BCG vaccination in a month. BCG vaccination: reaction and complications, vaccination rules, composition

Tuberculosis is a dangerous infectious disease. According to WHO, about 9 million cases of Koch's bacillus infection are recorded annually worldwide. The pathogen can affect the lungs, bones, leading to dangerous consequences.

Against tuberculosis is mandatory. Immunoprophylaxis is beginning to be carried out practically. Young children sometimes feel worse after vaccination.

It is important for parents to know what reactions can cause in newborns.

The first BCG vaccination is given to children in the hospital. The mother's antibodies to protect against TB infection are not passed on to the baby. Therefore, vaccination is a mandatory measure for the prevention of a dangerous disease.

Unfortunately, vaccination gives only temporary. Therefore, revaccinations are carried out periodically. The second time BCG is injected at 7, the third - at 14 years old.

Before each revaccination, it must be done. It makes it possible to determine the presence of residual immunity or infection with Koch's sticks. In most cases, the vaccine is well tolerated..

The body of a newborn perfectly copes with the task of forming specific immunity. Therefore, parents' worries about the risk of side effects are in vain. The main thing is that the child is absolutely healthy on the day of vaccination.

Of great importance is the observance of the rules of behavior by parents after the prevention of tuberculosis. In 5-10% of children, the post-vaccination period passes without any changes in well-being.

First days

Immediately after vaccination, the child begins to experience changes in well-being. This is a normal reaction of the immune system to the ingestion of antigenic material.

About how the post-vaccination period should proceed, doctors tell parents on the eve of the introduction of BCG to the baby. Doctors also inform about possible adverse reactions and actions if they occur.

The normal reaction in the first days after the BCG injection is:

soreness of the puncture;
pastosity, compaction in the area of administration of the drug;
loss of appetite;
weakness;
capriciousness;
skin itching;
nausea;
redness of the injection site;
point inflammation;
drowsiness.

Normally, redness should not spread to surrounding tissues. The occurrence of hyperemia is explained by the reaction of the immune system to the introduction of antigenic material. The capriciousness and anxiety of the child are associated with pain in the puncture zone, mild inflammation.

Unpleasant symptoms usually disappear within a few days. If post-vaccination reactions do not disappear for a long time, become more pronounced, then you need to consult a doctor.

A pathological reaction to BCG can be seen by the following symptoms:

intense swelling;
pronounced redness;
soreness of the puncture and surrounding tissues;
severe itching, rash.

This may indicate infection of the wound. This condition must be treated. Otherwise, there is a risk of improper formation of immunity.

A dangerous complication is the formation of an abscess, sepsis. Severe itching, rashes may indicate development. To prevent the appearance of unpleasant symptoms and complications after BCG, it is worth taking preventive measures.

Doctors advise:

do not make drastic changes in the diet of the child;
a few days before vaccination and for the same period after it, it is worth giving to an infant;
exclude from the menu products that can provoke allergies;
not after vaccination;
do not visit crowded places with the baby;
on the day of immunization and for several days after it, apply.

A month later

The reaction to BCG develops for a long time. The puncture heals for a long time - up to 4 months. Normally, an abscess forms first. If a yellow-green liquid comes out of the formed ball with watery contents, then there is no need to worry.

This reaction is considered normal. Pus should be carefully removed with a sterile bandage. Do not treat the seal with antibacterial ointments or anti-inflammatory agents. It is forbidden to squeeze out the contents of the vial.

After a while, the ball bursts on its own. The resulting wound is covered with a crust. When the scab falls off, a scar becomes visible. Such a trace indicates a properly formed immunity to tuberculosis.

Normally, the scar should have a diameter of 0.2 to 1 cm. After the crust falls off, a small amount of blood may appear.

A month after vaccination, the following local reactions are allowed:

slight redness;
pastosity;
coloration of the skin in blue, brown.

Severe redness and swelling around the wound indicates the development of inflammation. It is important to stop such a pathological process in time. The more pronounced and longer the normal reaction to BCG in a newborn is, the stronger and longer the anti-tuberculosis protection will be formed.

If a scar does not form at the puncture site, then this indicates that the baby has not developed specific immunity. Some people are resistant to tuberculin. The pediatrician may recommend re-vaccination after a while.

The temperature in the baby has risen: the norm or complication

Often after BCG. This may be a normal or pathological reaction. Minor hyperthermia (37-38 degrees) is a natural symptom.

The temperature rises in response to the introduction of antigenic material, indicating the beginning of the formation of specific immunity.

Hyperthermia usually occurs on the first day after the BCG injection. The temperature can stay at a high level for 2 to 4 days. The condition will normalize on its own. But there are children who react sharply to the growth of the thermometer.

