Occupational Health requirements for students and applicants to the Faculty of Medicine and Health

How effective is the vaccine in protecting me against respiratory TB?
The BCG vaccine offers limited protection against pulmonary (respiratory) TB in adults. Its effectiveness varies, but it is much more effective at preventing severe forms of TB (such as TB meningitis and miliary TB). Even if you’ve had BCG, you can still develop respiratory TB, so infection control measures remain essential.

What will happen if I don’t get the vaccine?
Declining the vaccine does not mean you cannot work in healthcare but:

You may be considered at higher risk if exposed to TB and you should be extra vigilant for TB symptoms and exposure. The general symptoms of TB disease include:

• Unexplained weight loss.
• Loss of appetite.
• Heavy night sweats.
• A persistent fever.
• Fatigue or a general or unusual sense of tiredness
• Swollen glands or joints

The symptoms of TB of the lungs (pulmonary TB) include:

• Coughing for 3 weeks or longer.
• Coughing up blood (Haemoptysis).
• Chest pain.
• Shortness of breath.

Will I be required to use additional PPE if I don’t get the vaccine?
No. PPE requirements are based on clinical risk, not BCG vaccination status. You’ll follow the same infection prevention guidance as everyone else.

Will not having the vaccine limit my employment opportunities when I qualify?
In the UK, BCG vaccination is not a condition of employment.

Employers focus on:

• TB risk assessment
• Symptom screening
• Evidence of immunity where relevant

Will I be able to change my mind if I decline having the vaccine now?
Yes. You can request the vaccine later if you change your mind, provided you are still eligible and have not had a previous BCG.

Will it hurt?
You’ll feel:

• A small scratch or sting during the injection
• Some soreness or itching afterward
• Most people find it mild and manageable.

Will I have a scar?
Most people do develop a small scar after the BCG vaccine, usually on the upper arm. This is a normal part of the healing process. The site may become red, then form a small blister or scab. This usually heals over several weeks. The final scar is typically small (about 5–10 mm) and fades over time

Not everyone gets a visible scar. Having no scar does not mean the vaccine didn’t work, and it does not usually require further vaccination.

Will I need a booster vaccine?
No. BCG is given as a single lifetime dose. Booster doses are not recommended.

Does the vaccine contain gelatine or porcine products?
No. The BCG vaccine used in the UK does not contain gelatine or porcine (pig-derived) products.

Will I still be able to go to the gym or swim after the vaccine?
Yes. You can continue normal activities. Just:

• Keep the site clean and dry
• Avoid tight clothing rubbing the area
• Do not cover it with plasters or dressings unless swimming or in the bath, remove plasters immediately following.

What do I do if I’m concerned about how the vaccine appears whilst healing?
A normal reaction includes:

• A small, raised area
• Redness
• A blister or scab
• A small scar as it heals

Seek advice if there is:

• Increasing pain
• Significant swelling
• Pus, spreading redness, or fever

If you have any concerns, contact your GP/Practice nurse

Can I bring my friend to the appointment?
No, you are expected to attend on your own. Exceptions may be made for support needs; you may also request an OH chaperone.

My parent/carer says I’ve had the vaccine, but it’s not on my GP records
If there’s no documented record, occupational health will usually:

• Look for a BCG scar
• Undertake a screening test known as a Mantoux test.
• Offer vaccination if appropriate

My parent/carer says I’ve had the vaccine, but I don’t think I have a scar
Not everyone develops a visible scar. If there’s no reliable record and no clear scar, you will be offered a screening test. Following which vaccination will be offered as indicated.