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BCG vaccine is contraindicated in hypogamma-globulinemia, congenital immunodeficiency, sarcoidosis, leukaemia, generalised malignancy, HIV infections or any other disorder in which natural immune response is altered, as also those on immunosuppressive therapy, corticosteroids, radiotherapy. In chronic eczema or other dermatological disease, the vaccine can be given in a healthy area of the skin.
Keloid and lupoid reactions may also occur at the site of injection and such children should not be revaccinated.
Special Case of Children Born to HIV Seropositive Mothers: If the child is infected BCG vaccine is contraindicated irrespective of the child's condition, given the potential risk of development of "BCG-itis" in the vaccinated child. The advice of a specialized medical team is required.
Neither absence of BCG scar formation nor negative PPD reaction is indicative of poor BCG uptake. There is no need to repeat BCG inoculation in babies who do not develop BCG scar as advocated in the guidelines of IAP 1996.
Immune Deficiency: The vaccine is contraindicated in individuals with cell-mediated immune deficiency.
Individuals known to be infected with human immunodeficiency virus (HIV), either non-symptomatic or symptomatic, should NOT receive BCG vaccine.
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