They may have seizures. In this case, antipyretic drugs are used. If hyperthermia is observed for a longer period (), then this may indicate the development of a pathological process.

After BCG, the following complications are possible:

infection. The entry of bacteria into the wound can cause severe inflammation, an abscess. In this case, the baby will have a fever, the injection site will become red and swollen;
development of an infectious disease. After vaccination, the immunity of the child weakens. Therefore, the baby becomes susceptible to infection with various viruses and infections. In addition to the high temperature, the baby appears,;
allergy. Occurs with high sensitivity to tuberculin. An allergic reaction is manifested by rashes, itching. In severe cases, anaphylactic shock may develop. At the same time, loss of consciousness, impaired respiratory function are observed;
development of tuberculosis. In children with weak immune systems, the body may not be able to cope with the vaccine. In this case, a vaccine-associated pathology develops;
exacerbation of a chronic disease. BCG weakens the immune system. This can lead to exacerbation of chronic pathologies of internal organs. In this case, the temperature also rises.

Side effects and consequences

Generally, the BCG vaccine is well tolerated. But some newborns develop side effects and severe complications. Bad consequences are due to incorrect, violation of asepsis by physicians.

Also of great importance is the quality and storage conditions of the antigenic material. Local complications are usually registered in the first six months after immunoprophylaxis.

Adverse reactions from BCG:

cold abscess;
lymphadenitis;
extensive ulcers at the injection site;
keloid scar;
osteitis;
inflammation of the lymph nodes;
granuloma annulare.

To minimize the likelihood of complications, you need to refuse to vaccinate a child who has such problems:

chronic pathologies in the acute stage;
the presence of an infectious viral disease;
(weight less than 2.5 kg at birth);
immune disorders (HIV infection, AIDS, psoriasis);
high body temperature;
the presence of complications after BCG in the next of kin.

Most often, side effects on BCG are local in nature. They occur in 0.06% of all vaccinated.

Response to revaccination against tuberculosis at 7 years

At the age of 7, the child is given the first BCG revaccination. As a rule, the reaction at this age to the vaccine is less pronounced than in infancy.

Usually there is a slight increase in temperature, weakness, loss of appetite. In the puncture area there is a slight redness and pastosity. Within three days, the condition returns to normal on its own. Since the body is already familiar with the antigenic material, adverse reactions and complications usually do not occur.

In some seven-year-old children vaccinated in infancy, the post-vaccination period is asymptomatic.

Is there a choice of vaccine?

Many parents do not inspire confidence in domestic vaccines. They want to know more about the types of vaccines, their composition, biological properties and differences. But most of all, parents are interested in whether it makes sense to purchase a vaccine for BCG vaccination on their own, giving preference to a foreign manufacturer.

The composition of the vaccine

The vaccination preparation contains live tuberculous microbacteria and monosodium glutamate (E621). There are no preservatives and antibiotics in it, which allows the use of the vaccine without the risk of developing allergic reactions.

Obtaining microbacteria occurs by sowing bacilli in a nutrient medium for 1 week, the culture is subject to isolation, filtration and concentration. It is turned into a homogeneous mass and diluted with purified water.

The technique for producing a vaccine preparation may vary slightly from manufacturer to manufacturer, as can the subtype of microbacteria. For this reason, the number of tuberculosis bacteria in each ampoule, designed for the same number of doses, also varies. All approved vaccines are certified by WHO, which allows them to be used without fear for the health of vaccinated children. Often, a 10-dose vaccine ampoule contains 0.5 mg of microbial cells, 3 ± 0.02 mg of monosodium glutamate.

The vaccination dose is 0.05 mg of vaccine combined with 0.1 ml of solvent. As the latter, an injection solution is used - sodium chlorite 0.9%. The grafting composition is mixed after checking the integrity of the vaccine ampoule, the validity of its period of use and the suitability of the solvent. The procedure is carried out before vaccination.

Vaccine Options and Choices

There are 2 types of vaccine against tuberculosis, which differ not in their components, but in their quantity:

This is a variant of the drug, designed for standard vaccination doses (0.05 mg of vaccine);

BCG-M.

A vaccine that contains 2 times less content of microbial cells. It is intended for vaccinating premature, underweight babies. It is also used in regions where there are no more than 80 people with tuberculosis per 100,000 people.

Both vaccines are domestic and, of course, of high quality. A complete preparation for BCG vaccination is also produced in Denmark and Poland. It is similar in composition, so the choice of an imported substitute is hardly advisable.

BCG vaccination: is the refusal real or is it mandatory?

