Annex A - summary of key issues relating to the changes in the BCG schedule
Published 27 July 2021
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This publication is available at https://www.gov.uk/government/publications/bcg-immunisation-programme-changes-from-september-2021-letter/annex-a-summary-of-key-issues-relating-to-the-changes-in-the-bcg-schedule
This guidance is based on advice from the Joint Committee on Vaccination and Immunisation (JCVI) [footnote 1][footnote 2], the UK’s independent advisory committee of immunisation experts. Full information will be available in the updated Tuberculosis chapter of the green book (Immunisation against infectious disease).
Timing
The Bacillus Calmette–Guérin (BCG) vaccine will continue to be offered to all eligible babies. Those born on or after 1 September 2021 will follow the new schedule. The vaccine should be given to eligible babies at 28 days or soon after. This may be at an earlier opportunity providing a Severe Combined Immunodeficiency (SCID) screening outcome result is available.
Vaccine supply
The BCG vaccine will continue to be available to order through the ImmForm website. Please ensure you have an ImmForm account to enable access. See the ImmForm helpsheet for information on registering for an ImmForm account.
Patient Group Directions (PGDs)
An updated PGD template from Public Health England (PHE) for the administration of the BCG will be available for NHS England and NHS Improvement areas to adopt and authorise for their commissioned services ahead of the requirement to administer BCG at 28 days.
Child Health Information Services (CHIS)
NHS England and NHS Improvement has met with NHSX to coordinate the changes to data requirements to the CHIS system to support the new BCG pathway. Neonatal BCG eligibility data will be recorded on CHIS, which will provide a cohort denominator for the first time. BCG vaccinations given will also be recorded on CHIS as for other childhood vaccinations. This will support the collection of Coverage of Vaccine Evaluated Rapidly (COVER) data providing a more robust national data set and contribute to improvements in the programme overall.
SNOMED codes
The recommended SNOMED codes for recording receipt of BCG in electronic patient records (CHIS/GP) are available.
NHS England and NHS Improvement is responsible for the commissioning of CHIS and the NHS neonatal BCG immunisation programme. Parents and caregivers of eligible babies born on or after 1 September 2021 will be offered a vaccination appointment by a healthcare professional.
Neonatal BCG providers will inform CHIS and the baby’s GP following vaccination. General Practices must update their clinical records as appropriate. See Annex C for BCG vaccination data flows and patient care pathway information.
Funding and service arrangements
NHS neonatal BCG immunisation programme is currently funded through the Clinical Commissioning Group (CCG) Maternity Tariff. Funding arrangements will not change.
A suite of updated neonatal BCG immunisation programme schedule 2/4/6 documents have been produced and have been used by regional commissioners when planning the revised service.
Information for parents, caregivers and health professionals
The following immunisation leaflets for parents and caregivers have been revised to support the change to the programme. These are available to order from the Health Publications website:
The BCG vaccine information for parents on the NHS website will be updated from August 2021.
Training slides detailing the schedule change will be available from August 2021 from the Tuberculosis section of the PHE Immunisation webpage.
A document entitled ‘Changes to the NHS neonatal BCG vaccine schedule: Information for healthcare practitioners’, which provides further information in relation to programme eligibility, scheduling and vaccine administration will be available from August 2021 from the Tuberculosis section of the PHE Immunisation webpage.
For advice on at risk groups, incomplete vaccination and those vaccinated abroad, please see the green book chapter and the information for healthcare practitioners.