BCG Vaccine

1
BCG Vaccine

• Dr Ingley
• Paediatric Department
• Glan Clwyd Hospital
• June 2002

2
Recommendations as per the green book ( for
children)

• BCG vaccine should be given to the following
  children
• contacts of cases suffering from active Pulmonary
  TB
• infants and children of immigrants from
  countries with a high prevalence of TB, wherever
  born
• (If BCG is given after 3 months of age, the
  infant would need Heaf test prior to BCG)
• Those intending to stay in Asia,Africa, Central
  and South America for gtone month
• school children age 10-14 years
• At the request of parents

3
AIM

• To assess our BCG vaccination practice in YGC
• To particularly look at the children born in YGC
  eligible for BCG vaccine in the neonatal period

4
METHOD

• BCG Diary since Feb00 in OPD
• Retrospective case note analysis of children who
  received BCG from the period Feb00 to June02

5
Data Collection

• Total Notes Audited - 95
• Excluded - 6
• Total BCGs given - 70
• YGC BORN - 41 (58)
• BCG given - 40
• Heaf tests - 50 (71)
• YGC BORN - 8 (20)
• No Heaf/BCG - 4

6
Age at BCG
7
Reason for BCG
8
Other reasons for BCG

• Holiday - 5
• Emigrating to USA - 5
• Emigrating to Asia - 3
• Family History of TB - 3
• YGC BORN - 3
• Prior to cardiac - 1 transplant

9
Referral by (YGC BORN only)
10
Referral Outside YGC ( 50)

• GP - 7
• Community - 2
• Mums request - 2
• HV - 2
• Paed Reg Clinic - 4
• Not Known - 4

11
Reasons for Delay

• Parent on Holiday - 1
• Parent missed appointment - 1
• Mum self discharged at 6hrs - 1
• OPV Given to two patients in Baby Clinic

12
CONCLUSION

• 20 children, born in YGC , needed Heaf test.
• 25 of children born in YGC, were given BCG at
  2-3 months age.
• THIS CAN BE AND SHOULD BE AVOIDED.

13
RECOMMENDATION

• Need for a full proof net to avoid any
  unnecessary delay in neonatal BCG vaccination
• Routine in Wrexham
• Routine in LWH
• Propose adding a simple questionnaire,
  ?attached to the hearing screening form

14
RECOMMENDATION contd.

• Any parent belonging to an area outside Western
  Europe/North America
• Is there a likely hood of parents to move to any
  area outside W. Europe/N.America
• Any family member currently receiving Rx for
  Tuberculosis
• Is there a likelihood of domestic contact with
  any individual from outside W.Europe/N.America

15
RECOMMENDATION contd.

• If there is a yes for any of these questions, the
  form with patients details should then be sent to
  the Paed OPD.
• Monthly BCG clinic already a routine
• Whose responsibility?
• Paed.SHO or the midwife looking after the
  mum?