Distribution of Bacillus Calmette-Guérin (BCG) Vaccine in Victoria 2013-2015

The Bacillus Calmette-Guérin (BCG) vaccine has an important role mitigating tuberculosis (TB) disease in high risk children. In Victoria, immunisation services at the Royal Children's Hospital (RCH) and Monash Health (MH) have been funded as the major providers of BCG vaccine since 2013.

In this article, we performed retrospective analysis of patients who attended RCH and MH for BCG between 1st November 2013- 30th November 2015. This was compared with local birth data in order to portray the distribution of BCG vaccine across various cohorts.

A total of 3,975 patients received BCG vaccine (1,775 at Monash, 2,200 from RCH). Detailed data is only available on 830 RCH patients. The median age of the study population was 6.9 months (IQR 3.9-11.3). The majority of children (98.9%, 2,575/2,604) received BCG vaccine prior to overseas travel. Of these, 96.0% (2,474/2,575) were travelling to countries in Asia. Only 13/2,604 (0.5%) were given BCG vaccine prior to travel to a country with low incidence of TB. Most infants were of Asian descent (93.3% mothers [2,425/2,604], 90.4% [2,346/2,604] fathers). A much smaller proportion was African (1.4% mothers [35/2,604], 1.5% [39/2,604] fathers). This contrasts with 2012 Victorian birth data, which showed that 82.2% (7,508/ 9,134) babies born to mothers from high TB prevalence countries were of Asian descent, whereas 8.9% (816/ 9,134) were of African descent. These results highlight scope to improve awareness and equity of BCG vaccine service, particularly to infants of African background.