The decision to vaccinate a child against tuberculosis should be agreed upon by the parents before birth. After them, there will be little time to make an informed decision. The pediatrician in the maternity hospital is "too busy" to devote every mother to the statistics of the incidence of tuberculosis, the properties and effects of the vaccine against it.

WHO insists on vaccinating all newborns, especially in countries where the annual mortality statistics from this pathology are by no means encouraging. Unfortunately, Russia is included in this list. At the same time, BCG vaccination is easily tolerated by children, the injection site does not require special care.

Temporary exemption from BCG vaccination

You can postpone the vaccination against tuberculosis for medical reasons:

Prematurity.

If the baby's body weight is less than 2.5 kg, then the vaccination is postponed. In some cases, the BCG-M vaccine is administered.

Diseases in an acute form.

Intrauterine infection, acute respiratory infections, purulent-septic diseases, allergies, chronic pathologies - any diseases must be eliminated or transferred to the remission phase for vaccination.

Intrauterine malnutrition III-IV degree.

Insufficient weight gain in relation to the height of the child.

Hemolytic disease of the newborn.

A disease caused by the incompatibility of the blood of the mother and child.

Severe damage to the nervous system.

Significant neurological symptoms are important.

Radiation therapy and immunosuppressive drugs.

Vaccination can be carried out six months after the end of therapy.

Primary immunodeficiency.

Live microbacteria in the composition of the vaccine can serve not to create antibodies, but to fully infect the child.

Low hemoglobin level.
Malignant neoplasms.
HIV infection diagnosed in the mother of the newborn.

If the child was issued a medical exemption, then he is registered to be vaccinated immediately after the elimination of temporary contraindications.

Absolute contraindications for BCG vaccination in a newborn

It is excluded the introduction of the named vaccine to children in whose families:

cases of congenital/acquired immunodeficiency have been noted;
severe complications after BCG vaccination were observed.

It is unacceptable to vaccinate children with:

severe hereditary diseases, for example, Down's disease;
severe perinatal lesions of the central nervous system (ICP);
congenital fermentopathy, that is, the absence or violation / congenital insufficiency of the function of any enzyme.

Revaccination is excluded if the previous BCG vaccination was accompanied by severe complications. We are talking about lymphadenitis, the presence of a keloid scar at the site of the previous injection.

Refusal to vaccinate

Every parent has the right to refuse to have their child vaccinated. This also applies to the "mandatory" BCG vaccination. If you are not convinced by the arguments of the pediatrician and phthisiatrician, you have the right to refuse routine vaccination, bearing absolute responsibility for the health of your child.

BCG vaccination schedule

According to the vaccination calendar of the Russian Federation, BCG should be administered three times:

3-7 days after birth;
7 years;
14 years old.

The last two revaccinations are carried out only if the Mantoux test is negative. The purpose of re-vaccination is to increase the number of active antibodies in case the child becomes infected. Revaccination may be canceled if the baby lives in an area with a relatively low prevalence of tuberculosis.

Combining BCG vaccination with other vaccinations

Each parent knows for himself that the result of the BCG vaccination is a small scar in the upper third of the left shoulder. It is formed as a result of a local inflammatory process. The reaction of the body to the introduced microbacteria manifests itself within 4-6 weeks after their introduction.

For this reason, no vaccinations are scheduled for the next 3 months. The exception is hepatitis B vaccination for children at risk, carried out at least 1 month later.

Before the BCG vaccination, which is performed on the day of discharge from the hospital, the first injection of the hepatitis B drug is given. As a rule, it is given within 24 hours after birth. Possible reactions appear and disappear in 3-5 days, so the BCG vaccine is administered after this period.

BCG vaccination: from preparation to healing

Vaccination of newborns is carried out in the maternity hospital and no preparation is required for its implementation.

The pediatrician, who examined the baby while still in the delivery room, assessed the condition of the crumbs, and if he found any violations, then additional examinations and analyzes will determine the presence of contraindications to inoculation with the BCG vaccine. In other cases, the injection is administered according to the schedule.

Features of the introduction of a vaccine to a child

BCG vaccination is done with a special tuberculin syringe, the volume of which is 1 ml. The place of vaccine administration is the region of the left shoulder, where the deltoid muscle is attached, that is, the border of its upper and middle thirds. The skin is treated with alcohol, and then pulled. The needle is inserted strictly intradermally with the cut up. First, a small dose of the vaccine is injected to make sure the needle is inserted correctly, followed by the remaining amount of the vaccine solution.

The correct technique for administering the vaccine will lead to the formation of a whitish papule (“buttons”) with a diameter of 7-9 mm. 15-20 minutes after vaccination, it disappears. If it is impossible to inject the drug into the shoulder, another place with a thick skin is chosen, for example, the thigh.

