BCG vaccine supply issues prompt calls to reduce wastage

By Chloe Harman on the 30 October 2015

WHO has called on all countries to reduce BCG vaccine wastage, in light of ongoing global supply constraints, to ensure that countries with highest TB rates and individuals who will benefit most from vaccination receive priority.

BCG vaccination should be prioritised for neonates and infants in recognised high-risk groups for TB, and for tuberculin-negative children under 5 years. | iStock

Healthcare professionals are encouraged to organise the administration of BCG vaccination in ways that optimise the use of the current multi-dose vials, for example by scheduling patients requiring BCG into the same clinic. Adherence to guidelines on the administration of BCG vaccine, including syringe and needle type, can maximise the number of doses obtained from each vial.

Further information
Vaccine Update September 2015

During this period of constrained vaccine supply, Public Health England endorses WHO's advice to limit BCG vaccination to neonates and infants of recognised high-risk groups for TB or to tuberculin-negative children under 5 years. Older children who are eligible for the vaccine are a lower priority but may be vaccinated alongside younger children to optimise clinic size.

BCG vaccination for individuals at occupational risk is considered the lowest priority. Vaccination for other individuals should be prioritised as follows:

Highest priority

All infants (aged 0 to 12 months) with a parent or grandparent who was born in a country where the annual incidence of TB is 40/100,000 or greater.
All infants (aged 0 to 12 months) living in areas of the UK where the annual incidence of TB is 40/100,000 or greater.
Infants aged older than 12 months who were not vaccinated during their first 12 months due to BCG vaccine shortage.
Previously unvaccinated children aged one to five years with a parent or grandparent who was born in a country where the annual incidence of TB is 40/100,000 or greater. These children should be identified at suitable opportunities, and can normally be vaccinated without tuberculin testing.

Moderate priority

Previously unvaccinated, tuberculin-negative children aged from six to under 16 years of age with a parent or grandparent who was born in a country where the annual incidence of TB is 40/100,000 or greater. These children should be identified at suitable opportunities, tuberculin tested and vaccinated if negative.
Previously unvaccinated tuberculin-negative individuals under 16 years of age who are contacts of cases of respiratory TB (following NICE recommended contact management advice).
Previously unvaccinated, tuberculin-negative individuals under 16 years of age who were born in or who have lived for a prolonged period (at least three months) in a country with an annual TB incidence of 40/100,000 or greater.
Previously unvaccinated, tuberculin-negative individuals under 16 years of age who are going to live or work with local people for more than three months in a country where the annual incidence of TB is 40/100,000 or greater.