Auckland Regional Public Health Service Rātonga Hauora ā Iwi o Tamaki Makaurau Working with the people of Auckland, Waitemata and Counties Manukau Auckland Regional Public Health Service BCG Programme Kathy Smith
Auckland Regional Public Health Service Rātonga Hauora ā Iwi o Tamaki Makaurau
Working with the people of Auckland, Waitemata and Counties Manukau
Auckland Regional Public Health Service
BCG ProgrammeKathy Smith
Auckland Regional Public Health Service Rātonga Hauora ā Iwi o Tamaki Makaurau
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BCG Vaccination
• Does not significantly impact on disease incidence
• Is effective in protecting young children against severe forms of disease – TB meningitis, miliary TB
• One dose only – revaccination is not recommended
• Ideally given in neonatal period – only given to children under 5 years of age in NZ
Auckland Regional Public Health Service Rātonga Hauora ā Iwi o Tamaki Makaurau
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BCG Vaccine• Live attenuated vaccine (M. bovis)• Administered by gazetted BCG vaccinators• Can be given simultaneously with any other
vaccines (incl live vaccines) – but into a separate site, using a separate syringe
• Intradermal injection – left upper arm (deltoid insertion)
• Further immunisations must not be given into that arm for 3 months after BCG – due to risk of local lymphadenitis
Auckland Regional Public Health Service Rātonga Hauora ā Iwi o Tamaki Makaurau
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Neonatal BCG eligibility Criteria(see page 523-524 of Immunisation Handbook 2017)
• BCG should be offered to infants who are at increased risk of TB:
• Living in house or family/Whanau with a person with either current or a past history of TB
• Have one or both parents or household members or carers, who within the last five years lived for a period of six months or longer in countries with a rate >40 per 100,000
• During their first five years will be living for three months or longer in a country with a rate > 40 per 1000,000 and are likely to be exposed to those with TB.
• https://www.healthed.govt.nz/resource/bcg-vaccine-information-health-professionals
Neonatal BCG eligibility Criteria(see page 523-524 of Immunisation Handbook 2017)
Auckland Regional Public Health Service Rātonga Hauora ā Iwi o Tamaki Makaurau
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Contraindications To BCG
• Cancer• Corticosteroids/other immune suppressives• Baby with known HIV infection • Suspected HIV infection (mother has HIV)• Other immune compromising conditions• High fever• Positive Mantoux test/contact of a case (beware also
of mothers who are contacts – they could be a case themselves)
• Generalised septic skin conditions
Auckland Regional Public Health Service Rātonga Hauora ā Iwi o Tamaki Makaurau
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Normal BCG Reaction and After Care
• Infant remains well and afebrile• Localised reaction only• After 1-6 weeks a red, raised lump/sore may
appear• May discharge for 2 to 3 months• Will leave a small scar• Keep clean and dry – dry dressing – gauze• Don’t use band aids or sticking plaster
Auckland Regional Public Health Service Rātonga Hauora ā Iwi o Tamaki Makaurau
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Adverse reactions to BCG - parent must contact Public Health nurse
• Ulcer at injection site > 10mm diameter• Abscess at injection site • A sore developing in the first 2 days after the
injection• Weeping from injection site > 2 to 3 months• Regional (axillary) lymphadenopathy• 1 in a million: disseminated BCG reaction
(usually in immune compromised)
Auckland Regional Public Health Service Rātonga Hauora ā Iwi o Tamaki Makaurau
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ARPHS BCG Programme
• BCG vaccinators at community clinics• No in hospital programme as yet.• LMC to either fill in neonatal assessment form
and fax/email to ARPHS or direct parents to ARPHS BCG webpage.
• http://www.arphs.govt.nz/• Appointments given as soon after birth as
possible
Auckland Regional Public Health Service Rātonga Hauora ā Iwi o Tamaki Makaurau
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Auckland Regional Public Health Service Rātonga Hauora ā Iwi o Tamaki Makaurau
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Auckland Regional Public Health Service Rātonga Hauora ā Iwi o Tamaki Makaurau
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Auckland Regional Public Health Service Rātonga Hauora ā Iwi o Tamaki Makaurau
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Auckland Regional Public Health Service Rātonga Hauora ā Iwi o Tamaki Makaurau
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Auckland Regional Public Health Service Rātonga Hauora ā Iwi o Tamaki Makaurau
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Auckland Regional Public Health Service Rātonga Hauora ā Iwi o Tamaki Makaurau
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Auckland Regional Public Health Service Rātonga Hauora ā Iwi o Tamaki Makaurau
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How to book a BCG www.arphs.govt.nz/bcg
or 0800 FOR BCG
(0800 367 224)