BCG vaccine

The BCG vaccine (Bacillus Calmette-Guérin) helps protect your baby against tuberculosis (TB).

What's TB?

TB is a serious infectious disease. TB can progress rapidly, particularly in young children and infants, and can lead to TB meningitis (swelling of the lining of the brain) in babies.

In young people and adults it usually affects the lungs, but can also affect the:

• lymph glands
• brain
• joints
• kidneys
• bones

Most people in the UK recover fully after treatment, but this usually takes several months.

How common's TB?

TB isn't a common disease. In Scotland, around 400 new cases of TB are diagnosed every year. Most of these cases occur in adults over the age of 25.

Cases of TB can be found all over the world. With increasing numbers of people travelling around the world, the risk of people coming into contact with the disease or bringing it into this country is increasing.

More about tuberculosis

Who's eligible for the vaccine?

The BCG vaccine's offered to those babies who are more likely than the general population to come into contact with someone with TB. This is because they either:

• lived in an area with high rates of TB
• their parents or grandparents came from a country with high rates of TB - including countries in South-East Asia, sub-Saharan Africa and some countries in Eastern Europe

An up-to-date list of countries with high rates of TB is available on the GOV.UK website.

When will my baby be immunised?

The vaccine's usually offered soon after birth, while your baby's still in hospital or soon after you return, however, it can be given at any time if necessary.

The vaccine will be made available to your baby at birth, or it can be given later. Your local Health Board will advise you about arrangements.

Countries with high rates of TB

If you answer ‘yes’ to any of these questions your baby may need a BCG vaccine if they haven’t already had one:

• Are you, your family or your baby’s father or his family from a country with a high rate of TB? (If in doubt, talk to a health professional.)
• Will you and your baby be going to live in a country with a high rate of TB for more than 3 months in the near future?
• Will you and your baby be travelling frequently to countries with a high rate of TB in the near future?
• Does anyone in your house have TB, or had it in the past, or comes from a country with a high rate of TB?
• Does anyone else who's likely to have long-term close contact with your baby have TB, or had it in the past, or comes from a country with a high rate of TB?

Improving how vaccines are offered in Scotland

To improve how vaccinations are offered to you or your child, you may notice:

• you're invited to a new location to receive your immunisations instead of your GP practice
• the health professional giving your immunisations changes

You'll still receive clear information about the location, date and time of your appointment.

The BCG vaccine contains a weakened form of the bacteria (germs) that cause TB. The vaccine doesn't actually cause TB, but it helps your baby develop protection (immunity) against the disease in case he or she ever comes into contact with it.

The vaccine's injected just under the skin of the upper part of the left arm.

What vaccine's used?

The BCG vaccine AJV is routinely used in Scotland.

Are there any reasons why my baby shouldn’t have the BCG vaccination?

The BCG vaccine shouldn't be given if your baby:

• is having treatment for cancer or other serious conditions that weaken the immune system
• is HIV positive
• is suffering from a generalised septic skin condition - babies with eczema can be given the vaccine in an area without skin lesions (broken skin)
• lives in a household where an active TB case is suspected or confirmed
• has had a confirmed anaphylactic reaction (a severe allergic reaction) to an ingredient in the vaccine - a list of ingredients is available in the BCG vaccine SSI Patient Information Leaflet (PIL)

The BCG vaccine should be delayed if your baby has high fever.

How do we know the vaccine's safe?

All medicines (including vaccines) are tested for safety and effectiveness by the Medicines and Healthcare Products Regulatory Agency (MHRA). The vaccine meets the high safety standards required for it to be used in the UK and other European countries. The vaccine has been given to millions of people worldwide.

Once they're in use, the safety of vaccines continues to be monitored by the MHRA.

After having the vaccine there may be side effects, but these are usually mild.

Side effects

Immediately after the vaccine's given, a raised blister will appear. This shows that the vaccine's been given properly.

Within 2 to 6 weeks, a small spot will appear. This may be quite sore for a few days, but it'll gradually heal and may leave a small scar.

Occasionally, your baby may develop a small sore where the vaccine was injected. If this is leaking and needs to be covered, use a dry dressing – never a waterproof plaster or creams – until a scab forms. It's better to leave the sore uncovered if possible and it's fine to leave it uncovered when bathing. This sore may take several months to heal completely. If you're worried, or you think the sore has become infected, see your GP.

Infant paracetamol

Vaccines protect your baby against the risk of very serious infections and should not be delayed.

Fever can be expected after any vaccination.  Fevers are usually mild, so you only need to give a dose of infant paracetamol if your child isn’t comfortable or is unwell.  Read the instructions on the bottle very carefully. 

Fever is more common when the MenB vaccine is given with the other routine vaccines at 8 and 16 weeks.  Infant paracetamol should be given to babies after each of these immunisation appointments.

Public Health Scotland’s booklet What to expect after immunisations: Babies and children up to 5 years has more information.

In infants who do develop a fever after vaccination, the fever tends to peak around 6 hours after vaccination and is nearly always gone completely within 2 days. 

Ibuprofen can be used to treat a fever and other post-vaccination reactions.  Giving ibuprofen at the time of vaccination to prevent a fever is not effective.

Remember, never give medicines that contain aspirin to children under 16.

Information about treating a fever in children.

If an infant still has a fever 48 hours after vaccination or if parents are concerned about their infant’s health at any time, they should seek advice from their GP or NHS 111. 

The diseases vaccines protect against are very serious and therefore vaccination should not be delayed because of concerns about post-vaccination fever.

If you're worried about your child, trust your instincts. Speak to your GP or phone the 111 service.

Read more about the common side effects of immunisations that might occur in young people

Where can I report suspected side effects?

You can report suspected side effects of vaccines and medicines through the Yellow Card Scheme.

This can be done by:

• visiting the Yellow Card Scheme website
• phoning the free Yellow Card hotline on 0808 100 3352 (available Monday to Friday, 10.00am to 2.00pm)

If you’re unsure about anything, or have any questions about the BCG vaccine, phone:

• your GP practice
• the NHS inform helpline

Immunisation leaflet

NHS Health Scotland have produced leaflets explaining the BCG vaccine in Scotland, why it's offered and when it's given.

These leaflets also available in Easy Read English and other languages - including Polish, Mandarin (Simplified Chinese) and Arabic.

BCG and your baby

Tuberculosis (TB) Factsheet

Other formats

• BCG and your baby (BSL)
• BCG and your baby (Audio)

Protecting your child

Protect your child against serious diseases (Leaflet)

Protect your child against serious diseases (Audio)

Protect your child against serious diseases (BSL)

After immunisation

What to expect after immunisations in babies and young children (Audio)

What to expect after immunisation: Babies and young children (Leaflet)

What to expect after immunisation: Babies and young children (BSL)