NHM UP Staff Nurse-2021 Shift-2nd
Nursing Foundation
Easy

The route of administration of BCG vaccine is

Appeared in: NHM UP Staff Nurse-2021 Shift-2nd

Explanation

  • The Bacillus Calmette-Guérin (BCG) vaccine is specifically administered via the intradermal (ID) route.
  • This involves injecting the vaccine into the dermis, the layer of skin just below the epidermis, to ensure optimal immune response.
  • The standard procedure creates a characteristic wheal (a raised, whitish bleb) of about 5 mm at the injection site, confirming correct administration.
  • The preferred site is the insertion of the left deltoid muscle in the upper arm.
  • This route is chosen to maximize the local immune reaction, leading to the formation of a papule and eventually a permanent scar, which serves as evidence of vaccination.

Why Other Options Were Wrong

  • Option A: The oral route is used for vaccines that are absorbed through the gastrointestinal tract. BCG is not effective when given orally.
  • Option C: Subcutaneous injection delivers the vaccine into the fatty tissue layer. If BCG is given this way, it can cause complications like local abscesses and enlarged lymph nodes, with a less effective immune response.
  • Option D: Intramuscular injection delivers the vaccine deep into the muscle tissue. This route is incorrect for BCG and does not produce the required localized immune reaction.

Related Visual

Visual explanation — Related Visual
Clinical Relevance
  • Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Vaccine Administration Routes as background academic context rather than a clinical decision trigger.
  • Correct administration technique is critical for the BCG vaccine's effectiveness and safety. An incorrect route, such as subcutaneous, increases the risk of adverse reactions like BCG-induced abscess and lymphadenitis.
  • Nurses must educate parents/caregivers about the normal evolution of the BCG vaccination site: a papule appears in 2-3 weeks, may ulcerate, and heals in 6-12 weeks, leaving a permanent scar. This is a normal and expected reaction.
  • The presence of the BCG scar is often used as a marker of prior vaccination during health check-ups.
How to Approach the Question
  • This is a factual recall question that tests your knowledge of immunization schedules and procedures.
  • First, identify the specific vaccine mentioned in the question, which is the BCG vaccine.
  • Recall the standard administration protocol for BCG. This vaccine has a unique and specific route that differs from most other common vaccines.
  • Evaluate the given options: Oral, Intradermal, Subcutaneous, and Intramuscular.
  • Associate the other routes with vaccines you know. For example, Oral is for Polio, and Intramuscular is for DTP/Hepatitis B.
  • Select the option that correctly matches the administration route for BCG, which is Intradermal.
Concept Tested & Keywords
  • Concept Tested: Vaccine Administration Routes
  • Stem keywords: BCG vaccine, route of administration
  • Lead-in keywords: is
  • Negative lead-in flag: false

Question ID

Qe2sD6Nvx1OTFL--1w9LPs

Reference Book

E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart B (pp 202-403 of 604) p. 41-43

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

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