Tuberculosis is a dangerous infectious disease caused by Mycobacterium tuberculosis, or Mycobacterium tuberculosis. The disease develops rapidly, has a lot of consequences and complications, leaving an imprint on the body for life. Unfortunately, like many others, the disease is easier to prevent than stop the infection. To date, the only method of preventing tuberculosis is BCG vaccination. Consequences, complications and contraindications - in the article.
Deciphering the BCG vaccine
What does BCG stand for? The decoding of the Latin name BCG is interpreted as bacillus Calmette – Guerin. Translated into Russian, this means "Bacillus Calmette-Guerin." Thus, the abbreviation BCG is not at all abbreviated. This decoding is a direct reading of the Latin abbreviation written in Cyrillic.
BCG vaccine: what is it?
BCG vaccine is a suspension of weakened bovine mycobacteria with loss of virulence for humans. There are two varieties:
- BCG - the content of Mycobacterium tuberculosis in the vaccine is too low to cause infection. However, this amount is enough for the body to develop immunity against a dangerous disease. In all countries, regardless of manufacturer, the composition of the vaccine is the same. That is why it is inexpedient to arrange a “race” for foreign products on a personal belief that it is better than domestic.
- BCG-M - due to the low content of microbial bodies (two times less than in the usual BCG vaccine), it is vaccinated against tuberculosis of premature, weakened children. In addition, if for some reason the child was "lost sight" in the hospital and the vaccine was not given on time, BCG-M is used in hospitals.
Is vaccination needed?
It is no secret that the vaccine does not give a 100% guarantee that subsequently infection with tuberculosis will not occur. So then what is it for, you ask. The fact is that BCG produces anti-tuberculosis immunity, which can provide powerful protection during primary infection, as well as with possible subsequent contacts with carriers of tuberculosis infection. If the body nevertheless turns out to be weaker than the disease, then the vaccine will prevent the development of especially severe, genitalized forms of tuberculosis (disseminated and miliary). Thus, not providing complete protection against infection, the vaccine will somewhat ease the course of the disease in case of infection.
Who is recommended for BCG vaccination?
Vaccination is recommended for categories of people:
- Newborns. All BCG children should already be vaccinated per year. Especially in regions with a high prevalence of tuberculosis.
- Persons in constant contact with infected tuberculosis (usually the medical staff of the TB dispensaries, etc.).
At what age is BCG vaccinated?
BCG when do? Primary vaccination is usually carried out for a healthy newborn child at 3-7 days of life. Previously, the doctor must necessarily examine the child, perform thermometry (at elevated body temperature, the procedure is contraindicated), take into account the history and all possible contraindications. In addition, BCG vaccinations for children are carried out only after consulting a specialist with ready-made results of blood and urine tests.
The vaccine should be administered intradermally, on the outer surface of the left shoulder, the dose should not exceed 0.05 mg. The technique of the procedure involves a gradual introduction - in order to make sure that the needle has entered at the right angle. If everything is done correctly, then at the injection site a papule with a diameter of 7-9 millimeters, white in color, usually disappears 15-20 minutes after the procedure.
Children who for one reason or another have not been vaccinated in the hospital are vaccinated as soon as possible. If more than two months have passed since the moment of birth, then the Mantoux reaction is necessarily carried out before vaccination . With a positive result, BCG is prohibited.
The doctor must mark the vaccination with the vaccination date, the date of vaccination, the series and the control number of the vaccine on the medical record of the newborn. In addition, the expiration date of the introduced drug, as well as the manufacturer, is also entered in the history.
Important! The place of the vaccine is forbidden to handle any solutions. Bandages are also not allowed.
Why such a rush?
Doctors are also often asked why BCG is done so early. When vaccinated, parents are puzzled why a newborn, still immature child is subjected to such a test on the third day. The fact is that the situation with tuberculosis is such that not all patients are aware of their problem, continue to lead a familiar lifestyle. Being carriers of a dangerous infection, they freely visit public places, which causes a great threat, especially for a small child. The risk of meeting a baby with a bacterium is very high. That is why the vaccination is carried out as early as possible, so that at the time of discharge, the child's immunity to Mycobacterium tuberculosis already begins to form.
BCG revaccination
Children aged 7 and 14 years should be revaccinated, but only subject to a negative reaction to the Mantoux test. The interval between Mantoux and booster should not exceed two weeks.
Unfortunately, in epidemiologically unfavorable regions of the country, children become infected with mycobacteria long before the first revaccination, so they are not exposed to BCG again.
What processes in the body occur after BCG?
Macrophages (or monocytes, a type of white blood cell) that absorb mycobacterium tuberculosis immediately begin to arrive at the injection site . The causative agent of the disease dies along with macrophages, resulting in the formation of necrotic caseous masses. Going out, they provoke the formation of a scar at the injection site.
BCG response
The reaction is the development of a papule at the injection site, which usually appears in newborns 4-6 weeks after vaccination. A scar should be formed at the site of vaccination, according to the size of which it is possible to judge the acquired anti-tuberculosis immunity. So, if a scar 2-4 mm in size has formed after BCG, then they say that the vaccinated body will resist the disease for 3-5 years. If the size is 5-7 mm, then the body is protected for 5-7 years, and at 8-10 mm for 10 years.
Usually the vaccine is well tolerated, but sometimes there are reactions:
- BCG blushed. If redness does not spread to surrounding tissues and is observed exclusively during the vaccination reaction, then this is the norm. In rare cases, in addition to redness, swelling and a keloid scar can form . There can be no cause for concern: in this way, the skin integuments react to the drug.