Reaction to BCG vaccination and side effects

The body begins to visibly respond to the vaccine administered 4-6 weeks after vaccination of the newborn. In the case of revaccination, the reaction manifests itself after 1-2 weeks. Correctly passing local inflammatory process is as follows:

the vaccination site turns red or turns dark (purple, blue, black);
a seal is formed at the injection site;
an abscess is formed, protruding above the surface of the skin;
a small ulcer forms in its center;
periodically the abscess is opened, its contents flow out;
gradually the ulcer begins to heal, in its place remains a scar characteristic of BCG vaccination with a diameter of 2-10 mm.

This whole process takes an average of 3 months and is considered the norm. The reaction to BCG vaccination is finally evaluated closer to a year after administration. A local vaccination reaction, in addition to itching, should not cause concern to the baby.

No special care for the pustule is required. Report any changes that bother you to your pediatrician at your scheduled checkups.

It is important to comply with the following requirements:

although the abscess looks like an open wound, it cannot be treated with any antiseptics;
it is unacceptable to wash the vaccination site with soap, rub with a washcloth when bathing;
you can not squeeze pus out of the wound, trying to speed up its healing;
the child should not scratch a protracted ulcer.

A doctor's consultation is only necessary if:

The temperature has increased after inoculation or in the process of suppuration.

Injection sites for no other apparent reason. In general, this is possible in response to the introduction of active bacteria or local inflammation, but if the thermometer shows more than 37.5 ° C for 3 days in a row, you need to call a doctor.

The diameter of the infiltrate and redness exceeds 1 cm, that is, edema.

It spreads to tissues not affected by the inoculation. This may signal infection of the wound, which requires appropriate treatment. Self-activity with the use of antiseptics and antibiotics is excluded.

The abscess did not form.
The scar did not appear or is barely noticeable.

The last 2 points mean that the body did not accept the vaccine, immunomodulation failed. The reason may be the improper administration of the vaccine, the individual characteristics of the crumbs. In this case, the vaccination is repeated provided that the Mantoux test is negative.

FACT: 2% of people are born resistant to TB. BCG vaccination is ineffective for them, so the expected local inflammation will not follow after it. They a priori cannot contract tuberculosis.

A video on why it is necessary to vaccinate BCG when immunity begins to develop after it.

Possible complications and consequences of vaccination

Incorrect technique for administering the vaccine, vaccinating a child with contraindications, individual characteristics of the baby - all this can provoke an incorrect response and serious consequences for the body to the vaccine.

Understanding what the expected reaction to the BCG vaccine looks like, parents should know what is the danger signal. Although such cases are recorded very rarely, they must be kept in mind.

Complications after vaccination:

Cold abscess.

If the drug was injected not intradermally, but subcutaneously, that is, the needle was inserted deeper than the permissible level, then the microbacteria got into the muscle tissue. This will provoke a local inflammatory process under the skin - the pus will not be able to go outside, which creates the risk of its penetration into the circulatory system. Outwardly, the complication looks like a slight swelling, the skin may become bluish. A pea-sized lump is tactilely felt. The complication requires surgical intervention.

Lymphadenitis.

Inflammation of the lymph nodes in the inguinal and axillary regions. It is easy to detect this complication - the lymph nodes increase noticeably (sometimes to the size of a chicken egg). With severe inflammation, surgical treatment is required.

Extensive ulcer with a diameter of more than 10 mm.

This indicates a high sensitivity of the child's body to the components of the vaccine. Therapy consists in the appointment of effective local treatment.

Keloid scar.

Instead of a white tender scar, the crumbs have a red bulging scar? This is a feature of his body, which does not allow further revaccination.

Extensive area of suppuration.

The reason lies in the immunodeficiency of the baby.

Osteomyelitis.

A purulent-necrotic process in bone and soft tissues provokes a poor-quality vaccine or an incorrect grafting technique.

Osteitis.

Inflammation of bone tissue against the background of vaccination may occur within 6-24 months. The reason lies in disorders of the immune system.

Generalized BCG infection.

A complication associated with the defeat of many organs and systems of purulent infection. The reason is immunodeficiency.

In the pre-war years, vaccination was carried out orally, which provoked an even greater number of complications. WHO insists that timely identified contraindications to vaccination, as well as the purchase of a certified vaccine, reduces the risk of their occurrence to a minimum.

If you suspect any of the above complications, contact your pediatrician and do not hesitate to visit a phthisiatrician.

Answers to recurring questions from parents

In addition to taking care of the vaccination site, possible complications of vaccination, parents often ask the same questions.

What to do if BCG was not vaccinated at the maternity hospital?

