BCG Vaccinations - Contraindications, Adverse
Reactions, and Breastfeeding
|
Authorised by:
Charge Nurse Newborn |
| August 2008 |
Contraindications
BCG Vaccine should not be given to:
- Neonates with an immuno-deficiency.
- Neonates receiving cortico-steroids.
- Neonates born to a mother with HIV or
suspected HIV infection.
- Neonates with a significant fever.
- Neonates with a generalised septic skin
condition.
- Preterm infants (see criteria). There is
some evidence of decreased effectiveness.
NB: Mothers with known history of
tuberculosis during pregnancy – please consult Auckland Healthcare BCG
Co-ordinator, Public Health Services, Epsom
From: TECHNICAL
GUIDELINES FOR TUBERCULIN TESTING AND BCG VACCINATION 1996
Adverse reactions (usually resolve
spontaneously
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Common causes:
|
- Injection site reactions – large ulcers,
abscesses commonly caused by faulty injection technique, (i.e. dose
given subcutaneously instead of intradermally, intradermal injection
given mid upper arm, not higher than the insertion of deltoid muscle
into the humerus.)
- keloid scars at injection site (occurrence
increases when injection given too high up the arm.
|
|
Rare causes:
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- axillary lymphadenitis
- osteitis
- osteomyelitis
- lupid and other types of skin disorders
- neurological disorders.
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Breastfeeding
- Mothers with positive Mantoux test,
without evidence of active disease can breastfeed.
- If active pulmonary disease or miliary TB
has been recently diagnosed it is recommended that mother and baby are
separated until mother has had anti-tuberculous therapy (usually for
at least two weeks) then can breastfeed.
- For the period of time mother and baby
are separated mother can express and someone else feeds baby, (unless
the mother has a tuberculous breast abscess).
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