TB vaccinations in schools?

[rachag]

Does anyone know if and when the Birmingham schools are going to start any vaccination programme? If so, would that be primary or secondary education age. PCT's may have different policies. Would this affect a school vaccination policy with, e.g grammar schools, taking pupils from several different primary care trust areas.
Would be great if anyone had any info about this.

[hermanmunster]

Hi Rachag


The immunisation policy is pretty standard throughout the country with each PCT following the advice of th JVCI (joint committee on vaccination and immunisation).

BCG is now done on people at risk for one reason or the other ... will try and find the latest list .

Many kids are done shortly after birth anyway and in many areas (like North Yorkshire) very few are ever done as they are relatively low risk, so far fewer done as teens ... back in a tick.

[hermanmunster]

Hi Rachag


The immunisation policy is pretty standard throughout the country with each PCT following the advice of th JVCI (joint committee on vaccination and immunisation).

BCG is now done on people at risk for one reason or the other ... will try and find the latest list .

Many kids are done shortly after birth anyway and in many areas (like North Yorkshire) very few are ever done as they are relatively low risk, so far fewer done as teens ... back in a tick.

back again:; - this is a summary..

http://www.patient.co.uk/doctor/BCG-Vaccination.htm" onclick="window.open(this.href);return false;

worth noticing that there is no schools programme now.

the at risk groups are:
The new immunisation schedule is based on risk assessment and involves targeted immunisation of neonates and others at high risk. BCG immunisation is now recommended for:

Infants (0 to 12 months of age) living in areas of the UK where the annual incidence of TB is significant (greater than 40/100,000).
Infants (0 to 12 months of age, and children who have not previously been immunised) with a parent or grandparent who was born in a country with a significant annual incidence of TB (greater than 40/100,000).
Previously unvaccinated children aged 1 to 5 years with the same background (that is, with a parent or grandparent who was born in a country with a significant annual incidence of TB greater than 40/100,000) and this can be done without tuberculin testing.
Children aged 6 to 16 years who are previously unvaccinated and tuberculin-negative with a parent or grandparent who was born in a country with a significant annual incidence of TB (greater than 40/100,000) after opportunistic identification and, in this case, negative tuberculin testing.
Previously unvaccinated, tuberculin-negative immigrants under the age of 16 years from countries with a significant incidence of TB (greater than 40/100,000).
Previously unvaccinated, tuberculin-negative contacts of respiratory TB cases or individuals with high risk of occupational or travel exposure.8

It is important to note that:

The majority of vaccinations should be given to neonates whilst still in hospital.
However, other individuals will also meet the criteria for immunisation and, as the schools' programme has now ceased, local policy will be needed to identify these outliers.
Individuals without risk factors for TB, who request vaccination, should not be offered the BCG vaccine.

[rachag]

Thank you very much for your detailed reply HM

[magwich2]

Time was when newly arrived immigrants were given a chest x-ray at the airport.

[hermanmunster]

People wanting to stay more than 6 months have to be screened before they arrive now.

http://www.ukvisas.gov.uk/en/howtoapply ... bscreening" onclick="window.open(this.href);return false;

[magwich2]

Presumably you could pass on TB in 5 minutes?

[hermanmunster]

Presumably you could pass on TB in 5 minutes?

tends to be more like close contact (household) for a prolonged period - hence the 6 month rule.
If we do get a case then the only people at risk are those spending a chunk of time with the infectious person - eg sharing a house, work contacts rarely have problems - school kids can pass it on though.
Nearly all the kids in a major outbreak here amongst teenagers had been immunised as kids..

[bromley mum]

Nearly all the kids in a major outbreak here amongst teenagers had been immunised as kids..

So, the vaccine does not give a 100% protection? I know 100% is impossible but is this vaccine less effective thab, say , the measles one?

[hermanmunster]

Trouble is with the BCG immunisation is that it doesn't work in the same way as a straight viral / bacterial imm.

Say the flu vaccine - it contains a combination of the commonest marker particles (antigens) from the the types of flu circulating and has stuff added to make it particularly enticing to the immune system, which "sees" the antigen, starts developing antibodies from B cells and "remembers" the pattern. When the person is then exposed to the real virus, the body starts rapidly developing more of the antibody as it has seen it before - the antibody then leads to the destruction of the virus -
***ta ra, a victory for the immune system over the beastly virus and minimal damage to the body ***

HOWEVER ... (bet you knew that was coming) - much of the damage of TB is related to the body's immune response - also more problems can occur decades after an initial infection. The BCG is an attenuated weak version of ONE of the TB mycobacterium (irritatingly not a straightforward bacterium) - it is attempting to stimulate the T cells to recognise the TB if it appears .
However, there are many many types of mycobacterium about, and not all are like the BCG one - the kids in the outbreak I mentioned had one from the subcontinent which is not sensitive to the BCG.
BCG is thought to prevent about 50% of cases (but very difficult to know definitely), it does seem to reduce the risk of the more serious and rare complications of widespread TB and TB meningitis.
Hence the reason why it is still used in some risk groups.


I have worked in some pretty high incidence areas where we have some eye watering anxt amongst people who would not even drive through the city
- I had BCG aged 13 (but don't think it actually reacted at all) - I have weak immunity on a heaf test, possibly just from general exposure as a kid in Birmingham in the 60's.