Many children are not vaccinated in a timely manner due to

lack of vaccine or parental refusal. Over time, some mothers change their minds or wait until the polyclinic receives the drug for the BCG vaccination. In this case, the baby is first checked for infection with tubercle bacilli, making him a Mantoux test.

If it is negative, then BCG vaccination is still relevant. If it is positive, but the result is within the normal range, then the child’s immunity independently coped with the microbacterium that “was in wait” for him in the big world. In this case, he no longer needs a BCG vaccination.

Is it possible to walk and swim after BCG vaccination?

Yes, it will not affect the processes taking place in the body in any way. But make sure that the baby does not catch a cold - during this period, it is undesirable to divert the defenses of his body to fight viruses, because they are “occupied” with tuberculosis microbacteria.

Is it possible to vaccinate a baby with a cold?

Yes, if allergic or infectious rhinitis is no longer in the acute phase. BCG vaccination is allowed against the background of residual manifestations of acute respiratory infections.

What should I pay attention to when vaccinating?

You can ask the vaccination nurse what vaccine will be used, get acquainted with the certificates of its quality. Remember that the appearance of many complications is a consequence of the wrong technique for administering the vaccine. You have familiarized yourself with it, so do not hesitate to follow the actions of the health worker.

Where can you get the BCG vaccine?

BCG vaccination is carried out free of charge in the maternity hospital, state clinics and tuberculosis dispensaries. For a fee, health workers can get vaccinated at home - this is allowed by law.

This service is not included in the list of mandatory services provided under the medical insurance policy.

For a fee, BCG vaccination is carried out in private medical clinics and centers. Most often, a domestic vaccine preparation is used for vaccination. The cost of the service will be about 450 rubles.

Summary

The vaccine is not a panacea for tuberculosis, but it saves 85% of vaccinated children in our country from this disease. The remaining 15% can theoretically receive the status of tuberculosis infected, but with timely preventive treatment, the disease will be stopped before it enters the active stage. Failure to vaccinate exposes the child to the daily risk of infection, at a time when his immune system is completely unprepared for a meeting with Koch's microbacterium.

The reaction to BCG in newborns is expressed in the appearance of a small scar at the site of vaccination. The vaccine is given in the hospital for 3-6 days after the birth of the baby. Vaccination is necessary to protect the child from contracting tuberculosis.

Tuberculosis is an infectious disease that is transmitted by airborne droplets. It affects not only the lungs, but also other internal organs. People who do not have immunity are susceptible to disease, which leads to death, disability.

Tuberculosis vaccination is carried out in the first days of life to provide maximum protection against the disease. BCG vaccination helps to reduce complications in case of illness, eliminate death.

The injection is given to the newborn in the left shoulder.

A small scar remains at the site of the vaccine. On average, it takes 60 days to develop immunity to a disease. Revaccination is mandatory at 7 years of age.

Contraindications

Temporary exemption from vaccination:

premature babies;
infected children;
in the presence of hemolytic disease.

Who is not vaccinated:

children with affected central nervous system;
HIV-infected;
babies with congenital pathologies and developmental disabilities;
children with immunodeficiency.

With temporary contraindications, the introduction of the vaccine is postponed until complete recovery. With absolute - children are not vaccinated.

What reaction to BCG is considered the norm

The reaction to vaccination in children is manifested from the moment immunity to the disease is developed. The body reacts to the vaccine within 1.5-2 months.

After the injection, a small papule is formed. It dissolves within the first 20 minutes. A scar and purulent discharge appear after a month. Then the wound is covered with a crust, which gradually disappears.

Signs of reaction to BCG vaccination:

redness around the injection site;
swelling;
change in skin tone to cyanotic;
abscess;
crust, scar.

The injection site heals up to 4 months. The norm for the scar is from 2 to 10 mm. After complete healing, there should be no redness and swelling of the skin.

What to expect after vaccination

The baby for 3-6 days after birth only gets used to the outside world and develops immunity to diseases. The reaction to the delivered vaccinations may occur, since the body is not yet strong.

A temperature rise of up to 37.5 degrees Celsius in the first 2 days is normal as the body is exposed to the vaccine. The use of antipyretics is not required when the child feels well.

Reaction in the first days:

Redness, darkening of the vaccination site. In the center, a slight suppuration forms. Treat with antiseptics, squeeze out pus is not recommended.
The swelling persists for 1-2 days.
An allergy may develop, and the injection site itches.
Temperature up to 37.5 degrees Celsius.

The reaction to the vaccine appears due to the development of immunity. It is normal and does not require treatment.

The resulting wound is not treated, the use of antibacterial agents is excluded. You can not squeeze out the appeared pus.

