A comparison of intradermal BCG vaccination by jet injection and by syringe and needle

Abstract

The local reaction and tuberculin sensitivity produced with intradermal BCG vaccination given by jet injection have been compared with the results using the standard method with syringe and needle. The comparison was made by 5 doctors in Cheshire and Yorkshire schoolchildren aged 11–12 years.Negative reactors to a tuberculin test with 10 TU were vaccinated by one of three methods: 1.(i) Syringe and needle, using one batch of freeze dried vaccine (F94).2.(ii) Jet injection, using the same batch (F94).3.(iii) Jet injection, using a batch with twice the viable count (F96).A total of 2,009 children were vaccinated and 1,736 (86 per cent) had their local vaccination reactions and tuberculin sensitivity read 6–10 weeks after vaccination. There were no important differences between these 3 groups in the weal size immediately after vaccination or in the mean size of the local vaccination reaction at 6–10 weeks. At 4 months larger proportions of the jet injection group showed abscesses or nodules, but by 12 months smaller proportions of these groups had residual scars and there were very few unsightly scars in any group.There were no important differences in tuberculin sensitivity between the groups.These results were obtained using jet injectors which were carefully selected and maintained. Provided technical difficulties with the instrument are successfully overcome jet injection has practical advantages over the use of syringe and needle and is the method of choice for intradermal BCG vaccination in schoolchildren.