Tuberculosis Protection - BCG Vaccination & Mantoux Testing
Tuberculosis (TB) is a bacterial infection that most commonly affects the lungs. TB can also affect other parts of the body including the kidneys, spine and brain. While it is possible for many people to fight off tuberculosis naturally, for some people it can lead to serious long-lasting health complications and can be fatal.
TB is difficult to treat as several strains of TB are resistant to many the drugs used to treat the disease. The BCG vaccine provides some protection but is not as straightforward to use other vaccines.
The BCG vaccine can only be given to those who have not been exposed to TB previously, or have not previously had the vaccine. A skin test (the Mantoux test) is therefore required before the vaccination can be given, in order to confirm this. Newborn babies must also first be tested for immunodeficiency (SCID test)..
Children and babies under 6 years old: BCG without a Mantoux test.
– Babies born on or after 1 September 2021 are required to bring in confirmation of a negative SCID result or confirmation that the child was not offered SCID screening before we can administer the BCG vaccine. You can find out more about SCID testing here.
Parents will need to bring their Red Book and the letter showing the outcome of the newborn’s bloodspot screening with them to their appointment. Vaccination may be administered earlier than 28 days provided that proof of a negative SCID result is available.
Children over 6 years old: Require a Mantoux test prior to the administration of the BCG vaccine
Adults: Require a Mantoux test prior to the administration of the BCG vaccine.
Who should have the Tuberculosis vaccine?
We advise the following people should have the BCG vaccine:
- Babies most at risk of contracting TB are those living in London and the Midlands – if you live in these areas it is strongly recommended to have your baby inoculated
- If you are planning to live or work in a country with high rates of TB
- Healthcare professionals who are exposed to occupational risk
*The vaccine should not be given to people who have been vaccinated previously, or who have been exposed to TB previously, which is why a skin test (Mantoux test) is usually undertaken prior to vaccination*
Babies born on or after 1 September 2021 are required to bring in confirmation of a negative SCID result or confirmation that the child was not offered SCID screening before we can administer the BCG vaccine.
How is the Tuberculosis vaccine given?
Children under 6 years can receive the BCG vaccine without the need for a prior Mantoux test.
One dose of the TB vaccine is required. BCG appointments are available on Wednesdays only.
Babies born on or after 1 September 2021 are required to bring in confirmation of a negative SCID result or confirmation that the child was not offered SCID screening before we can administer the BCG vaccine.
Parents will need to bring their Red Book and the letter with the outcome of the newborn’s bloodspot screening with them to their appointment. Vaccination may be administered earlier than 28 days provided that a SCID result is available, along with proof.
More information on SCID screening.
Children over the age of 6 and adults require two separate appointments over a three day period. The first appointment will involve a Mantoux test – this involves a tiny injection into the forearm. Mantoux test appointments are available Mondays only.
The second appointment will be 48 hours later and this will involve the nurse reading your Mantoux test and then administering the BCG vaccine if considered appropriate. BCG appointments are available on Wednesdays only. One dose of the TB vaccine is required.
How does the Tuberculosis vaccine work?
The vaccine to prevent tuberculosis is the BCG (Bacillus Calmette-Guerin).
A live, weakened strain of tuberculosis is injected to produce antibodies that protect against the infection. The BCG vaccination is thought to protect against the most serious types of TB infection.
What is Tuberculosis?
Tuberculosis (TB) is a serious infection caused by Mycobacterium tuberculosis.
TB affects mainly the lungs but can also affect other parts of the body, such as the kidneys, joints, and bones. Tuberculosis can lead to more serious health complications including meningitis, bone and spinal infection, joint damage and arthritis, liver and kidney problems and heart disorders. It can also be fatal.
What are the symptoms of Tuberculosis?
The symptoms of tuberculosis include:
- A cough that lasts more than 3 weeks
- Coughing up blood
- Unintentional weight loss
- Fever
- Chills
- Fatigue
- Night sweats
- Chest pain or pain with breathing/coughing
How is Tuberculosis spread?
Transmission normally requires extended, close contact with an infected person, this can be at home, at work or during travel.
It is usually via inhalation of droplets from an infected person’s coughs or sneezes.
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Jenny Gibson
We booked, we arrived and we had our vaccines. Everything as expected. What really stood out was the level of medical advice from the nurse giving us our injections. It was explained very clearly to us to the level of protection our vaccine would give. As this was a new vaccine the results of medical trials were also highlighted. There was no push to sell more products, just clear advice on what to avoid and what to do to prepare for our trip to the Far East.
Cian Haynes
I highly recommend Fleet Street Clinic for travel vaccines. The experience was smooth and professional. Chiara was incredibly knowledgeable, patient, and reassuring. She thoroughly explained each vaccine and made me feel at ease. The vaccinations were quick and relatively painless, with excellent aftercare advice. I feel well-protected for my travels thanks to Chiara and the team!
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Clare Elliott
Very easy to book. The nurse was great with my nervous daughter. I would recommend for travel vaccinations.
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I love this place; it's my go-to for vaccinations. Now they offer private COVID boosters even better—also much better availability than the high street chemist named after footwear. Everyone is so friendly and professional.
