Section 3: Bacillus Calmette-Guérin (BCG) Vaccination

Moderately Severe Reactions:

- Suppurative adenitis (draining lymph nodes) (frequency 1:1000)

Severe Reactions:

- Disseminated BCG infection (frequency <1:1,000,000) which may be fatal

Table 3.1: Adverse Events Following BCG Vaccine and Suggested Management

Complication Management
Common and Local Adverse Effects
Keloid formation (scar that spreads beyond
None; avoid injecting higher up in arm
borders of original lesion)
None (resolves spontaneously) or topical
Local hypersensitivity reaction
dressing
Less Common And Serious Adverse Effects
Conservative approach. Except if
Regional lymphadenitis (inflammation
suppurating and discharging, see section on
causing enlarged axillary lymph nodes)
management below
Local abscess formation See section below
Disseminated disease TB treatment

Management of BCG Abscess

• DO NOT INCISE AND DRAIN.
- Use warm water compresses over the injection site or suppurating lymph node(s)
4–5 times/day.
- Observe and document the progress of the lesion on the monthly NWT Tuberculosis
Surveillance and Screening form, Section 16 and on the client health record.

• Cover with dry (non-occlusive) dressing to keep clean. Swab for culture and sensitivity (C&S)
only if secondary infection is suspected.
• Antibiotic treatment, such as isoniazid (INH), is NOT routinely indicated.
• Regional adenopathy in the absence of erythema or vesicle formation should be considered
an expected reaction to the vaccine.

3-8 NWT Tuberculosis Manual - June 2014 2014

November