BCG, or tuberculosis vaccine

The vaccine gives protection against severe forms of tuberculosis, including tuberculotic meningitis and systemic tuberculosis.
Vaccine-preventable diseases

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To whom is the BCG vaccine administered?

In the national vaccination programme, the BCG vaccine is offered free of charge to children aged under 7 who are at an increased risk of tuberculosis infection.

The primary purpose of the BCG vaccinations of at-risk groups is to protect young children from the severe forms of tuberculosis, including tuberculotic meningitis and systemic tuberculosis.

A BCG vaccination is recommended for a child 

  • when tuberculosis has been diagnosed at any time in the child's mother, father, sibling or a person with whom the child lives
  • who has been born in a country with significant levels of tuberculosis, or when the child's mother, father, sibling or a person with whom the child lives has been born in one of these countries
  • who, within the next year, intends to move into a country with significant levels of tuberculosis for more than a month

High levels of multi-drug resistant (MDR) tuberculosis are found in all Baltic countries. While Estonia no longer is one of the Baltic countries with a high incidence of tuberculosis, it is comparable to them when vaccination needs are assessed. 

For example, it is appropriate to offer a BCG vaccine to

  • a child aged under 7 who is about to move to Estonia
  • A child born in Finland if one or both parents were born in Estonia, or if the parents visit Estonia regularly.

Children coming from countries with a high or moderate incidence of tuberculosis who have an increased risk of tuberculosis infection arising from their circumstances may be found among asylum seekers and refugees. 

This is why a BCG vaccination is recommended for children aged under 7 who have not received it previously and 

  • who have arrived in Finland from a refugee camp or possibly as smuggled asylum seekers, or
  • who live at a reception centre or a unit for minors. 

In some cases, a child may benefit from a BCG vaccination even if they did not belong to any of these at-risk groups. A BCG vaccination should be offered to a child if the child has some other regular and close contact with a person

  • who comes from a country with a high incidence of tuberculosis
  • who has contracted tuberculosis
  • who is known to have had significant exposure to tuberculosis
  • who cares for pulmonary tuberculosis patients or otherwise has regular and significant exposure to tuberculosis in their profession

The need for a BCG vaccination is assessed by the physician responsible for children's healthcare. A child is vaccinated based on a written recommendation of a physician.

Which vaccine is used and what does it contain?

The product purchased for the national vaccination programme is called BCG Vaccine AJVaccines and it is manufactured in Denmark. 

  • The vaccine contains live, attenuated Bacillus Calmette-Guérin bacteria.
  • The excipients include salts as pH control agents, amino acid salts, glycerol and purified water.
  • The vaccine contains no adjuvants or preservatives.

Dosage and schedule

  • The dose for infants under one year of age is 0.05 ml.
  • The dose for children over one year of age is 0.1 ml.

A single administration of the BCG vaccine is recommended. The vaccine is usually administered during the first week of life.

The vaccine may be given to a child who has not received a BCG vaccination until the child turns 7. There is no clear evidence of the vaccination being effective in children aged 7 years or over.

Most experts estimate that the protection lasts for approx. 15 years.

What are the contraindications and precautions associated with the vaccine?

A healthcare professional will check that there are no contraindications to administering the vaccine.

What are the benefits of the BCG vaccine?

In studies, the BCG vaccine has without exception been highly effective in preventing tuberculotic meningitis and systemic tuberculosis in young children. At the time when all children were vaccinated, these life-threatening illnesses were all but eradicated in Finland. 

The effectiveness of protection against pulmonary tuberculosis has varied in different studies. As the vaccine also has adverse effects, it is not administered to children with a low risk of contracting the infection.

The effectiveness of the BCG vaccine has been optimal in studies where it was administered at an as early age as possible in mild climatic conditions. 

While the protection afforded by the vaccine declines over time, partial protection may endure for decades. No revaccinations are administered in Finland, as their adverse effects would outweigh the benefits.

It is believed that the vaccine is the most effective if the recipient has not yet been exposed to any type of mycobacteria. Fewer environmental mycobacteria occur in a mild climate than in a warm and humid one. 

Environmental mycobacteria cause infections in persons with immunodeficiency, lung infections in smokers, and sometimes infections in the lymph nodes of the neck in young children. The BCG vaccine also gives protection against these conditions, and since the vaccination programme was modified, they have increased in Finland.

What are the potential adverse effects of the BCG vaccine?

All vaccines may have adverse effects, but they are usually transient and only occur in a small proportion of the vaccine recipients. 

Adverse effects of the BCG vaccine

History of the BCG vaccine in the national vaccination programme

A BCG vaccine was administered to all newborn infants at the maternity hospital until September 2006. Since that year, the vaccine has only been offered to children aged under 7 in at-risk groups.