For information on vaccine administration, storage requirements, co-administration with other vaccines and vaccine safety and adverse events, see the Canadian Immunization Guide chapter on BCG.149 In premature and low birthweight infants who require BCG vaccination, the use of the vaccine early is safe and immunogenic.150
Common local complications include injection site abscesses and regional lymphadenitis that may be suppurative.151 Local disease is self-limited but often chronic, and optimal management is uncertain: observation alone with aspiration of abscesses just before rupture were suggested in a Cochrane review but the evidence was poor.152 Local osteitis may occur in the absence of immune deficiency and requires drug therapy.153 Disseminated BCG disease occurs in children with primary immune deficiencies, including severe combined immunodeficiency (SCID), mendelian susceptibility to mycobacterial diseases154,154 and some cases of HIV infection.155
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