Possible side effects

In some cases, vaccination causes complications related to the health of the child. The cause may be an incorrectly delivered injection, an infection.

Side effects:

Allergy, itching.
No scar.
High body temperature.
Diarrhea.
Swelling and suppuration of the injection site.

Diarrhea, vomiting and fever are a normal reaction of the child's body to the vaccine. They are not life-threatening and do not require treatment.

To exclude the manifestation of side effects in a child, it is recommended:

do not change the diet;
give antipyretic only at temperatures above 38.5 degrees Celsius;
exclude antihistamines;
do not bathe for the first few days.

Vaccination has an effect on the child's body, and side effects are a protective reaction. Most often, symptoms resolve within 1-2 days.

A side effect is a scar, irregular in shape. The situation manifests itself 6-8 months after vaccination.

low-quality serum;
incorrectly inserted needle;
genetic abnormalities;
inflammation of the injection site.

To exclude the growth of the scar, you need to see a doctor. At 2 months, newborns must check for the presence of a scar, its size and quality.

Reaction time

Vaccination is done in the hospital for 3-6 days after birth. The reaction to the administration of the drug appears from the moment of action of the serum. On average, the development of immunity begins after 30 days, lasts up to 4 months.

How does healing proceed in infants:

the first 30 minutes - papule;
30-60 days - redness, abscess, scab formation;
3-4 months - a small scar.

Complete healing is determined by the scar. Its diameter is less than 1 centimeter without redness and crusts.

The manifestation of the reaction depending on the age of the child

The reaction to the vaccine in infants develops more slowly, as the body first encounters this type of bacteria. Most often, the main visible symptoms are: redness of the skin, cyanosis, abscess.

Children who are prone to allergies are most susceptible to side effects. The reaction to serum appears faster and harder. To reduce the risk of complications, antihistamines are used.

With revaccination at 7 and 14 years old, the reaction is practically not visible, complications are minimal. With reduced immunity, a teenager may experience itching, changes in stool, and fever.

Children who are innately immune to TB do not respond to the vaccine. To determine its effectiveness, X-rays, diaskintest are used.

What does not respond to a vaccine mean?

The absence of a scar is noted in 10% of children. When a child does not have a reaction to the BCG vaccine, a diagnostic Mantoux test is prescribed. It allows you to determine whether immunity to the disease is being developed.

In some cases, children have innate immunity, so there is no reaction. These include 2% of newborns worldwide. They are not susceptible to the disease, the Mantoux reaction is negative throughout life.

The absence of a scar most often means that the vaccine is ineffective. The Mantoux test is performed with a negative reaction after vaccination, before revaccination.

Papule result:

its absence is negative;
small size - doubtful;
from 9 to 16 mm - positive;
over 16 mm - overreaction.

A positive test indicates the effectiveness of the vaccine. A negative result is a sign of a lack of immunity and will require a second BCG vaccination.

If the introduction of the vaccine did not bring results, the Mantoux test is negative, then the re-vaccination is not given according to the schedule, but 2 years after the previous one. In the absence of immunity, the child is at risk.

What are the possible complications

In 99.8% of cases, vaccination against tuberculosis passes without complications. Occasionally, children have life-threatening consequences that require treatment and observation.

Complications:

Abscess. Compaction and profuse suppuration appears when the drug enters the subcutaneous fatty tissue. Such a reaction will require the help of a surgeon, taking antibiotics.
Severe allergies. Manifested when the child is sensitive to the drug. Antihistamine, antiallergic ointments and tablets are used for treatment.
Inflammation of the lymph node. Perhaps if the child's body has not coped with the development of immunity.
Keloid scar. The scar tissue grows, the injection site becomes rough, has a bluish tint. Complication prohibits revaccination.
Generalized BCG infection. Rare complication. It is expressed by edema, redness, the presence of an open ulcer.
Osteitis or tuberculosis of the bone. Occurs against the background of reduced immunity, diseases of the musculoskeletal system.

Complications require immediate medical attention. In most cases, you will need to take medications, antibiotics. Necessarily after the injection, the neonatologist observes the newborn during the day.

The reaction to the BCG vaccination in the form of suppuration of the injection site, an increase in body temperature, is normal. The scar formed on the shoulder indicates the effectiveness of the serum, the development of immunity. In rare cases, complications that require treatment are possible.

Today, one of the most common diseases in our country and around the world is tuberculosis. Every year, about 9 million people fall ill with it, more than a third of them are fatal.

To reduce the risk of tuberculosis and mitigate its consequences, the child is vaccinated with BCG in the first days of life.

In this article, we will tell you why the BCG vaccine is needed, when the first and subsequent vaccinations are done, and what they protect the children's body from.

