BCG vaccine (tuberculosis): name, age, compulsory, baby

Tuberculosis is an infectious disease that mainly affects the lungs. Its vaccine, BCG, is not mandatory and its use must be delayed in certain cases. What is the name of this vaccine? At what age to do it? And the reminders? Explanations by Dr Patrick Aubé, general practitioner.

The BGC vaccine (live attenuated vaccine) is used to protect against tuberculosis. It has not been compulsory since 2007. However, it may be indicated in certain young children for protect them from certain serious forms of tuberculosis. A press release dated April 7, 2022 from the Medicines Agency (ANSM) recommends postpone for 12 months after birth, the use of live attenuated vaccines, such as BCG, in the children of mothers treated with infliximab (an anti-inflammatory drug (marketed under the names: Remicade®, Remsima®, Inflectra®, Flixabi®, Zessly®) indicated in adults for the treatment of several autoimmune diseases: rheumatoid arthritis, Crohn’s disease, psoriasis, etc. during pregnancy or lactation. Used during pregnancy, infliximab crosses the placenta and can be detected in the blood of children exposed during pregnancy up to 12 months after birth. It has also been detected at low levels in milk. By their mode of action, infliximab-based drugs weaken the immune system of treated patients, potentially including children exposed during pregnancy and lactation.

What is the BCG vaccine used for?

BCG vaccine is used foractive immunization against tuberculosisin particular to protect young children from serious forms of tuberculosis, including certain meningitis.

Who invented the BCG vaccine?

Albert Calmette, doctor and biologist, and Camille Guérin, veterinarian and biologist, hence the term BCG for Bacillus of Calmette and Guérin.

Is the BCG vaccine compulsory?

Vaccination against tuberculosis no longer mandatory since 2007. A decree suspending its obligation to professionals in the health and social sector was published on March 1, 2019. Thus, BCG vaccination is no longer required during the training or hiring of these professionals from April 1, 2019. Nevertheless , occupational physicians can offer the BCG tuberculosis vaccine on a case-by-case basis to professionals in the health and social sector not previously vaccinated and having a negative reference immunological test and likely to be highly exposed, such as:

  • staff in repeated contact with tuberculosis patients and especially those at risk of multidrug-resistant tuberculosis.
  • laboratory personnel working on mycobacteria (cultures, animal models, etc.).

For which children is the BCG vaccine indicated?

The AJVaccines® BCG Vaccine is currently not available in town. It is distributed only in vaccination centres, PMI services and centers for the fight against tuberculosis (CLAT). The available vaccines are currently at reserve for children most at risk and likely to progress in the event of infection to tuberculosis. These are primarily children under five who also present a risk factor linked to their environment or their relatives / entourage (in particular a family history of tuberculosis or links with a country where tuberculosis is very common). The children living in Île-de-France are no longer a priority for vaccination, in the absence of other risk factors. Children born in Mayotte or Guyana should receive this vaccine as a priority.

>> From 1 month (and up to 15 years) for children at high risk of tuberculosis:

  • born in a country where tuberculosis is highly prevalent;
  • at least one of whose parents is from one of these countries;
  • having to stay at least one month in a row in one of these countries;
  • having a family history of tuberculosis;
  • residing in Guyana or Mayotte;
  • in any situation considered at risk of exposure to the tubercle bacillus by the doctor: unfavorable housing conditions, precarious socio-economic conditions, regular contact with adults from a country where tuberculosis is highly present.

What are the recommendations during pregnancy or breastfeeding?

In a press release dated April 7, 2022, the ANSM recommends delay 12 months after birth administration of the BCG vaccine in the children of mothers treated with infliximab during pregnancy or breastfeeding. Infliximab is an anti-inflammatory drug indicated in adults for the treatment of several autoimmune diseases (rheumatoid arthritis, Crohn’s disease, psoriasisetc.). Used during pregnancy, infliximab crosses the placenta and can be detected in the blood of children exposed during pregnancy for up to 12 months after birth. Due to the risk of infection, live vaccines should not, with some exceptions, be administered to children within 12 months after birth if they were exposed to infliximab during pregnancy. Likewise, administration of a live vaccine to a child of a breastfeeding mother treated with infliximab is not recommended.

