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Who should have the BCG (TB) vaccine?

BCG vaccination is only recommended on the NHS for babies, children and adults under the age of 35 who are considered at risk of catching tuberculosis (TB). The BCG vaccine isn't given to anyone over the age of 35, as there's no evidence that it works for people in this age group.

Babies who should have the BCG vaccine

BCG vaccination is recommended for all babies up to one year old who:

  • are born in areas of the UK where the rates of TB are high
  • have a parent or grandparent who was born in a country where there is a high rate of TB  

Read the NHS leaflet: TB, BCG and your baby

Find out which countries have a high rate of TB.

Older children who should have the BCG vaccine

BCG vaccination is recommended for all older children and adults at risk of TB, including:

  • older children with an increased risk of TB who were not vaccinated against TB when they were babies 
  • anyone under 16 who has come from an area of the world where TB is widespread 
  • anyone under 16 who has been in close contact with someone who has pulmonary TB (TB infection of the lung)  

Find out which countries have a high rate of TB.  

Adults aged 16 to 35 who should have the BCG vaccine

BCG vaccination is recommended for people aged 16 to 35 who are at occupational risk of TB exposure, including:

  • laboratory staff who are in contact with blood, urine and tissue samples
  • veterinary staff and other animal workers, such as abattoir workers, who work with animals that are susceptible to TB, such as cattle or monkeys 
  • prison staff who work directly with prisoners
  • staff of care homes for the elderly
  • staff of hostels for homeless people
  • staff who work in facilities for refugees and asylum seekers
  • healthcare workers with an increased risk of exposure to TB

Travellers who should have the BCG vaccine

The BCG vaccine is also recommended for people under the age of 16 who are going to live with local people for more than three months in an area with high rates of TB.

Read more about travel vaccinations.

Find out which countries have a high rate of TB.

Individual requests for BCG vaccination

If you want BCG vaccination for yourself or your child, you will be assessed to see if you are at high risk of catching TB. If you aren't at risk, you won't be eligible for BCG vaccination. If you are at risk, you will be tuberculin tested and offered BCG vaccination according to local arrangements.

The tuberculin skin test/Mantoux test

Before you have the BCG vaccination, you should be tested to see if you are already infected with or have active TB disease. 

The test, called the tuberculin skin test, or Mantoux test, will be carried out before BCG vaccination if someone:

  • is six years or over
  • is a baby or child under six with a history of residence or a prolonged stay (more than three months) in a country with a high rate of TB 
  • has had close contact with a person with TB
  • has a family history of TB within the last five years

The Mantoux test assesses your sensitivity to a substance called a tuberculin purified protein derivative (PPD) when it's injected into your skin.  

The greater the reaction, the more likely it is that an individual is infected with or has active TB. In this case, the individual should not have the BCG vaccine, as it would have no clinical benefit and may cause unpleasant side effects. 

If you have a strongly positive Mantoux result, you should be referred to a TB specialist team for further assessment.

If the Mantoux test is negative, you can go ahead and have the BCG vaccine.

Who should not have the BCG vaccination?

The BCG vaccine is not recommended for:

  • people who have already had a BCG vaccination
  • people with a past history of TB
  • people with a positive tuberculin skin test (Mantoux)
  • people who have had a previous anaphylactic reaction (severe allergic reaction) to any of the substances used in the vaccine
  • newborn babies in a household where a case of TB is suspected or confirmed
  • people who have a septic skin condition at the site where the injection will be given 
  • people who have received another live vaccine less than three weeks earlier
  • people with a weakened immune system, either as a result of a health condition such as HIV, treatments such as chemotherapy, or medicines that suppress the immune system, such as steroid tablets
  • people who have cancer of the white blood cells, bone marrow or lymph nodes, such as leukaemia or lymphoma
  • people who are seriously unwell (vaccination should be delayed until they recover)
  • pregnant women

BCG vaccinations are not usually offered to people over the age of 16 and never over the age of 35, because the vaccine doesn't work well in adults.

Read answers to the frequently asked questions about BCG.

Article provided by NHS Choices

See original on NHS Choices