Aims Data from the Public Health Agency (PHA) for 2009–10 identified 70 infants from the Belfast Trust who had been identified with a risk factor for Tuberculosis (TB) as not receiving the BCG vaccination prior to discharge-theoretically missing 16% of this population (total with risk factor 438).

Given the rise in TB, with figures in 2009 from the Health Protection Agency (HPA) identifying 9,040 cases in the UK, our aim was to review the data to clarify why these infants were being missed.

Methods We reviewed the neonatal notes for those infants who did not get the BCG vaccination despite a positive risk factor, categorising as per results section. We further reviewed the data for parental refusal to analyse documentation.

Results Unable to access 7% of charts.

Parental refusal 23%, received vaccination 17%, deferred for medical reason 17%, no identifiable risk factor in hospital 12%, medical decision not required 10%, missed 7%, transferred prior to discharge 4%, transcription error 3%.

Parental refusal group –50% clarified the risk factor, 29% documented risks vs benefits explained, 43% offered follow-up advice and 35% documented written info given.

Conclusions 1.1% were truly missed (5/438).

Parental refusal was the largest category for not receiving vaccination and had poor documentation to explain why. We identified a breakdown in how data is transported to PHA/or recorded in PHA.

We recommended education for staff, highlighting the need for proper documentation. We also recommended a review of how information was passed to the PHA.