A 6-week-old infant comes for vaccination. The nurse notes the BCG vial has been open for 3 hours in a session lasting 4 hours in total. The infant has not yet received BCG. What is the CORRECT action?

• A Administer BCG from the open vial; it remains potent for 4 hours after opening
• B Transfer remaining BCG to a new vial with diluent and administer to the infant
• C Refrigerate the open vial and use it for the next session within 24 hours
• D Discard the open BCG vial; BCG is an open vial policy exception because it must be discarded within 3 hours or at end of session ✓

Explanation

Under the Indian Open Vial Policy (OVP), BCG is specifically excluded from multi-dose vial use beyond the session. BCG vaccine must be discarded within 3 hours of opening or at the end of the session, whichever is earlier—it cannot be stored and used in subsequent sessions unlike vaccines such as OPV, DPT, Hepatitis B, and TT. Since 3 hours have elapsed, the vial must be discarded. BCG cannot be transferred between vials as this risks contamination and inactivation. This is a critically tested exception to the OVP.

Reference: Ghai Essential Pediatrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.