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Guidelines for injection of BCG VACCINE SSI

It is generally accepted that the best method of BCG vaccination is intradermal injection with use of a syringe and a needle.

This is the most accurate method because the dose can be measured precisely and the administration can be controlled. Hereby the rate of adverse reactions can be minimized.

BCG VACCINE SSI

BCG (Bacillus Calmette-Guérin) VACCINE SSI is a live freeze-dried vaccine for intradermal use.

•  The vaccine is stored at 2^o to 8^o C
• The vaccine is reconstituted with DILUTED SAUTON SSI
• Use a sterile 1.0 ml syringe fitted with a short bevelled needle
  (25 to 26 G)
• Do not freeze!

Reconstitution of BCG VACCINE SSI
(10 dose vial)

Transfer exactly 1.0 ml Sauton to the vial using a sterile syringe with a long needle.

Do not remove the rubber stopper

• To suspend the vaccine turn the vial gently upside down a few times - Do not shake
• The suspension should be homogenous, slightly opaque and colourless
•  
• Any reconstituted vaccine not used should be discarded after maximum 4 hours

The site of injection

• The recommended site of injection (all age groups) is the deltoid region of the arm, about one third down the upper arm over the insertion of the deltoid muscle

Dosage of BCG VACCINE SSI

• For infants < 12 months 0.05 ml of the reconstitued vaccine is recommended
• For children > 12 months and adults 0.10 ml of the recinstituted vaccine is recommended
• Gently swirl the vial before drawing up each dose
• Draw up slightly more than one dose and remove any air bubbles and extra vaccine

Injection technique

                                          The skin should not be cleansed with antiseptic before the injection

Jet injectors or multiple puncture devices should not be used

The skin is stretched between the thumb and forefinger

The needle should be almost parallel with the skin surface and the bevel of the needle facing upwards

The needle should only be inserted approximately 2 mm into the superficial layers of the dermis

The vaccine is given slowly

You will feel a slight pressure as you press the plunger, and a small flat swelling will appear (very similar to a mosquito bite)

If the skin does not swell or you feel you can press the plunger too easily, then the    vaccine is probably given too deeply.

You can try to draw back the needle into correct position and give the rest of the vaccine

After injection 

            
The swelling will disappear within 10 to 15 minutes

If there is no swelling never give a second dose of vaccine.

Vaccination given too deeply gives adequate results in turns of clinical protection.

However, a large scar, an abscess or enlarged lymph nodes may result from a vaccination given deeply.

Make a note on the person's chart for careful follow-up