For most people, the Bacillus Calmette-Guérin (BCG) vaccination provides protection against TB.
The BCG vaccine is not given as part of the routine childhood vaccination schedule unless a baby is thought to have an increased risk of coming into contact with TB.
For example, all babies born in some areas of inner-city London (where TB rates are higher than in the rest of the country) should be offered the BCG vaccination.
Who needs BCG vaccination?
Currently, the BCG vaccination is recommended for three main groups of people. These are outlined below.
Babies
The BCG vaccination is recommended for all babies up to one year old who:
- are born in areas where the rates of TB are high
- have one or more parents or grandparents who were born in countries with a high rate of TB
Older children and adults
- older children who were not vaccinated against TB when they were babies, and who have one or more parents or grandparents born in countries with a high rate of TB
- anyone under 16 who has been in close contact with someone who has pulmonary TB
- anyone who has not been vaccinated and has come from an area where TB is widespread
At-risk occupations
The BCG vaccination is recommended for people under 35 years of age whose occupation puts them at increased risk of exposure to TB. These people include:
- laboratory staff in contact with clinical materials, such as blood, urine and tissue samples
- veterinary staff and other animal workers, such as abattoir workers, who work with animals susceptible to TB, such as cattle or monkeys
- prison staff who work directly with prisoners
- staff of care homes for the elderly
- staff of hostels for homeless people
- people who work in facilities for refugees and asylum seekers
- healthcare workers with an increased risk of exposure to TB
The BCG vaccine is not usually offered to people over 35 years of age, as there is little evidence it provides protection if given at this stage.
Repeat BCG vaccinations are not recommended. Although the BCG may offer less protection over time, there is no evidence to suggest repeat vaccination offers a significant benefit.
See when the BCG vaccination is needed for more information about who can and cannot be vaccinated.
Travel vaccination
The BCG vaccine is also recommended for people under 16 years of age who are going to live and work with local people for more than three months in an area with high rates of TB.
Parts of the world that have high rates of TB include:
- Africa – particularly sub-Saharan Africa (all the African countries south of the Sahara desert) and west Africa, including Nigeria and South Africa
- southeast Asia – including India, Pakistan, Indonesia and Bangladesh
- Russia
- China
- South America
- the western Pacific region (to the west of the Pacific Ocean) – including Vietnam and Cambodia
The vaccine
GPs and travel clinics cannot administer the BCG and arrangements will need to be made with a local TB service.
If you need to be vaccinated against TB, you will first be given a Mantoux skin test. This checks how sensitive you are to the TB vaccine. Your skin reaction will be checked two to 10 days later.
A positive reaction suggests that you have already been infected with the bacteria that cause TB and you may already be immune. If so, you will not need to have the vaccine. If you have a negative result to the Mantoux test, you will be given the vaccine as a single injection.
Read more about travel vaccinations.
Side effects
After having the tuberculosis vaccine, children may feel dizzy and may also develop a rash.
In all cases, a small raised red spot usually develops at the site of the injection within two to six weeks. This can grow into a circle up to 7mm in diameter, which may be crusty where fluid has dried on the surface, and it may also be bruised. A small scar is usually left at the site of the vaccination.
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