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Scar among Bacillus Calmette-Guerin Vaccinated Children Presenting to an Immunisation Clinic at a Tertiary Hospital

Ajaya Kumar Dhakal1, Divya Kc1, Barsha Shrestha1

  • 1Department of Paediatrics, KIST Medical College and Teaching Hospital, Imadol, Lalitpur, Nepal.

JNMA; Journal of the Nepal Medical Association
|March 2, 2026
PubMed

Insights

Most children develop a Bacillus Calmette-Guerin (BCG) vaccination scar, but scar failure occurs in some. This study determined BCG scar prevalence and clinical differences in children with and without scars.

Area of Science:

  • Pediatrics
  • Immunology
  • Public Health

Background:

  • Bacillus Calmette-Guerin (BCG) vaccination typically results in scar formation within 12 weeks.
  • However, variations in scar development exist among children due to multiple factors.
  • Understanding scar prevalence and associated clinical characteristics is crucial for monitoring vaccine efficacy and child health.

Purpose of the Study:

  • To determine the prevalence of Bacillus Calmette-Guerin (BCG) vaccination scar failure in children.
  • To compare clinical characteristics between children who developed BCG scars (scar-positive) and those who did not (scar-negative).

Main Methods:

  • An observational, cross-sectional study was conducted with 386 children attending a tertiary care hospital for 12 or 15-month vaccinations.
  • Data collected included medical history of BCG vaccination, child and maternal clinical profiles, and hospitalizations for respiratory tract infections.
  • Purposive sampling was employed.

Main Results:

  • The prevalence of BCG scars was 88.34% (341 out of 386 infants).
  • Vaccination was confirmed in 94.82% of cases via history and vaccination card.
  • The median scar size was 4mm transversely and 3mm vertically. 8.30% of infants were hospitalized for respiratory infections, with no cases receiving anti-tubercular treatment.

Conclusions:

  • BCG scar formation is common, with scar failure observed in a minority of children.
  • The rate of BCG scar failure in this study was comparable to findings in other research.
  • Further investigation into clinical differences between scar-positive and scar-negative children may be warranted.
Abstract

Keywords:
BCG scarBCG vaccinationNepalscar failure

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