Click here for Chinese translation

 

BCG Vaccine and Tuberculosis Immunisation in Sydney

The BCG vaccine (Bacille Calmette-Guérin) is designed to protect against tuberculosis (TB), a severe and infectious disease that primarily affects the lungs but is capable of impacting other organs. Here’s everything you need to know about TB immunisation and why it matters for individuals travelling from or to regions with high TB incidence.

Who Is at High Risk of Tuberculosis?

Certain populations are more vulnerable to TB infection, including:

• Newborns and infants living in or visiting TB-endemic areas
• Healthcare workers frequently exposed to TB patients
• Individuals with compromised immune systems, such as those with HIV
• Migrants from regions with high TB prevalence
• Close contacts of people diagnosed with TB.

 

Where Are You Most Likely to Be Exposed to Tuberculosis?

The highest risk of TB exposure exists in high-incidence regions across specific countries and cities within Africa, Asia, and Eastern Europe. These areas have both elevated TB rates and environments that facilitate the spread of the disease.

• Africa: Countries such as South Africa (including Johannesburg and Cape Town) report high TB prevalence, driven by both community spread and healthcare-associated infections.
• Asia: India (notably in Mumbai and New Delhi) and China have the highest global TB burdens. Southeast Asian countries like Indonesia and the Philippines also report high TB infection rates.
• Eastern Europe: Russia (including cities like Moscow) and Ukraine face ongoing TB challenges, particularly with multi-drug-resistant TB strains.

High-Risk Settings for TB Exposure

• Healthcare Facilities: Hospitals and clinics in TB-prevalent regions can be hotspots for transmission, especially in facilities with poor ventilation.
• Prisons: Overcrowded correctional facilities in countries like South Africa and Russia significantly contribute to TB outbreaks.
• Crowded Urban Areas: Densely populated areas in Mumbai or Johannesburg facilitate the airborne spread of TB, especially in poorly ventilated housing conditions.

 

Are you planning to visit these regions? Ensure you are protected with the BCG vaccine and book an appointment with one of our expert travel doctors at ITVC to discuss TB prevention strategies.

 

What Are the Symptoms of TB?

Tuberculosis (TB) can present differently depending on the part of the body affected. The most common form is pulmonary TB, which targets the lungs. Key symptoms of pulmonary tuberculosis include:

• A persistent cough lasting more than three weeks
• Coughing up blood or phlegm
• Chest pain and difficulty breathing

 

Other general symptoms of TB can affect the entire body, including:

• Unexplained weight loss
• Night sweats
• Fever and chills
• Loss of appetite
• Persistent fatigue

 

When TB infects other areas (extrapulmonary TB), symptoms may vary. For instance, kidney TB might cause blood in the urine, while TB meningitis can trigger headaches and confusion. If you notice these symptoms, seek medical care promptly to prevent further spread and complications.

About the BCG Vaccine

The Bacille Calmette-Guérin (BCG) vaccine is primarily used to protect against tuberculosis. It contains a weakened strain of Mycobacterium bovis, a close relative of the TB-causing bacterium. This vaccine is most effective in preventing severe TB in children, such as TB meningitis and miliary TB.

However, the BCG vaccine offers limited protection for adults and does not completely prevent pulmonary TB. In countries like Australia, where TB incidence is low, BCG is not part of the routine vaccination schedule but is offered selectively for individuals travelling to high-risk areas or those with increased exposure.

 

Who Needs the BCG Vaccine?

• Infants and Newborns: The BCG vaccine is usually administered shortly after birth in countries where TB is prevalent to protect infants from severe forms of the disease.
• Travellers: Individuals travelling from low TB areas, such as Australia, to countries with higher TB incidence like Africa, Asia and Eastern Europe are recommended to get vaccinated, especially if they’ll stay long-term or have frequent exposure to high-risk settings.

What Age Should the BCG Vaccine Be Given?

The BCG vaccine can be administered to newborns and infants shortly after birth to protect against severe forms of the disease, including TB meningitis. Older children and adults travelling to high-risk areas may also receive the BCG injection for protection against exposure. 

 

Does the BCG Vaccine Provide Lifelong Protection?

Unfortunately the BCG vaccine’s protection does not last for life. Its effectiveness is strongest in infancy and childhood but eventually wanes over time. The BCG vaccine primarily prevents serious complications, such as TB meningitis, but offers limited defence against adult pulmonary TB. 

Can You Still Get TB After the BCG Vaccine?

It is possible to contract tuberculosis even after receiving the BCG vaccine. The vaccine does not offer complete immunity, particularly for adults. It is most effective in children, reducing the risk of severe TB, but waning immunity increases the chance of infection later in life.

Side Effects of the BCG Vaccine

The BCG injection is generally safe, however some individuals may experience mild side effects, including:

• Redness and swelling at the injection site
• A small ulcer or abscess at the site, which can leave a scar
• Swollen lymph nodes in nearby areas (e.g., under the arm)

More serious side effects, such as an allergic reaction or infections, are rare but may occur in immunocompromised individuals. For this reason, the vaccine is not recommended for those with weakened immune systems, such as people with HIV, or for pregnant women. If you experience unusual side effects after receiving the BCG vaccine, consult your healthcare provider.

BCG and False-Positive Tests

If you’ve been vaccinated with BCG, it may cause false-positive results in TB skin tests (Mantoux test). Blood tests such as interferon-gamma release assays (IGRAs) are preferred for diagnosing TB in individuals previously vaccinated with BCG.

Why Isn’t the BCG Vaccine Part of the Routine Vaccination Schedule in Australia?

The BCG vaccine is not part of Australia’s standard vaccination schedule because the incidence of tuberculosis (TB) is relatively low across the country. Instead, TB immunisation is offered selectively to individuals with greater exposure risk, such as newborns with parents from high-TB regions or travellers visiting TB-endemic countries.

 

Who Should Not Be Vaccinated with BCG?

The BCG vaccine is not suitable for certain individuals, such as:

• Immunocompromised individuals, including those with HIV
• Pregnant women
• Individuals receiving immunosuppressive treatments
• Newborns and children in low-TB-risk areas unless exposed to high-risk environments
• People with a history of complications from previous BCG vaccinations. 

Book Your TB Vaccination at the International Travel Vaccination Centre

If you or your child need TB immunisation, visit us at one of our Sydney clinics for expert travel health advice and vaccination services. Protect yourself and your family against tuberculosis — plan ahead for safe and healthy travel.

For more information, contact the International Travel Vaccination Centre or call us on 1300 557 070.