What is the BCG vaccination?

The BCG vaccine is a serum containing live and dead bacteria. When they enter the body, immunity is developed against severe forms of tuberculosis.

Deciphering BCG is a translation from the Latin language BCG, stands for Bacillus Calmette-Guerin and its composition has not changed since the 20s of the last century.

Frequency of BCG Serum Injection

BCG vaccination in newborns is performed in the first year of life. As a rule, it is done directly within the walls of the maternity hospital in the first days after birth.

Before vaccination, preparation should be made, during which doctors find out if the child has contraindications for the administration of serum.

The next vaccination is done after 7 years. To prepare for re-vaccination, the child is given a Mantoux test. If the test done shows a negative result, then the introduction of the vaccine is a mandatory procedure. It is also recommended to re-vaccinate children who have constant contact with people with tuberculosis, or who are its carriers.

The third vaccination is performed at the age of 14, but it is not mandatory. As a rule, almost no one does it.

Infant vaccination technique

BCG vaccination for newborns, according to WHO (World Health Organization) standards, is performed on the outside of the left shoulder. Serum is a powder that is diluted in saline before BCG. BCG vaccination is given to newborns using a special tuberculin syringe. The injection is made under the upper and middle layers of the skin. It is pierced either in one place, or several punctures are made next to each other.

The vaccination reaction in an infant to the introduction of serum begins to appear after a month and lasts up to 4 months. At the site where the BCG vaccination is given, a small speck is formed. The norm is a spot with a diameter of less than 1 cm. Then a small swelling appears, inside of which there is pus. In no case should the abscess be squeezed out and treated with brilliant green or iodine solution. He will soon heal himself, and his surface will be covered with a crust. It is also forbidden to remove it from the skin, it will fall off on its own as it heals.

The color of the skin at the injection site may change - this is also the norm. Then, for six months, the baby undergoes the formation of a scar. Its length varies from 3 to 10 mm. The resulting scar indicates that the vaccination was successful, and the baby has developed immunity against mycobacteria.

How to care for a baby after vaccination?

If the vaccination went without negative consequences for the baby, it is still impossible to make changes to the baby's diet at the same time. Do not experiment on a child by changing the formula if the baby is bottle-fed. If the baby is breastfed, then the nursing mother should also refrain from eating new food. Otherwise, the child may be allergic.

A newborn after BCG may experience vomiting, loose stools and fever. In this situation, you should not rush to see a doctor - this is the norm. It is necessary to provide the baby with plenty of fluids, since during this period there is a significant loss of fluid. For several days, the child may experience a decrease in appetite, but this is not dangerous for his health.

A slight increase in temperature is usually associated with a reaction from the immune system to the drug. If the temperature does not go beyond the normal range, this does not mean that the vaccination is ineffective, because all children have their own reaction to the serum.

If the baby is not sick with anything, then it is not necessary immediately. Taking medication is recommended only when the temperature rises above 38.5 ° C. should be given to a newborn at night. If the baby has a temperature decrease, it is necessary when it rises to 37.5 ° C.

If the child is prone to allergic reactions, then the doctor may prescribe as a preventive measure.

Parents should not independently decide on the use of a particular drug by a child; only a pediatrician can make a diagnosis.

Often, the injection site becomes red or swollen. In some cases, it can become inflamed, accompanied by suppuration, and an ulcer forms in this place. Its healing can take a long time. Even if the injection wound turned red and inflamed, you do not need to treat it. Sometimes an attempt is made by newborns to comb the place where the drug was injected, then it is recommended to put a gauze bandage on it.

Parents may have a reasonable question, when can I bathe a baby? If his body temperature is not elevated, then bathing is not contraindicated. You can not bathe a baby if he is. Water procedures are allowed only after receiving the result.

It is recommended to seek medical help if for a long time it is not possible to bring down the high temperature even with the help of medications. A doctor's call is also necessary if the baby is in a restless state, he has a reduced appetite for a long period, convulsions appear and the BCG site fester.

List of contraindications

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It must be said that not all babies can be vaccinated with BCG. There are contraindications that prevent the introduction of the vaccine to a newborn. First of all, this applies to children born before the due date, and babies with a weakened immune system. These are quite serious contraindications and vaccination should be postponed to another time or should be performed after 7 years. Before you revaccinate, you need to make sure that the child has not been in contact with bacteria. This can be seen in the negative Mantoux test.

In addition, BCG vaccination is contraindicated in the following cases:

Lack of weight in a newborn - it should not be lower than 2.5 kg .;
Contact with mycobacteria before vaccination;
Active form of chronic diseases.

