Why do I need another skin test (PPD) now, if I have never needed it before? No one receives a PPD in the country I came from because we receive the BCG vaccine. I prefer to have a chest x-ray because the PPD is not going to be accurate for me.


In the USA, receiving BCG vaccine is not considered a contraindication to TB skin testing. TB skin testing occurs unless there is documented evidence of a prior positive PPD test. Chest x-rays are not interchangeable substitutes for a PPD. A CXR is only obtained in the event of a documented positive PPD test. A negative Interferon gamma release assay (IGRA) blood test IS an acceptable alternative for an annual TB skin test.

Some students have had a positive TB skin test in the past but are unable to obtain the documentation. In those cases, provider verification of (verbal) history is acceptable. A provider must complete the HSIP form with this information and sign for authentication to meet the documentation guidelines for our program.