Tuberculosis is an infectious disease that primarily affects the lungs. Its vaccine, BCG, is not mandatory and its use has to be postponed in certain cases. What is this vaccine called? At what age should you do this? And the memories? Explanations by Dr. Patrick Aube, general practitioner.
The BGC vaccine (live attenuated vaccine) is used to protect against tuberculosis. It is no longer mandatory since 2007. However, it can be indicated for certain young children to protect them from certain severe forms of tuberculosis. A press release dated April 7, 2022 from the Medicines Agency (ANSM) recommends postponed by 12 months after birth, the use of live attenuated vaccines, such as BCG, in children born to mothers treated with infliximab (an anti-inflammatory drug (marketed under the names: Remicade®, Remsima®, Inflectra®, Flixabi®, Zessly®) indicated in adults for treatment various autoimmune diseases: rheumatoid arthritis, Crohn’s disease, psoriasis, etc. during pregnancy or lactation. Use during pregnancy, infliximab crosses the placenta and can be detected in the blood of children Exposure during pregnancy up to 12 months after birth. It has also been detected in small amounts in milk. By their mode of action Infliximab-based drugs weaken the immune system of treated patients, possibly also children Exposure 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 types of meningitis.
Who invented the BCG vaccine?
Albert Calmette, doctor and biologist, and Camille Guérin, veterinarian and biologist, hence the term BCG for Calmette and Guerin bacillus.
Is BCG vaccination compulsory?
Vaccination against tuberculosis no longer mandatory since 2007. On March 1, 2019, an ordinance suspending the obligation to health and social care professionals was published. Thus, as of April 1, 2019, BCG vaccination is no longer required during the training or hiring of these professionals. Nonetheless, company doctors may offer the BCG vaccination BCG tuberculosis vaccine on a case-by-case basis for health and social care professionals who have not been previously vaccinated and have a negative reference immunological test and are likely to be highly exposed, such as:
- Staff in repeated contact with tuberculosis patients and particularly those at risk for multidrug-resistant tuberculosis.
- Laboratory personnel working on mycobacteria (cultures, animal models, etc.).
For which children is the BCG vaccination indicated?
The AJVaccines® BCG vaccine is not currently available in the city. It is only distributed in immunization centers, PMI services, and Centers to Control Tuberculosis (CLAT). The available vaccines are currently at Reserve for children most at risk and likely to progress to tuberculosis if infected. Those are primarily children under five who also have a risk factor related to their environment or relatives/relatives (particularly a family history of tuberculosis or links to a country where tuberculosis is very common). the Children living in Île-de-France are no longer a priority for vaccination if there are no other risk factors. Children born in Mayotte or Guyana should be given this vaccine as a matter of priority.
>> From 1 month (and up to 15 years) for children at high risk of tuberculosis:
- born in a country where tuberculosis is widespread;
- at least one parent is from one of these countries;
- must reside in one of these countries for at least one month at a time;
- have a family history of tuberculosis;
- residing in Guyana or Mayotte;
- in all situations that the doctor classifies as a risk of exposure to tuberculosis bacteria: poor housing conditions, vulnerable socioeconomic conditions, regular contact with adults from a country where tuberculosis is widespread.
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 to children born to mothers treated with infliximab during pregnancy or lactation. Infliximab is an anti-inflammatory drug indicated in adults for the treatment of several autoimmune diseases (rheumatoid arthritis, Crohn’s disease, psoriasis, Etc.). 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. Because of the risk of infection, with some exceptions, live vaccines should not be given to children within 12 months of birth if they have been exposed to infliximab during pregnancy. Likewise, Administration of a live vaccine to an infant of a breastfeeding mother who is being treated with infliximab is not recommended.
- Tell the doctor responsible for your child’s vaccination if you took infliximab during your pregnancy or if you are breast-feeding and taking infliximab to avoid putting your child at 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 (particularly BCG) for 12 months after birth to ensure that there is no longer any infliximab in their 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 the benefits of breastfeeding versus the risk of exposing the child to diseases that the vaccine prevents.
- If your doctor finds it necessary to give these vaccines earlier or during breastfeeding, they may need to do a blood test on your child to make sure that infliximab is no longer in their organization.
- If the vaccination is postponed, your doctor will issue your child with a temporary vaccination contraindication slip for medical reasons in order to enable your child to access childcare in the community.
What is the composition of the BCG vaccine?
BCG is a live attenuated vaccine.
What is the name of the BCG vaccine?
BCG AJVaccines® vaccine (formerly known as BCG Vaccine SSI®).
When should the BCG vaccination be carried out?
Vaccination against tuberculosis is recommended for infants from 1 monthideally during the 2nd month and up to 15 years of age in children who have been exposed to the tuberculosis bacillus.
Children who meet at least one of the following criteria are considered to be at high risk of tuberculosis:
- child born in a country highly endemic for tuberculosis;
- child with at least one parent from one of these countries;
- Child must reside in one of these countries for at least one month at a time;
- child with a family history of tuberculosis (collateral or direct ancestors);
- child residing in Île-de-France, Guyana or Mayotte;
- Child in a situation where, according to a medical assessment, there is a risk of exposure to the tubercle bacillus, particularly a child living in disadvantaged housing conditions (precarious or overcrowded housing) or disadvantaged or precarious socio-economic conditions (especially among beneficiaries of CMU, CMUc , AME, etc.) or in regular contact with adults from a highly endemic country.
The vaccine is also “indicated for persons from geographical areas with high incidence of tuberculosis”, comments dr. Patrick Aube. risk areas
According to the WHO, the geographical areas with a high incidence of tuberculosis are:
- the African continent as a whole;
- the continent of Asia as a whole, excluding Japan, including the countries of the Near and Middle East except 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 except Greece, Hungary, Slovakia, Slovenia and the Czech Republic.
When is the BCG vaccine to be recalled?
A BCG booster vaccination in the general population and in occupational groups exposed to tuberculosis has not been indicated since 2004. Consequently, the booster vaccination with Tubertest® after a BCG vaccination no longer has to be carried out systematically.
What are the side effects of the BCG vaccination?
Vaccination against tuberculosis is well tolerated. It can cause some mild reactions like inflammation at the injection site. In the following weeks, the area around the sting may be a bit hard, but you don’t need to worry. If in doubt, do not hesitate to consult your doctor.
What does the BCG vaccine cost and is it reimbursed?
The price of the BCG vaccine is €10.26 with a 65% refund.
Many thanks to dr. Patrick Aubé, general practitioner Author of the book 20 medicinal plants for healing every day at Leduc.S editions.