15.2 BCG vaccination

Recommendations vary between countries, with some countries requiring health staff to be BCG vaccinated if never vaccinated and TST negative. There is limited evidence regarding the benefits of BCG vaccination in adults1 who have previously not had BCG vaccination.

Despite the limited evidence of efficacy, it is generally recommended to vaccinate healthcare personnel with negative TST, particularly in situations with a significant exposure to MDR-TB1 (facilities treating MDR-TB, prisons or within regions with high prevalence of MDR-TB).

BCG vaccine should only be administered if:
– The person is HIV negative;
– The person is not pregnant1 ;
– The person has previously never had BCG vaccination;
– The person has previously never had active TB;
– The person is TST negative.

Inform the person vaccinated that BCG does not confer complete protection and that tuberculosis may still occur if other protective measures are not used.

Testing for TST response soon after BCG vaccination is not recommended. More information on BCG vaccine is provided in Appendix 22.

Ref Notes

Pregnancy is not an absolute contra-indication but generally live vaccines should not be administered. Women staff’s vaccination status should be determined before they become pregnant.