BCG is an

Hariyana-CHO-2021

Pharmacology

Easy

Appeared in: Hariyana-CHO-2021

Explanation

BCG is a live attenuated vaccine that must be administered into the dermis, the topmost layer of the skin.
The intradermal route is essential for stimulating a strong, local cell-mediated immune response, which provides protection against severe forms of tuberculosis (like TB meningitis) in children.
A correct intradermal injection results in a visible wheal (a 5-7 mm raised blister) at the injection site, which is a sign of proper administration.
Over several weeks, this initial reaction evolves into a papule, then a small ulcer, and finally heals to leave a permanent, tiny scar, which serves as evidence of successful vaccination.

Option A: Injecting the live BCG vaccine deep into the muscle can result in a poor immune response and increases the risk of local abscess formation.
Option B: Administering BCG vaccine into the subcutaneous fatty tissue is incorrect and increases the risk of complications like local abscesses and regional suppurative lymphadenitis (swollen lymph nodes).
Option D: This option is incorrect because a specific, correct route of administration for the BCG vaccine exists and is well-established in immunization protocols.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Route of administration for BCG vaccine as background academic context rather than a clinical decision trigger.
Correct administration technique is critical for vaccine efficacy and patient safety. An incorrect route for BCG can lead to reduced immunity and serious adverse effects like abscesses or severe lymphadenitis.
Nurses must educate parents about the normal reaction to BCG, including the formation of a papule, ulcer, and eventual scar over 6-12 weeks. This counseling helps prevent unnecessary anxiety and improper local care.
What if? If a prominent wheal does not form immediately after injection, it may indicate a faulty technique (e.g., the injection was too deep). However, the dose should not be repeated during the same visit to avoid an overdose reaction.

How to Approach the Question

Identify the core of the question, which is the specific administration route for the BCG vaccine.
Recognize this as a factual recall question based on the national immunization schedule and standard nursing procedures.
Mentally review the different types of injections: Intramuscular (IM), Subcutaneous (SC), and Intradermal (ID), and the vaccines typically associated with each.
Recall that the BCG vaccine is unique among routine childhood vaccines for its required intradermal route.
Eliminate IM and SC as incorrect options for BCG, remembering they are associated with higher risks of complications for this specific vaccine.
Conclude that Intradermal injection is the correct and only standard route for BCG.

Concept Tested & Keywords

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E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart A (pp 26-201 of 604) p. 99-101

E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart B (pp 202-403 of 604) p. 42-44

E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 187-189