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Referral process

During the newborn screening process after birth, the examining Midwife, Doctor or Neonatal Nurse will explore your baby’s eligibility for the BCG Vaccination. This is the vaccination that offers protection against Tuberculosis (TB). The BCG vaccination is not a routine vaccination, it is risk based which means it is offered to babies who have parents or grandparents born in a country where TB has a high prevalence rate of 40:100,000 or more.

You will be asked about countries in which you as parents & both sets of grandparents were born in. They will also ask if there is any family history of TB. It is crucial your baby is identified to receive the vaccination where eligible. Even if you don’t have any immediate plans to travel, you may have relatives that travel to the UK frequently and this could potentially put you baby at risk of contracting TB as this is passed on through airborne droplets spread from an infected person when they sneeze, cough, speak etc. To ensure you receive your baby’s BCG appointment is received timely, please ensure you tell the midwife if you plan on staying with a relative temporarily while you recover from the birth, are moving home or have changed your contact number. We would like to avoid an appointment going to the wrong address. We have access to BIGWORD telephone interpretation services within clinic where required. We generally only book a face to face translator for hearing impaired parents.

After the referral

You do not need to do anything. You will be given an information leaflet explaining about TB & the BCG vaccination, please ensure you read this information, so you understand why this is being offered. The Midwife will complete a referral, which is a request for the vaccination. Once received, the BCG Coordinator will triage this to explore whether an urgent vaccine is required or not and that we have all the information we need. An appointment will then be sent out to you in the post. It is crucial you attend this appointment at the time allocated on your letter with your baby as failure to bring your baby to the appointment will result in a delay in your baby receiving the vaccination.

What if I cannot attend the appointment?

If you cannot attend or your baby is unwell or receiving antibiotics, please contact the BCG pathway co-ordinator to discuss, the telephone number is on the letter.  Please note, we are not a 24 hour service and your call may not be dealt with immediately. Please ensure you leave a clear message and we will return your call. This will secure you a further timely appointment. Do not ignore the appointment as your baby will be discharged back to your GP. It is also important to remember late attenders may not be seen due to a high volume of appointments scheduled.

Can I get the vaccine anywhere else?

You will not be able to request this vaccination anywhere else. The hospital of birth provides this service. Please ensure you do not cancel your baby’s appointment in favour of your GP offering this as this is not an option. If your baby has received the BCG vaccination somewhere else, for example if your baby was transferred to another hospital for specialised care and given the BCG before discharge, please contact us and advise us. This ensures your appointment is given to someone else.

Your baby can receive the BCG vaccination at any stage alongside the routine immunisations. There is no reason to delay this as the BCG vaccination is administered in the left arm, this is a different method of administration compared to the routine immunisation. You can find this information in the British National Formulary (BNF) online

Please do not bring any other family members to your baby’s appointment. Only one parent and baby will be permitted. If you have any concerns around this, you may contact us ahead of your appointment to discuss further. Please ensure that you bring your baby’s read book to the appointment.  

After the vaccination

Around 2 – 6 weeks after your baby has received the BCG vaccination, occasionally a little longer, you may see what looks like a pimple appear on your baby’s arm at the vaccination site, possibly about the size of a 5 pence piece. This can look quite big on a little arm and it may look like this;

Please do not worry, this is a normal reaction and generally caused by an immune response. Your baby may bathe as usual. Don’t be afraid to clean/bathe this area with a cotton pad. This pimple may or may not pop but we urge you NOT TO squeeze, pop, pick or put on any ice packs, creams, plasters or lotions. Please keep the area clean and dry to aid the healing process. You will be given an information leaflet after the BCG vaccination is given and this is available in various languages. If you are concerned you should speak to your GP or call 111 for advice. It is worth noting 1:5 babies may not have this response. This does not mean the vaccination has not been successful and there is no reason to repeat the vaccination.

We look forward to meeting you in clinic with your baby on the day where you will meet a member of our BCG Team who are Midwives and trained specifically as BCG vaccinators and will be able to answer any of your concerns.


BCG Coordinator Debbie Parker

BCG Pathway Coordinator Carly Moss

BCG Office contact 0161 701 3858 – 08.00hrs until 16.00hrs only