January 12, 2008

Telltale Second and Third World Skin Scars
Lima, Peru

The terms Second World and Third World are out of date, but the idea stills hits home. Catch me on a politically correct day, and you'll find me using "developing country."

Regardless of the label, there are some skin scars that reveal telling information about where someone was born, their lifestyle, and even what immunizations they've had. Some immunization scars can be very visible, and very unattractive.

Tuberculosis (TB) is a problem in Peru, like in many developing countries around the world, and immunization at birth is now commonplace. But what I didn't realize was that the scar that's so easily identifiable (and obvious) on the upper left arm or shoulder blade of the populous of Second and Third World countries came from this vaccination.

I found this out after Tatiana and I had authorized Aidric's TB shot, and I'm not pleased about it. I don't want my son to have the brand of the Second World on his skin.

Mild TB immunization scar on Tatiana

I only want what's best for Aidric, and feel he probably needs to have this shot, but am also certain that the injection wasn't given to him in a percutaneous manner, a method (using a device with several small needles) which would have avoided leaving him with a scar that looks like he was burned with an in-dash automobile cigarette lighter.

In the USA, a different approach is taken. People at higher risk of TB have regular skin tests to see if they are infected. If the skin test becomes positive they receive treatment.

However, only about 1 in 10 people infected with TB go on to develop the disease. So, 9 out of 10 people given a course of drugs to prevent it developing will have been given the drugs unnecessarily in the USA.

There is no FDA approved TB vaccine in the U.S.

There is a greater than 75% chance that Aidric will have a scar from his intradermally administered TB vaccination. Who knows, maybe he'll grow up to be humbled by its presence when he looks in the mirror—a gentle reminder of where he came from, regardless of his station in life.



January 16th, 2008

This type of vaccine used to be given in the US too - your dad probably has a similar scar to Tatiana's. My mom has one, but hers is barely visible now.


January 20th, 2008

I and almost all of my contemporaries (I'm 45) have these scars.

Anyone know when the USA stopped this way of giving vaccines?

The United States


November 9th, 2010

I and my parents are from the USA, but I have the TB vaccination scar because they happened to be in England when I was needing the vaccination (1984). My sister does not have it because she was in the States at the time she needed it. So maybe you will be happy to know that the scar could be a brand of England too, not just second world… Oh, and I've been told that I would test positive for TB because of the vaccine- but I've not verified that.


Craig | travelvice.com

November 9th, 2010

Interestingly enough, our son didn't get this scar — so either he wasn't injected (properly or at all), or is one of the 20% or so cases that doesn't result in one.

The United States


January 11th, 2011

Vaccination against TB was never a practice in the US since we've never had a serious TB problem. We did vaccinate against Smallpox until around 1972. The Smallpox vaccination was typically given in the upper left arm, resulted in a blister and within a month resulted in a circular scar simular to the scars some BCG (TB) vaccinations cause. Smallpox vaccinations are given by placing a drop of the vaccine on the arm, then pricking the skin with a bifurcated needle to induce the vaccine under the skin. When successful, the vaccine causes a reaction which results in a dime to quarter sized blister which usually diminishes within two to three weeks at which time the scab falls off and a resulting scar is formed. The BCG (TB) vaccine is given interdermally (just under the skin) usually on the upper arm and causes a raised bump where the vaccine is. Over a period of 4-6 months, a small blister forms and eventually heals into a small circular scar, sometimes indented, and ranges from very small to dime sized. Usually someone given the smallpox vaccine will only have one scar even if vaccinated again later, whereby someone given the BCG (TB) vaccine will usually have a scar for each vaccination.

Most everone worldwide over the age of 42 will have a smallpox vaccination scar. In the US, prior to 1968-1972 it was a required vaccination to enter school, but was usually given at age one or upon entering school. Military recruits were re-vaccinated periodically.

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