Jet gun or syringe? A trial of alternative methods of BCG vaccination

In a trial of alternative methods of BCG vaccination, 628 children were vaccinated by syringe and needle and 690 by needleless jet injector. The lesions produced by vaccination with the jet injector were significantly smaller than those resulting from intradermal injection by syringe and needle and only 31 (4%) of the lesions from the jet injector had failed to heal by 3 months, compared with 311 (50%) from the syringe and needle. All but one of the children vaccinated by jet injector developed scars of 4 mm or more in diameter but only one had a scar in excess of 10 mm, compared with 41 scars of this size among those vaccinated by syringe and needle. There was a significant difference in tuberculin conversion rates for the two vaccination methods in one of the districts possibly related to differing vaccine reconstitution techniques.The cost of vaccination per 1000 children by jet injector was less than 40% of the costfor syringe and needle, using a new disposable syringe and needle for each child.In terms of acceptability to the children, freedom from complications and lower cost vaccination the jet injector proved to be the better method.