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Bcg Vaccine

bacillus calmette-guerin live vaccine
Used for Tuberculosis
Used for Tuberculosis

The BCG vaccine is a vaccine that lowers your risk for getting tuberculosis (TB) from a bacteria called Mycobacterium tuberculosis (M. tuberculosis). It's given percutaneously (through the skin). This vaccine is only recommended for people who haven't had an infection with M. tuberculosis before and are at high risk for getting TB. The BCG vaccine isn't commonly used in the United States and is only typically given to certain people who are at high risk for TB.

Reviewed by:
reviewer
Robert Chad Hakim, PharmD, BCCCP
reviewer
Allison Gourley, PharmD
Last reviewed on April 7, 2022
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageCostContraindicationsPricesMedicare
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What is The BCG vaccine?

What is The BCG vaccine used for?

  • Prevention of TB

How The BCG vaccine works

The BCG vaccine is a live attenuated vaccine that protects you from M. tuberculosis, which is a bacteria that causes a condition known as tuberculosis (TB). The vaccine helps your body's immune system make antibodies against the bacteria, which will attack the bacteria if it ever infects your body.

Drug Facts

Common BrandsBCG vaccine
Drug ClassVaccine
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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What are the side effects of The BCG vaccine?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Swollen lymph nodes
  • Pus at administration site

Other Side Effects

  • Sores at administration site
  • Itching
  • Tenderness at administration site

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Serious allergic reactions: hives, rash, shaking, itching, nausea, flushing, dizziness, shortness of breath, chest pain
  • Severe infection: fever, difficulty breathing, diarrhea, weakness, cough, stomach pain, sweating, chills

Source: DailyMed

pros-and-cons

Pros and cons of The BCG vaccine

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Pros

Works well to prevent TB

Can be given to children

Usually only need 1 dose to be fully vaccinated

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Cons

Given through the skin, using the multi-puncture device

Might be difficult to find since it's not commonly given in the United States

Must be given by a healthcare professional

pharmacist-tips

Pharmacist tips for The BCG vaccine

pharmacist

  • You must get tested for TB before you receive the BCG vaccine because this vaccine can only be given to people who don't have a TB infection.

    • After you get the BCG vaccine, loosely cover the area where you got the vaccine to keep it clean and dry. The area must be kept dry for 24 hours, so don't wash that area during this time.

      • You must get a TB skin test 2 to 3 months after you receive the BCG vaccine to test if the vaccine worked or not. Your provider might order another dose of the vaccine for you, depending on your test results.

        • You might feel flu-like symptoms for 1 to 2 days after receiving the BCG vaccine. However, if you get a fever of 103°F or higher or redness and swelling around where the vaccine was given that lasts longer than 2 to 3 days, contact your provider because these are typical signs of a TB infection. You'll need to get tested for TB and get treated right away if you're positive.

          • Since the BCG vaccine is a live vaccine, don't receive other live vaccines, such as the live flu vaccine (LAIV) nasal spray and the measles, mumps, rubella (MMR) vaccine, for at least 30 days after receiving the BCG vaccine.

            • Let your provider know if you're taking antimicrobials or medications that weaken your immune system before receiving the BCG vaccine because your immune system might not respond as well to the vaccine.

              • Make sure to keep a record of all your immmunizations and show it to your provider or pharmacist before receiving any vaccine, including the BCG vaccine, to make sure you're receiving all your vaccines on schedule.

