Australia has one of the lowest rates of Tuberculosis (TB) disease in the world, but it remains very common in some countries, including places Australians frequently travel to visit friends and relatives (VFR). TB is a disease caused by bacteria called Mycobacterium tuberculosis. TB spreads through the air but it is not easy to catch. It affects the lungs in 70% of cases, but can also affect lymph nodes, the brain, kidneys, or spine.
It is more common for children to have TB that affects more than one part of the body (miliary TB) and brain inflammation (meningitis). As TB tends to be more serious in children, we recommend protection with BCG vaccine for children < 5-years of age travelling to countries with high rates of TB.
About BCG vaccine
BCG stands for “Bacille Calmette-Guerin” and is named after Dr Calmette and Dr Guerin who developed the vaccine and it has been used since the 1920s to prevent TB. BCG vaccine was developed from a germ similar to TB called Mycobacterium bovis. It is a live-attenuated vaccine that has been processed so that it is not harmful to humans.
The BCG vaccine does not prevent someone being infected with the bacteria that causes TB, but it prevents the development of the disease. It is specifically designed to prevent TB in children and can be given from birth onwards. The World Health Organization currently recommends a single lifetime dose.
The BCG vaccine should be administered at least 4-6 weeks prior to departure to give enough time for the vaccine to be effective.
The BCG vaccine should only be given by a medical or nursing professional who is trained in BCG vaccination procedures working within a recognised BCG clinic, noting the vaccine is administered intradermally (ID). A GP referral will be required for most specialist travel clinics.
What to expect following BCG vaccine
BCG, like all vaccines, has a list of common and expected side effects and a list of rare side effects that may occur in the weeks following:
- A small red papule will appear at the injection site in the weeks following the vaccine
- An ulcer (open sore) may develop 2-3 weeks later (usually less than 1 cm in diameter) and last from a few weeks to months
- The majority of infants will develop a flat scar at the site once the ulcer heals.
Rare of more serious side effects:
- Axillary lymphadenopathy (swelling of the lymph nodes under the left arm)
- Persisiting ulcer lasting longer than a few months
- A large abscess (collection of pus) at the injection site
- Keloid scarring at the site
If you suspect a rare or serious side effect, it is strongly recommended to seek medical advice either from a GP or the medical clinic where the BCG was administered.
For specialist immunisation advice or to report an Adverse Event Following Immunisation (AEFI), please contact SAEFVIC.
Refer to the useful resources and links below to find out more about the BCG vaccine.
BCG Clinics in Victoria
- The Royal Children’s Hospital: BCG Clinic
- Monash Health Immunisation Service
- Children’s Private Medical Group
- Melbourne Paediatric Specialists
- Offspring Child Health Specialists
- Family Immunisation & Travel Specialists (FITS)
- A/Prof Mike Starr
- MVEC: Intradermal vaccination
- RCH Tuberculosis disease fact sheet
- Australian Immunisation Handbook: Tuberculosis
- BCG vaccine for Tuberculosis (TB) protection fact sheet
- BCG vaccine- what to expect? parent handout
- Department of Health & Human Services, Victoria: Management, control and prevention of tuberculosis – Guidelines for health care providers
- Journal of Family Medicine and Primary Care: Scar formation and tuberculin conversion following BCG vaccination in infants: A prospective cohort study
Authors: Nigel Crawford (Director SAEFVIC, Murdoch Children’s Research Institute) and Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children’s Research Institute)
Reviewed by: Mel Addison (SAEFVIC Research Nurse, Murdoch Children’s Research Institute)
Date: August 2020
Materials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.
You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family’s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.