BCG vaccination: An update on current Australian practices

ABSTRACT

[...]many practitioners have limited experience with the use and administration of this vaccine. [...]of these shortages, it is important to prioritise vaccine access to those who will be benefit most from vaccination. BCG vaccination protects against Hansen's disease, caused by M. leprae, with an overall protective effect of approximately 25%.15 There are also observational data from European studies suggesting that BCG vaccination provides some protection against nontuberculous mycobacterial lymphadenitis in children.16 Of interest to those living in south-eastern Australia, the BCG vaccine is not thought to provide significant protection against M. ulcerans infection, although it may protect against M. ulcerans osteomyelitis.15'17'18 BCG vaccination also has 'off-target' effects beyond preventing TB.19 In the Australian context, the BCG vaccine is most recognised for its use in treating bladder cancer. While clinical trials for novel indications are critical, the efficacy of BCG vaccination for these conditions remains uncertain. Because of the potential side effects and limited access to the vaccine, BCG vaccination should not be used for these indications outside of clinical trials.23 Adverse effects and contraindications The BCG vaccine is generally safe and well tolerated.