                faqs

                Frequently asked questions about The BCG vaccine

                Who should receive the BCG vaccine?
                The BCG vaccine isn't commonly used in the United States (US) because of the low rates of TB in the US and the vaccine's ability to cause inaccurate results on TB skin tests. It's only recommended for children and adults who are at high risk of exposure to M. tuberculosis, such as children who live with adults with TB infections or some healthcare providers who care for people with TB. Ask your provider or pharmacist if you aren't sure if you need to receive the BCG vaccine.
                Why is it important to get the BCG vaccine if I need it?
                The BCG vaccine lowers your risk for TB, which can be a life-threatening infection. TB is spread through the air from one person to another. Once you breathe in the bacteria, it can cause pneumonia, but it can also spread to the rest of your body and cause infections in the kidney, spine, or brain. Symptoms include a cough that lasts 3 weeks or longer, chest pain, coughing up blood or sputum, fever, and poor appetite. Treatment of TB is complicated because it typically requires multiple antibiotics, taken for 6 to 9 months. And if you don't take all of the antibiotics as prescribed, you can be at risk for drug-resistant TB, which is a very serious infection that's hard to treat.
                Where can I go to receive the BCG vaccine?
                The BCG vaccine isn't commonly used in the United States because of the low rates of TB, so it might be hard to find. If your provider has recommended you or your child to receive the BCG vaccine, ask them for help on how to find it.
                What's the difference between the BCG vaccine and TICE BCG?
                Even though the BCG vaccine and TICE BCG have similar names, they're completely different from each other. The BCG vaccine is a vaccine that protects against TB caused by M. tuberculosis. TICE BCG is a medication that has Mycobacterium bovis in it and is used to prevent and treat cancer in the urinary bladder.
                Can I use the BCG vaccine if I'm pregnant?
                The BCG vaccine isn't recommended if you're pregnant because there's not enough information to show whether or not it causes harm to your unborn baby. Talk with your provider if you have questions about the use of the BCG vaccine in pregnancy.
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                What are the risks and warnings for The BCG vaccine?

                The BCG vaccine can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

                risk-warning

                Severe allergic reactions

                As with any vaccine, there's a small chance that you might have a severe allergic reaction to the BCG vaccine. Your provider might ask you to stay at the clinic for a short period of time after you've received your vaccine to make sure you can get proper care in case of a serious allergic reaction. Sometimes, these reactions can happen after you've already left the clinic. Get medical help right away if you notice symptoms of a severe allergic reaction, such as feeling faint, swelling of the face, closing of the throat, difficulty breathing, hives or rash, dizziness, shaking, nausea, or chest pain.

                risk-warning

                Possible TB infection

                • Risk factors: Weakened immune system from medical conditions or medications

                  Although rare, it's possible for the BCG vaccine to cause a TB infection. The risk is higher if you have a weakened immune system from either certain medical conditions (e.g., HIV (human immunodeficiency virus) and cancer) or from taking certain medications (e.g., high-dose corticosteroids and transplant medications). If you have a weakened immune system, don't receive the BCG vaccine without talking to your provider first.

                  Some people might experience flu-like symptom side effects, such as fever, loss of appetite, and muscle pain, for 1 to 2 days after receiving the BCG vaccine. But let your provider know if you have a fever of 103°F or higher or redness and swelling around where the vaccine was given that doesn't go away after 2 to 3 days - these might be signs of an active TB infection that must be treated right away.

                  dosage

                  The BCG vaccine dosage forms

                  The average cost for 1 vial of 50mg of The BCG vaccine is $158.90 with a free GoodRx coupon.0
                  vial
                  Vial
                  DosageQuantityPrice as low asPrice per unit
                  50mg1 vial$158.90$158.90

                  Typical dosing for The BCG vaccine

                  You must get a tuberculin skin test (TB skin test) to make sure you're not currently infected with TB before you can get the BCG vaccine.

                  The typical dose is to drop 0.2 mL to 0.3 mL of the BCG vaccine onto the skin in the shoulder area that has been punctured with a multi-puncture device.

                  After 2 to 3 months, you'll need to get a TB skin test to check if the vaccine worked or not. You might need another dose of the BCG vaccine, depending on your test results.

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                  How much does The BCG vaccine cost?

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                  The BCG vaccine contraindications

                  Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because The BCG vaccine will not be safe for you to take.

                  • People with weakened immune systems from medical conditions or medications

                  • Using the BCG vaccine to treat active TB

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