Only widely used live bacterial vaccine
Bacilli Calmette Guerin- BCG 230 subcultures over 13 years of M.bovis.
- First human to be vaccinated by intradermal technique in 1927.
- WHO has recommended the Danish 1331 strain for the production of BCG.
- Freeze dried is a more stable preparation. Normal saline is recommended for reconstituting the vaccine as distilled water causes irritation.
- Usual strength is 0.1 mg in 0.1 ml. Dose to newborn below 4 weeks of age is 0.05 ml.
- Tuberculin syringe (Omega microstat needle fitted with a 1 cm steel 26 gauge intradermal needle).
- A satisfactory injection should produce a wheal of 5 mm in diameter.
- Vaccination 2-3 weeks papule 5 weeks 4-8 mm 6-8 weeks Scar.
- If there is a local abscess formation- treat with aspiration if it doesn’t heal spontaneously. If not successful- incise and treat with local applications of INH or PAS powder daily 0-80% protection.
- GACVS recommends- children who are known to be HIV infected even if asymptomatic should no longer be immunized with BCG. BCG can be given at the same time as OPV and DPT.