he scar on the lower half of the arm near the elbow is normal to many Kenyans; its bearers do not often think about its significance. This scar, that forms a few weeks after administration, is an indication of having received the Bacille Calmette-Guérin (BCG) vaccine, which protects its bearer from Tuberculosis (TB) disease from a young age.
Tuberculosis is a bacterial infectious disease that often affects the lungs but can also affect other parts of the body. It is an airborne disease, which is easily spread when people who suffer from it expel the bacteria through coughing, sneezing and singing. In addition to spreading the disease to others, if left untreated, a person may become severely ill or die.
Tuberculosis still remains one of the world’s deadliest communicable diseases, claiming the lives of approximately 1.5 million people annually, according to global statistics published in 2013. Kenya is one of the 22 high burden TB countries in the world, with a TB mortality rate of 22 deaths per 100,000, a figure that is above the global average.
History of TB and the BCG Vaccine
Scientists have confirmed the presence of TB in humans from ancient times. Traces of the disease have been found in skeletal remains from the prehistoric era. “Consumption” and “Phthisis” were terms historically used to describe TB, a disease that was responsible for one in every four deaths during the 19th century.
Before the Industrial Revolution, myths often associated TB with vampires. This belief grew as a result of infected family members losing their health when one member of their family died from TB. People believed the original person caused this with TB draining life from the other family members.
Robert Koch discovered the TB causing germ in March 1882 and received a Nobel Peace Prize for this in 1905. The first genuine success in immunisation against TB was achieved in 1906 when Albert Calmette and Camille Guérin invented the Bacille Calmette-Guérin (BCG) vaccination for Tuberculosis.
The BCG vaccine was first used on humans in 1921 in France but received widespread acceptance in the US, Great Britain, and Germany only after World War II. This vaccine provides some protection against severe forms of paediatric non-pulmonary TB, such as TB meningitis, but is unreliable against adult pulmonary TB, which accounts for most of the TB disease burden and transmission worldwide.
Today, all children born in Kenyan hospitals receive the life-saving BCG vaccination immediately after birth. This immunisation is on the World Health Organisation’s (WHO) list of essential medicines and is part of the Immunisation Schedule of the Kenya Expanded Programme on Immunisation (KEPI).
The vaccine, which is given as a single dose, is given as an injection to infants on the left forearm and leaves a distinctive scar.
All mothers need to ensure that their children have received the BCG, along with the Polio and Hepatitis B vaccines, before they are discharged from hospital after delivery. These vaccines can be acquired at no cost at all Kenyan hospitals.
Recent BCG Vaccine Shortage in Kenya
Towards the tail end of 2015, fears erupted across the country as the Ministry of Health announced the shortage of BCG vaccine supplies. The deadly nature of TB coupled with its high prevalence in Kenya were the main contributors to the scare.
Principal Secretary of Health, Dr Nicholas Muraguri explained that the vaccine shortage had been occasioned by production delays at a global level, leading to limited supplies across the African region.
In January 2016, mothers and their babies breathed a sigh of relief, as 1.3 million doses of the serum landed in the country, with 3.4 million more being expected to follow soon after.