Interpretation of Tuberculosis Test Results in COVID-19 Vaccinated Persons
Inactive vaccines do not interfere with tuberculosis (TB) test results. There is no immunologic reason to believe either a Tuberculin Skin Test (TST) (administered by intradermal placement of 0.1 cc of purified protein derivative) or blood draw for interferon gamma release assay (IGRA) would affect the safety or effectiveness of mRNA COVID-19 vaccines. We have no data to inform the impact of the COVID-19 mRNA vaccines on either TB test for infection (i.e., TST or IGRA).
All potential recipients of COVID-19 vaccination should weigh the risks and benefits of delaying TST/IGRA with their providers.
For healthcare personnel or patients who require baseline TB testing (at onboarding or entry into facilities) at the same time they are to receive an mRNA COVID-19 vaccine:
- TB symptom screening should be completed for all healthcare personnel or patients.
- If utilizing the IGRA, draw blood for interferon-gamma release assay prior to COVID-19 vaccination.
- If utilizing the TST, place prior to COVID-19 vaccination.
- If a vaccination has been given and testing needs to be performed, defer TST or IGRA until 4 weeks after COVID-19 vaccine 2-dose completion.
For healthcare personnel who require TB testing for other reasons:
- TB symptom screening should be completed for all healthcare personnel.
- Test for infection should be done before or at the same time as the administration of COVID-19 vaccination. If this is not possible, the prioritization of a test for TB infection needs to be weighed with the importance of receiving COVID-19 vaccination based on potential COVID-19 exposures and TB risk factors.
- Healthcare personnel with high-risk conditions for TB progression should be fully evaluated as soon as possible.
- Healthcare personnel without high-risk conditions for TB progression should proceed with contact tracing (i.e., symptom screening, chest radiograph or other imaging, a specimen for microbiologic evaluation) but delay test for TB infection (TST or IGRA) if prioritized for receiving COVID-19 vaccination.