- BCG is festering. Suppuration and abscesses are a normal reaction to the components of the vaccine, which will pass soon. You should consult a doctor if, in addition to suppuration, redness and swelling appeared around the vaccination site: it is possible that an infection of the wound has occurred, which must be treated.
- BCG has become inflamed. It is worth worrying and contacting a doctor only if swelling and inflammation spread to the skin of the shoulder, outside the vaccination site.
- BCG itches. Itching at the injection site is normal, but doctors advise putting a gauze on the wound to keep the child from combing.
- Temperature after BCG. An increase in body temperature in a newborn to 38 degrees is the norm, but if a seven-year-old child has a fever after revaccination, consult a doctor immediately.
What does the lack of reaction indicate?
If, after vaccination, a scar does not form at the injection site, this is a sign that the vaccine was ineffective, because immunity to the most dangerous disease has not formed. In this case, there should be no reason for concern: some time after receiving a negative reaction to the Mantoux test, you can revaccinate without waiting for 7 years of age.
The lack of response to the first vaccine is rare, observed in 5-10% of children. In addition, about 2% of the world's population has innate immunity to tuberculosis. This means that, in principle, they cannot get sick during life.
Contraindications to vaccination
BCG contraindications are not so extensive, they include:
- The body weight of the newborn is less than 2500 g (at 2-4 degrees of prematurity).
- Acute diseases or a period of exacerbation of chronic diseases. In this case, vaccination should be carried out only after complete cure, when the clinical manifestations of the disease will be completely gone.
- Congenital immunodeficiency.
- The presence in the family of a newborn of a generalized BCG infection.
- Maternal HIV infection.
- Leukemia.
- Lymphoma
- Therapy with immunosuppressive drugs.
Contraindications to revaccination
Contraindications to revaccination are:
- Exacerbation of chronic diseases or any acute diseases at the time of BCG vaccination. Body temperature (elevated) is a serious argument for transferring the vaccine. Usually revaccination is carried out a month after recovery.
- Malignant neoplasms.
- The state of immunodeficiency.
- Tuberculosis (including at the stage of recovery).
- Positive reaction to the Mantoux test.
- Complications after primary vaccination.
Persons temporarily exempted from vaccination due to contraindications should be monitored and accounted for by medical personnel until they are fully recovered and vaccinated. Persons who have been revaccinated are also under observation and must come to check the vaccination reaction 1, 3, 6, 12 months after the procedure.
What does a vaccination response test include?
Such a check is carried out after 1-3 months, six months and a year after vaccination and revaccination, it includes:
- Recording the size of the local reaction.
- Registration of the nature of the reaction (it is estimated whether the formation of papules, pustules with a crust or scar). In addition, pigmentation at the vaccination site is checked.
BCG vaccine: complications possible?
Is the vaccine completely safe? Does BCG vaccination have complications? The consequences can manifest themselves in the form of:
- Osteitis is bone tuberculosis. The development of the disease usually occurs after 0.5-2 years after vaccination, it causes serious damage to the immune system.
- Generalized BCG infection - formed when a child has congenital immune disorders.
- Inflammation of the lymph node - immediate surgical intervention is required if there is a sharp increase in the lymph node in size (more than 1 cm in diameter).
- Cold abscess - requires surgical intervention. This phenomenon is a consequence of subcutaneous (instead of intradermal) administration of BCG vaccine. The vaccine, the consequences of which are such, was illiterate.
- Keloid scar - is a red, swollen skin at the site of vaccination. In the presence of a scar, revaccination at the age of seven is not carried out.
- An extensive ulcer indicates a high sensitivity of the child to the components of the drug. Local treatment is usually prescribed.
Compatibility with other vaccines
BCG is a specific vaccine, the simultaneous use of which other drugs is unacceptable. In addition, it is not allowed to carry out additional vaccination not only on the day of BCG administration, but also for 4-6 weeks after, during the period of reactions to the drug. After BCG injection, at least 35-45 days should pass before any other vaccination.
Before BCG vaccination, the child is vaccinated against hepatitis B. The only condition is the period of immunological rest, that is, up to the age of 3 months, any vaccinations are contraindicated in the baby.
Caring for a child after BCG
Usually, there are no consequences after vaccination, however, something needs to be done to “reinsure”:
- First, the diet of the child should remain the same. After vaccination, the baby may experience loose stools, fever, and vomiting. All these consequences are considered normal, they do not pose a danger to life and health.
- Antipyretic (provided that the child is not sick) should be given at night at temperatures above 38.5 degrees. With febrile seizures, you can bring down the fever at 37.5 degrees.
- The use of antihistamines is highly undesirable. Redness and swelling should go away on their own: a healthy body will cope on its own.
- Swimming is not prohibited.
You should consult a doctor if the temperature cannot be brought down with antipyretic (paracetamol), if the child is restless and refuses food for a long time. In case of seizures, loss of consciousness and purulent abscess at the site of vaccination immediately call an ambulance.
Refusal of BCG
Today, more and more often, parents of babies complain about one or another of the planned vaccinations, considering them harmful. The practice of refusing vaccination is in fashion . BCG vaccination, the consequences of which are very deplorable, is no exception.
A tuberculosis vaccine can be discarded just like any other. The legislation of the Russian Federation confirms this right, thereby shifting responsibility for children to their parents.
What would I like to note about this? Today in the public domain is a large amount of information about absolutely everything. Each person is able to independently study issues related to the life and health of him and his family, make decisions and bear responsibility for their beliefs.
If you decide not to vaccinate your own child, no one will say anything against it. It is only necessary to write a refusal in the card with your own hand, necessarily indicating that you will not have any complaints to the medical staff afterwards.