BCG (Tuberculosis) Vaccine

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Hi nurses,

I want to preface this by saying I am not asking for medical advice - I'm just curious about people's experiences.

I'm aware that there is a vaccine (with less than perfect efficacy ;) ) for tuberculosis. I'm also aware, per the CDC's website, that it isn't widely used in the US. I have heard that testing positive to the TST is fairly common among seasoned health professionals. Do any of you see this in your facilities?

I'm curious if any of you have gotten the vaccine, have been recommended to get the vaccine, or want to get it. I'm kind of thinking I would like to get it, since the idea of TB is slightly terrifying...but I was wondering how you all deal with this facet of health care? I'm a little surprised that the CDC doesn't seem to recommend the BCG vaccine for most people. Does anyone know if it's easy to get, or if you really need special circumstances to get it?

also, if there is a better thread for this, please feel free to relocate this post :)

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Specializes in ICU, LTACH, Internal Medicine.

I was born in former USSR and at the place where TB is still epidemic. So I had BCG three times (one at birth, second when I entered medical field - that was mandatory b/o high possibility of contact, and third two month before I emigrated b/o I did mouth-to-mouth resuscitation on a guy who happened to have open form of TB, so I was given it mostly for panic reasons and couldn't refuse b/o doing so would delay immigration paperwork). Now, since after even a single dose BCG Mantoux test becomes false positive for unknown period of time, I have to do Quantiferon Gold (IV blood draw) test every year instead. One time I was given Mantoux while still in school, and the clinical coordinator who pushed me to it almost lost her job because it came out "systemically positive" and sent me to hospital.

BCG is sort of less then moderately effective - it has no effect whatsoever on prevention of "primary complex" or "latent TB" (the most common and non-complicated form). It is said to prevent between 30 and 50% of disseminated TB in population already infected (sorry, no English sources) and, by other sources, prevents from 0 to 80% of total cases, depending on the population, general health, infection prevalence and the source of vaccine

http://www.cdc.gov/mmwr/pdf/rr/rr4504.pdf

BCG vaccine - Wikipedia, the free encyclopedia (used for links only)

I couldn't find if there's any difference in efficacy between prevention of "classic" TB and MDR TB.

Approximately 1% of neonatal recipients in Russia had complications (from local BCG lymph node inflammation to disseminated infection), all of them requiring at least 6 months of full-dose, 1-3 components therapy.

Overall, the risk of TB in the USA is relatively low even for medical workers, and so the vaccine only recommended for children and adults who have negative Mantoux/Quantiferon AND are in conditions where transmission is practically unavoidable AND specific preventive measures cannot be implemented.

CDC | TB | Fact Sheets - BCG Vaccine

Practically, it means that one needs to live in the same crowded and unhygienic household with patient suffering from open form of TB and have no other place to go. I only heard about one such situation - working and living in the Native American reservation with multiple "open" cases. AFAIK, nurses who run a clinic serving Mexican immigrants (90% of them illegal, so without immunization certificate) working in fields at summer are not given BCG, although they find at least one "open" case.

CDC | TB | Fact Sheets - BCG Vaccine

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Specializes in Pedi.

I've never had it nor was I ever offered it, even when traveling to parts of the world where active TB is more common. Last year, I worked per diem at a boarding school that had a large international population and many of those from China had received BCG but they're the only people I've ever come across who've had it.

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Specializes in Neuro ICU and Med Surg.

I have worked with nurses from China, the Phillipines, and India who have all had the BCG vaccine. They are the only people I have ever known to have it.

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Katie, thank you so much! It was so nice to get your perspective. Thanks for taking the time to respond :). And thanks to the other responders as well, I appreciate the various experiences/perspectives.

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Specializes in SICU, trauma, neuro.

Great info, Katie!

I don't know how "common" positive TSTs are among seasoned health professionals, but every once in a while I'll meet one who just gets an annual CXR in place of the TST because they have a history of testing positive.

My husband is an immigrant from Korea, and he received BCG before coming to the US. Years back when we were dating he got a job as a group home PCA before finding a job in his field (he has no health background--his undergrad and graduate degrees are in Finance) and the nurse didn't ask him about his history. I was in nursing school at the time and hadn't heard of BCG before this. A few hours after getting the TST, he showed me his arm and asked "Is it supposed to do this?" He had a flaming red induration >1 inch across, and his whole inner forearm was red--red like sunburn in the center, and red like someone had scratched him w/ their fingernails around the periphery. So long, narrow streaks. Then he mentioned "I think I got some TB vaccine before coming to US." Followup CXR was clear.

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