BCG Referral Information for the Community BCG Clinic March 2016

At Norfolk and Norwich University Hospital midwives routinely identify babies eligible for neonatal BCG at ante-natal booking and the maternity notes are flagged. NeonatalBCG vaccinations are not carried out at NNUH. A referral is generated at birth (form attached) and sent to the Community TB Nurses.On receipt of the referral, parents are contacted by phone /text to book their appointment at a Community BCG Clinic held at Norwich Community Hospital.

Babies born at Queen Elizabeth Hospital King’s Lynn are vaccinated by the midwives in midwifery lead clinics at the QEH and North Cambridgeshire Hospital / Wisbech. Older children are seen in the immunisation clinic at the Roxbough Childrens’ Centre. (Referral form attached for those missed and identified later)

Babies born at the West Suffolk Hospital are vaccinated by the midwivesand the Respiratory Nurse runs catch up clinics for any age child who have been missed or are identified later in primary care. (Referral by letter please)

Historically Health Visitors in Norfolk have identified and referred neonates at risk of exposure to TB at their first visit. I would appreciate if you could take this opportunity to check that the family are aware that a referral has been done. If not, please send one through to the Norwich TB Nurses, Queen Elizabeth or West Suffolk Hospitals usinga referral form (attached for Norwich and QEH) or letter. We can only vaccinate babies we know about. Don’t forget to ask about older siblings who may have missed their BCG or need it now due to a new partner born in a high risk country (link below).

Practice Nurses are crucial in providing a safety net so that missed babies are referred when they present for their 6 week check/primary immunisations at 8 weeks.

The Practice Nurse can also opportunistically identify unvaccinated children who would have qualified for neonatal BCG and refer to the BCG Clinics.

BCG on the NHS is offered to those at risk of exposure to TB using the following criteria:

  • Infant (aged 0 -12 months) born in an area of the UK where the annual incidence of TB is 40/100,000 or greatere.g. Brent, Luton.
  • Baby/child born to parent or grandparent from high risk country where the rate is >40 per 100,000 population.
  • Family history of TB in the last five years.
  • New entrants who are mantoux or IGRA negative who
  • are previously unvaccinated and
  • who are from high incidence countries and
  • younger than 16 years of age or
  • 16-35yrs from Sub-Saharan Africa or a country with a TB incidence of >500 per 100,000 or more

Private BCG is available at the Norwich Community BCG Clinic to:

  • Individuals at occupational risk as specified in Immunisation against infectious disease (Green Book) although some Occupational Health Services will provide vaccination.
  • Individuals under 16 years old who is going to live or work with local people for more than three months in a country where the annual incidence of TB is 40/100,000 or greater.
  • Those requesting BCG vaccination with no risk factors.

Babies can start the routine immunisations at 2 months of age regardless of when they have their BCG, and vice versa; they can have their BCG at any time before/during their primary immunisations. The BCG can be administered at any time before or after any other live vaccination(link below).