The Minster Practice, Lichfield
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BCG vaccineBacillus Calmette-Guerin (BCG) vaccine was introduced for general use in the UK in 1953 with the aim of immunising all children at age 13 before they left school. Protection against tuberculosis of 70-80%, which lasts at least 15 years, has been shown in British schoolchildren . Recommended sites for the injection are the middle of the upper arm at the insertion of the deltoid muscle (higher up the arm can lead to unsightly scarring) or the upper lateral surface of the thigh. The following is a normal reaction to the vaccine. In the first few hours after BCG immunisation, superficial redness, about 1 inch in diameter, develops and subsides over the following few hours. Within 2 - 6 weeks, a local reaction develops at the injection site. A small spot develops increasing in size over a few weeks widening into a circular area about ⅜ inch diameter with scaling, crusting and occasionally bruising. Sometimes a shallow ulcer develops up to ½ inch diameter. The lesion slowly subsides over several months and eventually heals leaving a small flat pale circular scar. It is not necessary to protect the site from becoming wet during washing and bathing but should any oozing occur a temporary dry dressing may be used until a scab forms. It is essential that air is NOT excluded. If absolutely essential an impervious dressing may be applied (e.g. for swimming) but only for a short period as it may delay healing and cause a larger scar. Severe injection site reactions, large ulcers and abscesses are most commonly due to faulty injection technique where the dose is administered too deeply.
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