  • Inform the doctor in charge of vaccinating your child if you have taken infliximab during your pregnancy or if you are breast-feeding and you are taking infliximab, so as not to expose your child to a risk of infection.
  • If you received this medicine during your pregnancy, your doctor may need to delay vaccinating your child with a live attenuated vaccine (in particular BCG) for 12 months after birth, in order to ensure that he has not no more infliximab in his system.
  • If you are currently taking this medicine and are breast-feeding, it is not recommended to vaccinate your child with a live attenuated vaccine (such as BCG) unless infliximab is undetectable in their blood. Discuss with your doctor about the benefits of breastfeeding against the risk of exposing the child to diseases prevented by vaccination.
  • If your doctor deems it necessary to administer these vaccines earlier or during breast-feeding, he may need to take a blood test from your child to ensure that there is no more infliximab in his organization.
  • If the vaccination is postponed, your doctor will issue a temporary vaccination contraindication certificate for your child for medical reasons, in order to allow your child to access community childcare.

What is the composition of the BCG vaccine?

BCG is a live attenuated vaccine.

What is the name of the BCG vaccine?

BCG vaccine AJVaccines® (formerly known as BCG Vaccine SSI®).

When to do the BCG vaccine?

Vaccination against tuberculosis is recommended for infants from the age of 1 monthideally during the 2nd month, and until the age of 15 in children exposed to the tuberculosis bacillus.

Children at high risk of tuberculosis are considered to be children who meet at least one of the following criteria:

  • child born in a country highly endemic for tuberculosis;
  • child with at least one parent from one of these countries;
  • child to stay at least one month in a row in one of these countries;
  • child with a family history of tuberculosis (collateral or direct ascendants);
  • child residing in Île-de-France, Guyana or Mayotte;
  • child in any situation judged by the doctor to be at risk of exposure to the tubercle bacillus, in particular child living in unfavorable housing conditions (precarious or overcrowded housing) or unfavorable or precarious socio-economic conditions (in particular among beneficiaries of CMU, CMUc , AME, etc.) or in regular contact with adults from a highly endemic country.

The vaccine is also “indicated for people from geographical areas with a high incidence of tuberculosis”, comments Dr. Patrick Aubé. Risk areas

The geographical areas with a high incidence of tuberculosis, according to the WHO, are:

  • the African continent as a whole;
  • the Asian continent as a whole with the exception of Japan, including the countries of the Near and Middle East with the exception of Cyprus, the United Arab Emirates, Israel, Jordan and Oman;
  • Central and South American countries except Antigua and Barbuda, Barbados, Bermuda, Bonaire, Cuba and Costa Rica, Curaçao, Jamaica, Virgin and Cayman Islands, Puerto Rico;
  • Central and Eastern European countries with the exception of Greece, Hungary, Slovakia, Slovenia and the Czech Republic.

When to recall the BCG vaccine?

BCG revaccination in the general population and in professionals exposed to tuberculosis has not been indicated since 2004. Consequently, the booster with Tubertest® no longer needs to be carried out systematically after BCG vaccination.

What are the side effects of the BCG vaccine?

Vaccination against tuberculosis is well tolerated. It can cause some mild reactions such as inflammation at the injection site. In the following weeks the area around the sting may be a little hard but there is no need to worry. If in doubt, do not hesitate to consult your doctor.

What is the price of the BCG vaccine and is it reimbursed?

The price of the BCG vaccine is €10.26, with a reimbursement of 65%.

Thank you to Dr. Patrick Aubé, general practitioner author of the book 20 medicinal plants to treat yourself every day at Leduc.S editions.

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