent tuberculosis (TB), especially in areas where the disease is endemic (widespread). The BCG vaccine is highly effective in preventing serious forms of childhood TB, such as TB meningitis (inflammation of the covering around the brain or spinal cord) and disseminated TB (spread of TB infection from the lungs to multiple organs).

Tuberculosis (TB) is an infectious disease caused by the bacteria known as Mycobacterium tuberculosis. It is spread from one person to another through droplets released into the air, such as by coughing or sneezing.

Common symptoms of TB include cough lasting three weeks or longer, coughing out blood, feeling tired, fever, night sweats and unexplained or unintentional weight loss.

Who Should Receive the BCG Vaccine?

The BCG vaccine is routinely given in Singapore to newborns soon after birth, as recommended under the National Childhood Immunisation Schedule (NCIS).

It may also be considered for adults who have not been previously infected or are unvaccinated, but are at a higher risk of contracting TB. These include those with risk of exposure from work, such as healthcare/long-term care facilities personnel, prison personnel or workers exposed to cattle or monkeys. Mantoux testing (a test to check if one is infected with TB) is recommended before vaccination to confirm lack of current or previous TB infection.

What Precautions Should I Follow Before Receiving the BCG Vaccine?

Inform your healthcare professional if:

• You/your child are allergic to this vaccine or any of the other ingredients of this vaccine
• You are pregnant, planning to become pregnant, or breastfeeding
• You/your child are taking any other medications
• You/your child have a weak immune system due to an illness such as Human Immunodeficiency Virus (HIV) infection or cancer
• You/your child are currently on treatment which weakens your/their immune system such as medications (e.g. steroids) or radiation therapy to the bone marrow
• You/your child are currently not feeling well and having a fever
• You/your child have a skin infection that affects the whole body
• You/your child have recently received any other vaccines

How Is the BCG Vaccine Given?

It is given by injection into the skin.

One dose is given to newborns soon after birth as part of the NCIS. The vaccination is usually offered while your baby is still in hospital.

If your baby was unable to receive the BCG vaccination while still in the hospital, BCG vaccination is offered as one dose for children up to 5 years of age (i.e. <6 years). Children aged 6 months or older are required to undergo Mantoux testing before vaccination.

It is also administered as one dose for adults who are not previously infected or are unvaccinated, but are at a higher risk of contracting TB.

What Are Some Common Side Effects of the BCG Vaccine?

For newborns

• Pain, redness and swelling at the injection site
  • You may place a cold compress over the affected area for relief
  • You may give paracetamol for pain relief
  • A small lump appears at the injection site followed by an ulcer, which may ooze with pus, before healing on its own (usually by 3 months) to a superficial scar
    • Keep the area clean and dry
    • A light sterile gauze dressing (changed daily) may be applied if there is a lot of pus
• Fever
  • You may give paracetamol
  • If fever persists, see doctor for medical advice

For adults

• Some may feel faint after the vaccination
  • Sit for 15 minutes after receiving the vaccine to avoid fainting
• Pain, redness and swelling at the injection site
  • You may place a cold compress over the affected area for relief
  • You may take paracetamol for pain relief
  • A small lump appears at the injection site followed by an ulcer, which may ooze with pus, before healing on its own (usually by 3 months) to a superficial scar
    • Keep the area clean and dry
    • A light sterile gauze dressing (changed daily) may be applied if there is a lot of pus

• Headache and fever
  • You may take paracetamol to treat the headache or fever

Please see a doctor if these side effects do not get better or become worse.

What Are Some Rare But Serious Side Effects That I Need to Seek Medical Advice Immediately?

The symptoms of a drug allergy include one or more of the following:

• Swollen face/eyes/lips/tongue
• Difficulty in breathing
• Itchy skin rashes over your whole body

Rarely, infection or swelling of lymph nodes with/without pus at the armpit (same side injection was given) may occur.

If you/your child experience any of these symptoms, you should inform your healthcare professional immediately.