Bacille Calmette-Guérin (BCG) Vaccine

BCG is a vaccine containing live, weakened tuberculosis (TB) germs that activate a person’s immune system. Countries have used BCG for almost 100 years. Globally, about 100 million children receive BCG yearly. BCG protects infants and young children from severe forms of TB such as TB Meningitis and Disseminated TB. There is uncertainty about whether BCG protects people from TB infections after the first few years of life.

A TB “germ” is type of bacteria. TB bacteria are spread through the air from an infected person, usually by coughing. If a person breathes TB bacteria, they may become infected. This is called TB infection (TBI). People who have TBI generally do not know it as they are not sick and do not have symptoms. People with TBI cannot spread the bacteria and infect others. Not everyone who has TBI ends up getting sick.
However, in some people, TBI can cause a person to become sick with TB disease (TBD). TBD can occur in any part of the body but mostly occurs in the lungs and can cause symptoms like coughing, weight loss, night sweats and fever. A person with TBD in the lungs can spread TB bacteria to other people.

BCG vaccine is usually given in the first few months after a baby is born. BCG vaccine is safe for almost all infants. However, not all infants need the BCG vaccine. Vaccines, like any medicine, can have side effects. Side effects, if they occur, are usually mild and go away within a few days. You can give medication for pain/fever if needed.

Check with your health care provider if you have concerns or need advice about which medications to give. Mild side effects include swelling, redness, and soreness where your baby got the vaccine.

Other side effects can include a small, raised bump, sometimes pus-filled and can leak fluid 2-4 weeks after getting the vaccine.

Note: the bump that forms actually means the vaccine is working, teaching the immune system to fight TB germs. See below on how to care for the bump if it occurs.

After your infant receives BCG vaccine:

• Wash your baby’s arm normally
• Place a cool damp compress over any swelling
• If the bump is draining, cover it with dry gauze and not a band aid or waterproof dressing.
• It will heal within 2-5 months and usually leaves a small scar.

DO NOT:

• Poke, squeeze, pop, or scratch the bump
• Use any type of cream or ointment
• Rub or massage the site

If you are concerned about a reaction with the vaccine, talk to your healthcare provider or call 811.

BCG is a vaccine used to protect infants and small children who may be living or visiting areas where there is an increased risk of TB. It is best to talk to your health care provider about travel plans to other countries, or if you plan to have family from other countries come and stay with you after your baby is born. TB is also found in many Inuit and First Nations communities in Canada, including in the NWT, therefore it is important to understand the risk of TB in your home community or communities you may visit often to make a decision about whether BCG is right for your baby.

In NWT, BCG vaccine is typically provided at 1 month of age after SCID screening is negative and HIV status of the parent is known.

SCID is a group of rare genetic conditions that severely affect the immune system and the body’s ability to fight infections. Children born with SCID who don’t receive treatment develop frequent severe infections. All infants in the Northwest Territories are tested for SCID at birth. Babies that have SCID cannot receive any live vaccine, including BCG, because their immune system does not work normally. If BCG is given to a child with SCID, there is the potential for a severe infection.

Tell your healthcare provider if baby’s biological parents or your baby has any of the following immune system conditions or concerns such as:

• SCID – severe combined immune deficiency syndrome (or if anyone in your family has a severe form of immune disease) OR your baby had a positive SCID test at birth
• HIV positive or the HIV status of the birth parent is unknown. In NWT, all prenatal patients are tested for HIV.
• Taking medications that weaken or affect the immune system during pregnancy or while breastfeeding

Other reasons your baby should NOT get the BCG vaccine:

• Your baby has a positive TB skin test (TST)
• Your baby has been diagnosed with TBI or TBD
• Your baby has burns or other serious skin conditions
• Your baby is older than 12 months of age

To find out more about the BCG vaccine, contact your local health unit or visit the following links:

• NWT Immunization Schedule 
• Immunize Canada 
• To track of your family’s immunizations and to receive vaccine schedule reminders download the CANImmunize App.