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Why BCG Vaccine Is A Must

BCG vaccine is one of the oldest vaccines given to babies. It stands for Bacillus Calmette Gurrain, the strain of bovine tuberculosis used in the vaccine first made by French scientists Calmette & Gurrain. BCG vaccine is a live bacterial vaccine given for protection against tuberculosis, mainly severe forms of childhood tuberculosis.

Though BCG can be given any time from birth to 15 days of life, in Kenya it is given along with the zero dose of oral polio vaccine at birth or before a mom is discharged from the hospital after delivery. The vaccine is given as an injection to the left forearm into the dermis, the outer layer just under the skin.

A wheal or swelling of 6mm is raised above the surface. No spirit or antiseptic should be applied over the site before injection. Good bath with soap and water is enough to clean the local injection site. At the most, one can use normal saline to clean the area.

Immediately after the BCG vaccine, there is a small swelling at the injection site which persists for six-eight hours. After that the swelling disappears and the injection site looks normal. After six to eight weeks, a swelling reappears which looks like a mosquito bite. It grows in size and forms a nodule which breaks open and discharges some fluid forming an ulcer. The ulcer heals by forming a scar. The whole process may take two to five weeks.

Some times this process of ulceration and healing recurs two-three times. Ultimately the typical puckered scar is formed which remains for lifetime. The injection site should not be pressed or rubbed. It should not be fomented. Nothing needs to be applied locally.

BCG vaccine does not lead to fever, so visit the doctor if the child develops fever after BCG vaccine. BCG is given as early as possible in life, before child comes in contact with adults suffering from tuberculosis. If it is given beyond six months, it is preferable to do a prior Mantoux test to see if the child is already sensitised to tuberculosis, since if the child is already sensitised as shown by positive Mantoux test, then BCG is not necessary.

Formation of scar is neither necessary nor is the only indication of success of BCG vaccine. It may take three to six months for the scar to form. If no scar is visible at all after six months one needs to do Mantoux test.

 

 

TB Vaccine For Newborns Can Prevent Lung Cancer, Says Study

A life-saving vaccine given to newborns against tuberculosis can also prevent lung cancer, a new study has revealed.

A study published in the Jama Network journal has tabled findings that the BCG vaccine, which newborns are given soon after birth, reduces chances of one developing lung cancer.

The study, which sought to find out the association between BCG vaccination during childhood and subsequent cancer development, involved a 60-year follow-up of a clinical trial of the vaccine.

A total of 2,963 participants took part in the study where 1,540 received the BCG vaccine while 1,423 received placebo.

The comparison

"The rate of lung cancer was significantly lower in BCG vs placebo recipients (18.2 vs 45.4 cases per 100,000 person-years). This represents an associated 2.5-fold decrease in lung cancer among those receiving BCG vaccine," reads the study published on September 25. The original study was conducted in five US states between December 1935 and December 1998.

Participants then were 2,963 American, Indian and Alaska native schoolchildren younger than 20 years, with no evidence of previous tuberculosis infection.

Statistical analysis was conducted between August 2018 and July 2019.

The study found that childhood BCG vaccination was associated with a lower risk of lung cancer development in American, Indian and Alaska native populations.

"This finding has potentially important health implications given the high mortality rate associated with lung cancer and the availability of low-cost BCG vaccines," added the study.

According to the Globocan report, there were 673 cases of lung cancer in Kenya in 2018. There were also 659 deaths in the same period. This means only about 20 per cent of those diagnosed with lung cancer survive.

One theory of how BCG prevents lung cancer indicates one of the vaccine's side effects is that it creates memory T cells and B cells – types of white blood cells responsible for immunity – that are able to adapt and secrete antibodies.

But the study noted that treatment of lung cancer with BCG has had limited success.

"The immunity of prevention and treatment are different. BCG might function as an effective preventive measure but not as a treatment for lung cancer," the study says.

Study limitation

One of the study's limitations is that it did not take into account other causes of cancer like obesity, smoking, exposure to wood fire smoke, environmental pollution, physical inactivity and radiation.

"Missing or unspecified data were present for some variables, but we have no reason to believe that this differentially affected the randomised sub-groups," the study indicated.

Lung cancer was also the only cancer that was directly linked to effect of BCG vaccine.

BCG Vaccine Administered To Over 50,000 Adults As Part Of Efforts To Curb TB

The Delhi health department has so far administered the BCG vaccine to over 50,000 adults as part of its efforts to combat tuberculosis (TB) and reduce mortality rates, according to an official statement.

 The Adult BCG Vaccination Study, conducted under the National Tuberculosis Elimination Program (NTEP), aims to target high-risk adult populations in five revenue districts – "New Delhi, North-East, West, East, and South – "with six other districts serving as control areas, the statement said. The Bacillus Calmette-Guérin (BCG) vaccine, traditionally administered to newborns, is now being explored for its potential to reduce TB cases among adults, especially those at higher risk, the release said.

 Previous studies, including the Chingleput BCG trial, have shown a modest 36 per cent efficacy over a 15-year period, suggesting potential benefits of adult vaccination, it added. According to the World Health Organization (WHO), a TB vaccine with just 50 per cent efficacy could reduce TB incidence by 12 per cent and mortality by 8.5 per cent, by 2030.

 The Delhi government's study is part of an initiative by the Ministry of Health and Family Welfare, in collaboration with the Indian Council of Medical Research (ICMR) and the Department of Health Research (DHR).

 "It focuses on vaccinating adults aged 18 years and above from high-risk groups, including contacts of TB patients within the last three years, individuals treated for TB within the last five years, those with a Body Mass Index (BMI) below 18 kg/m², adults aged 60 and above, self-reported smokers and self-reported diabetics," read the statement.

 So far, around 50,000 eligible adults across the targeted districts in Delhi have received the BCG vaccine, the statement said. The study will closely monitor the health outcomes of these participants over the next three years, with 14 periodic assessments to evaluate the vaccine's effectiveness, it added.

 This effort aligns with the National Strategic Plan 2017-2025 for TB, which seeks to meet India's Sustainable Development Goals (SDG) targets for TB elimination by 2025, the release said.  By focusing on prevention, including adult BCG vaccination, Delhi hopes to make significant strides in eradicating the disease, the statement added.

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