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FAQs
No, for us to correctly interpret the results of your Mantoux test and to validate the test, we need to administer the test at our own clinic. You may need to repeat the Mantoux test at the Fleet Street Clinic for us to be able to administer the vaccine.
On the third day following the test, you’d have a follow up appointment to evaluate the results and if required you can have the BCG vaccine during the same appointment. Mantoux tests are only suitable for children aged 6 years and older, and adults. Children and babies under 6 years are able to book a BCG without a Mantoux test.
Latent TB is identified from your Mantoux test and means that you have already been exposed to tuberculosis. A person with latent TB is not infectious and cannot pass on TB, however, the infection is lying dormant in their body causing no harm. Without treatment, some will go on to develop TB at some point in their life, perhaps within the first 2 years of infection. It is treatable once identified.
Reactions to the BCG vaccine are uncommon and usually mild. Most BCGs will blister and cause a small scar at the injection site. This is common and nothing to worry about. The length of time it takes to heal can vary but you can seek guidance from your nurse or doctor if you have any concerns about how your BCG is healing. As with most vaccinations, you may also experience fever, raised temperature and/ or headache. Again these are common. Any abnormal or severe reaction should always be checked out by a doctor.
TB is not very common in the UK. According to the UK Health Security Agency:
“In 2019, the number of people notified with TB in England rose for the first time in 9 years, from 4,615 in 2018 to 4,725 in 2019; a rise of 2.4%.”
“Most people notified with TB were concentrated in major urban centres. London accounted for over a third of cases.”
To put this into context, the UK is still considered a low-risk country worldwide for TB by the World Health Organisation (WHO). Many countries experience dramatically higher case numbers per year, especially in Africa, Asia and Latin America.
The BCG is not now routinely given as part of the NHS childhood vaccination schedule. You can only get vaccinated on the NHS if your child or an adult is considered to be of higher risk. This includes certain areas of the UK where TB levels are highest and also if parents or grandparents of a child are from countries with known higher levels of TB.
– Babies born on or after 1 September 2021 are required to bring in confirmation of a negative SCID result or confirmation that the child was not offered SCID screening before we can administer the BCG vaccine. More information about SCID testing here.
Your child’s vaccination history is recorded in a red book. Please bring this with you when they attend for vaccination so that we can keep their vaccination records accurate and up to date.
If you forget to bring it we can always update it subsequently.
The TB vaccine is more commonly referred to as the BCG. The BCG is given as part of the childhood schedule for those infants identified as at risk of TB, or to adults whose occupation may put them at risk of the disease.
– Babies born on or after 1 September 2021 are required to bring in confirmation of a negative SCID result or confirmation that the child was not offered SCID screening before we can administer the BCG vaccine. More information about SCID testing here.
If an infant is eligible for the vaccination, the BCG vaccination is licensed to be given from birth. As of September 2021, infants are only eligible to receive the vaccination when the results of the SCID heel prick test have been made available, and SCID (severe combined immunodeficiency) is not suspected.
Click for more information about SCID testing here.
The BCG is a live vaccination, and given intradermally (just under the skin). The healing process of this usually means a small pustule forms, which eventually heals leaving a small, flat scar.
TB is still present in all countries and age groups.
The BCG vaccination is available for those individuals deemed to be at risk of disease. Therefore, the vaccination is more commonly given in those countries which have higher rates of TB, and where the vaccination forms part of the national programme. Speak with your doctor if you are unsure whether you or your children are suitable for a BCG vaccine.
BCG does not offer 100% protection against TB, but is believed to be up to 80% effective at preventing the most severe forms of the disease such as TB meningitis in infants and widespread lung infection (miliary TB)..
Severe disease, such as TB meningitis is more common in infants, particularly under one year of age, which is why the national immunisation is offered to infants.
Babies born on or after 1 September 2021 are required to bring in confirmation of a negative SCID result or confirmation that the child was not offered SCID screening before we can administer the BCG vaccine. More information about SCID testing here.
It is uncertain how long protection from the BCG vaccination lasts, however, only one vaccination is given. No additional doses or boosters are needed.
The BCG is most effective in infancy where it can provide protection against severe clinical disease. The vaccination can be given to older children if risk factors for the disease are present, and in adults, to those who are at risk of the disease through occupation.
Babies born on or after 1 September 2021 are required to bring in confirmation of a negative SCID result or confirmation that the child was not offered SCID screening before we can administer the BCG vaccine. More information about SCID testing here.
Usually at 28 days of age, or when an infant has received the results of a negative SCID screen.
Babies born on or after 1 September 2021 are required to bring in confirmation of a negative SCID result or confirmation that the child was not offered SCID screening before we can administer the BCG vaccine. More information about SCID testing here.
The 6 needles test was more commonly referred to as the Heaf test, which has now been replaced with a Mantoux test.
A Mantoux test is given to all individuals over the age of 6 years old before a BCG vaccination can be given. A positive Mantoux test is classed as one where an area of induration is present on reading at the site of the Mantoux test (between 48-96 hours from administration). The BCG vaccination cannot be given to those who have a positive Mantoux test.
A small injection of purified protein derivative is given just under the skin (intradermally) to the left forearm.
A negative test is where no induration is present on reading at the site of the Mantoux test (between 48-96 hours from administration). The BCG vaccination can be given to those who present a negative Mantoux test.
