rss
Thorax 1999;54:762-764 doi:10.1136/thx.54.9.762
  • Original article

Administration of the BCG vaccination using the multipuncture method in schoolchildren: a comparison with the intradermal method

  1. N Al Jarada,
  2. D W Empeya,
  3. G Duckworthb
  1. aEast London TB Service, bCommunicable Disease Surveillance Centre (Thames)
  1. Dr N Al Jarad, Department of Respiratory Medicine, Bristol Royal Infirmary, Bristol BS2 8HW, UK.
  • Received 28 January 1999
  • Revision requested 22 March 1999
  • Revised 15 April 1999
  • Accepted 25 May 1999

Abstract

BACKGROUND BCG vaccination using the multipuncture device (the Heaf gun) is recommended in the UK for infants and very small children only. The aim of this study was to investigate the rate of conversion of the tuberculin test, the safety and acceptability of BCG vaccination using the multipuncture device and to compare it with the conventional intradermal method in schoolchildren.

METHODS Schoolchildren attending schools in Tower Hamlets who were eligible for BCG vaccination were tuberculin tested using the Heaf gun. Those with grade 0–1 reaction were randomised to receive BCG vaccination using either the multipuncture or the intradermal method. The site of BCG vaccination was inspected after eight weeks for inflammatory changes and scarring. A questionnaire about pain and inflammation at the site of vaccination was completed. The Heaf test was repeated at eight weeks and its results were assessed by an examiner unaware of the results of the previous Heaf test and the method of BCG administration. The Heaf test conversion was deemed to have occurred if there was a change of at least one grade in the response.

RESULTS One hundred and sixty nine children (83 girls) of mean age 11.8 years completed the study, of which 81 received BCG by the multipuncture method. The Heaf test did not convert in 22 of 81 (27.2%) receiving BCG by the multipuncture device compared with six of 88 (6.8%) who received the vaccine by the intradermal method (odds ratio 0.2, 95% confidence interval 0.07 to 0.55). The BCG scar was visible in all children who had intradermal BCG compared with 67 of 81 (81.8%) of the multipuncture group. The multipuncture method was less painful and caused fewer inflammatory changes than the intradermal method.

CONCLUSIONS In schoolchildren the multi- puncture device for administering BCG caused a lower rate of tuberculin conversion as measured by the Heaf test and less of an inflammatory response than the intradermal method. The method needs to be modified before it is applied on a wider scale to schoolchildren.

Footnotes

  • The study was self initiated and was not funded by any organisation.

  • Conflict of interest: none.

This Article

  1. Abstract
  2. Full text
  3. PDF

Register for free content

The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.