BCG Vaccine Reactions in Infants: What to Expect - Pediatrics

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Regarding the BCG vaccine?


Hello Doctor: My baby received the BCG vaccine on May 29, and until today, I have noticed that there is hardly any trace at the injection site.
I remember that when my older child received the vaccine, there was a small bump immediately after the injection.
However, my younger daughter has no visible signs at all, not even a small red dot.
I called to inquire about this, and the person who administered the vaccine told me that this is normal and that signs of pus may take 2 to 4 weeks to appear.
I mentioned that the BCG vaccine usually creates a small bump right away, but they said that it can vary from child to child.
I am very worried, so I would like to ask the doctor if this is considered normal.
Thank you, Doctor!

Qing, 20~29 year old female. Ask Date: 2007/06/04

Dr. Xiao Kaiwen reply Pediatrics


Dear Qing,
In response to your question, the vaccination site for the BCG vaccine typically develops a small red nodule (red dot) or a small blister.
However, it is also possible that some children may initially show no reaction due to individual differences in their constitution (provided that the injection technique and vaccine are correct).
Subsequently, within three to six weeks, it may progress to pus or ulceration, and eventually form a scab and scar.
Therefore, I recommend that you continue to monitor your child's local reaction.
Sincerely,
Pediatrics Department, Qishan Hospital
Xiao Kaiwen

Reply Date: 2007/06/04

More Info


The BCG (Bacillus Calmette-Guérin) vaccine is primarily used to protect against tuberculosis (TB) and is typically administered to infants shortly after birth. Understanding the expected reactions to the BCG vaccine can help alleviate concerns for parents regarding their child's health post-vaccination.

When a child receives the BCG vaccine, it is common for a localized reaction to occur at the injection site. This reaction can vary significantly from one child to another. Some children may develop a small blister or papule at the injection site within a few days, while others may not show any immediate signs. It is important to note that the absence of an immediate reaction does not indicate that the vaccine was ineffective.

Typically, the expected timeline for reactions to the BCG vaccine is as follows:
1. Initial Reaction: After administration, some infants may develop a small bump or blister at the injection site within 1-2 weeks. This is a normal immune response to the vaccine.

2. Development of a Wound: Over the next few weeks, this bump may evolve into a small ulcer or sore, which can sometimes become crusty or weep. This is part of the body's immune response and is generally expected.

3. Healing Process: The sore usually heals over a period of several weeks to months, often leaving a small scar. The scar is a sign that the vaccine has stimulated the immune system.

In your case, since your baby received the BCG vaccine on May 29 and you have not observed any reaction yet, it is still within the normal range of responses. The healthcare provider's reassurance that it may take 2-4 weeks for any signs of a reaction to appear is consistent with typical expectations. Each child's immune response can vary, and some may not show any visible signs until later.

It is also important to monitor the injection site for any unusual signs, such as excessive redness, swelling, or discharge that seems infected. If you notice any concerning symptoms or if the site does not show any signs of healing after a reasonable period, it would be advisable to consult your pediatrician for further evaluation.

In summary, the absence of an immediate reaction to the BCG vaccine does not mean that the vaccine was ineffective. The expected immune response can vary widely among infants, and it is normal for some children to take longer to show signs of a reaction. If you have ongoing concerns, maintaining open communication with your healthcare provider is key to ensuring your child's health and well-being.

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