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U.S. Department of Health and Human Services


Core Curriculum on Tuberculosis, 2000

Chapter 9
BCG Vaccination


BCG vaccination is not generally recommended in the United States because of the low risk of infection with M. tuberculosis, the variable effectiveness of the BCG vaccine against pulmonary TB, and the vaccineís interference with the ability to determine tuberculin reactivity. In the United States, the use of BCG vaccination as a TB prevention strategy is reserved for selected persons who meet specific criteria. BCG vaccination should be considered for infants and children who reside in settings in which the likelihood of M. tuberculosis transmission and subsequent infection is high, provided no other measures can be implemented (e.g., removing the child from the source of infection). In addition, BCG vaccination may be considered for health care workers who are employed in settings in which the likelihood of transmission and subsequent infection with M. tuberculosis strains resistant to isoniazid and rifampin is high, provided comprehensive TB infection-control precautions have been implemented in the workplace and have not been successful. BCG vaccination is not recommended for children and adults who are infected with HIV because of the potential adverse reactions associated with the use of the vaccine in these persons. A diagnosis of M. tuberculosis infection and the use of treatment for infection should be considered for any BCG-vaccinated person who has a positive tuberculin skin test, especially if there is a likelihood of prior exposure to M. tuberculosis.


After working through this chapter, you will be able to

  • Explain how reactions to the tuberculin skin test are interpreted for BCG-vaccinated persons;
  • Explain when BCG vaccination should be considered for an infant or child;
  • Explain when BCG vaccination should be considered for health care workers.


Released October 2008
Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Division of Tuberculosis Elimination -

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