The current WHO position paper on BCG vaccination (167) states that children known to be living with HIV should not receive BCG vaccination because they are at increased risk of developing disseminated BCG disease. However, if they are receiving ART, are clinically well and immunologically stable they should be vaccinated. Immunologically stable children have a CD4% exceeding 25% (children younger than five years) or a CD4 count of 200/mm3 or higher (children older than five years). In settings without access to CD4 testing, immunological stability may be assessed clinically based on the absence of new opportunistic infections and any other symptoms