A newborn infant received BCG vaccination at 1 day, but no scar has developed at 6 month on the injection sit… - NORCET 10 Prelims-2026

NORCET 10 Prelims-2026

Community Health Nursing

Easy

Appeared in: NORCET 10 Prelims-2026

Explanation

The absence of a scar following a BCG vaccination does not reliably indicate a lack of protective immunity.
Current guidelines from the World Health Organization (WHO) and many national immunization programs, including India's, explicitly advise against revaccinating infants if a scar does not form.
There is no conclusive clinical evidence to support the practice of revaccination, as it has not been shown to provide additional benefit and is considered an unnecessary procedure.

Option B: Revaccination is not recommended as there is no evidence it provides extra protection. Official immunization schedules do not include revaccination based on scar status.
Option C: The Mantoux test is used to screen for TB infection, not to check vaccine efficacy. A positive result can be caused by the BCG vaccine itself, making it an unreliable tool for this purpose.
Option D: The IGRA test is a blood test used to diagnose latent or active TB infection. It has no role in assessing the immune response to a BCG vaccination.

Visual 1: Infographic: Illustrating the typical timeline of a BCG reaction, from papule formation at 2-3 weeks, to ulceration at 5 weeks, and finally healing with a scar by 12 weeks. The visual should include a note stating that scar absence occurs in a minority of cases and is not an indication for revaccination.
Visual 2: Chart: A comparison table clarifying the distinct purposes of 'BCG Vaccine' (prevention), 'Mantoux Test' (screening for TB infection), and 'IGRA Test' (diagnosing TB infection).

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain BCG vaccination guidelines and post-vaccination assessment as background academic context rather than a clinical decision trigger.
A key nursing role is providing accurate health education. Nurses must confidently reassure parents concerned about the absence of a BCG scar, explaining that revaccination is not necessary and avoiding needless anxiety and procedures.
Strict adherence to the National Immunization Schedule is a cornerstone of public health and patient safety. Administering unscheduled vaccines or tests without a clear indication is poor practice.
What if? If the infant was known to be immunocompromised (e.g., with HIV or congenital immunodeficiency), the live BCG vaccine would have been contraindicated from the start, as it could cause a severe, disseminated infection.

How to Approach the Question

Identify the core clinical question: It's about the correct management of a common variation in a routine vaccination outcome (absent BCG scar).
Recall the standard immunization guidelines for BCG. The key is to know whether an absent scar necessitates any action.
Evaluate the purpose of each option. Recognize that 'Revaccinate' is an intervention, while 'Mantoux test' and 'IGRA test' are diagnostic tools.
Eliminate the diagnostic tests first by confirming their purpose. Mantoux and IGRA are for detecting TB infection, not for assessing vaccine response.
Between the remaining actions ('Avoid revaccination' vs. 'Revaccinate'), choose the one supported by current evidence and official health policy, which is to avoid revaccination.
Conclude that the most appropriate action is often to follow established guidelines, which in this case, means no further action is needed.

Concept Tested & Keywords

Concept Tested: BCG vaccination guidelines and post-vaccination assessment.
Stem keywords: BCG vaccination, newborn, no scar, 6 month
Lead-in keywords: most appropriate action
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
Negative lead-in flag: false

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