For children whose weight does not exceed 2.5 kilograms, a lighter vaccine called BCG M is allowed. In the light version of the serum, the content of antibodies of the causative agent of tuberculosis is two times less than in the conventional vaccine.

Sick children are not vaccinated, vaccination is performed only when the baby recovers. The vaccine does not make sense if the baby has already had contact with a person with tuberculosis. It is worth noting that not always a child can become infected during the first contact. In some babies, antibodies begin to be produced in the body.

Vaccination is not done if there are the following serious contraindications:

HIV infection;
the presence of complications in close relatives after BCG vaccination.

The introduction of BCG in such children can have quite serious consequences. Mycobacteria contribute to the spread of infection in the child's body. These babies are not vaccinated.

List of complications after BCG vaccination

Immunity not developed

The reaction to BCG in each newborn is expressed in its own way. In some cases, complications may occur, the most common of which is unformed immunity against tuberculosis. This suggests that the reaction to the serum did not go well. Either the baby's immune system is weakened, or the baby is not genetically susceptible to mycobacteria. The last factor means that infection of a child with tuberculosis is impossible.

Keloid scar

Sometimes it happens that wound healing occurs with certain difficulties. A child may develop a keloid, which is a hereditary disease. It is characterized by the growth of scar tissue when the skin is damaged. When a keloid scar appears after the introduction of the vaccine, the vessels become visible through it. The scar acquires a bright color, its appearance may be accompanied by burning and itching.

Elevated temperature

Often, as a complication after BCG, babies have an increased body temperature. This is an absolutely normal reaction of the child's body to the introduction of BCG.

Redness, skin irritation

The reaction to the BCG vaccination can manifest itself in the form of small redness and swelling at the injection site, which are of a short-term nature. Also, the injection site can fester and become inflamed, spot inflammation and scabies can occur.

Inflammation of the lymph nodes

After BCG vaccination, the lymph nodes in a child may become inflamed. An increase in the lymph nodes in the armpits of a newborn mother is noticed, as a rule, when they bathe their baby. Lymph nodes can reach the size of a walnut, and in exceptional cases be the size of a chicken egg.

If the vaccine has festered in the baby or any of the symptoms described above is observed, then this is considered a serious reason for seeking medical attention as soon as possible.

Less commonly, the following severe complications occur from the introduction of the BCG vaccine:

Bone tuberculosis (osteitis);
Generalized BCG infection.

Both diseases occur due to malfunctions in the infant's immune system.

The vaccine can also cause:

Cold abscess - is formed when the technique of administering the vaccine is violated. To eliminate such a problem, surgical intervention is required;
Osteomyelitis - suppuration occurs at the injection site, which further affects the bone tissue.

Why is it necessary to get the BCG vaccine?

Today, there are more and more discussions about whether BCG vaccination is needed for newborns? Since the picture of the incidence of tuberculosis can hardly be called favorable, children are vaccinated already while they are in the maternity ward.

There is an opinion among supporters of vaccination that the vaccine can protect babies from the occurrence of more severe forms of the disease. These include:

extrapulmonary form of tuberculosis;
disseminated tuberculosis;
tuberculous meningitis.

Phthisiologists, who, by the nature of their work, have to deal with this disease every day, are of the opinion that even if a child becomes infected, his recovery will occur without negative consequences. Infants who are not given BCG are fatal if they become infected with one of these forms of tuberculosis.

Despite this, there is a large army of opponents of vaccination. They ask themselves that if maternity hospitals carry out universal vaccination of infants, and the incidence rate does not decrease, then is this not a reason to revise the very principle of protecting children from the disease?

Today, parents have the right to make their own decisions about whether to vaccinate their child against tuberculosis. If they nevertheless decide to refuse it, then it is possible to issue a refusal in writing. The text, as a rule, contains the phrase that the parents assume responsibility for the health of the child, and they have no claims against the staff of the medical institution.

Often, parents want to refuse to vaccinate a newborn, but they do not want to take responsibility on their shoulders, shifting it to medical workers. Before refusing a vaccine, you need to carefully consider all its pros and cons. We must not forget that the health of the child will depend on the choice made by the parents in the future.

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 to stop the infection that has arisen. To date, the only method is BCG vaccination. Consequences, complications and contraindications - in the article.

Deciphering the BCG vaccine

What does the abbreviation BCG stand for? Deciphering the Latin name BCG is interpreted as bacillus Calmette-Guerin. Translated into Russian, this means "Bacillus Calmette-Guerin." Thus, the abbreviation for BCG is not at all an abbreviation. This decoding is a direct reading of the Latin abbreviation written in Cyrillic.

BCG vaccine: what is it?

The BCG vaccine is a suspension of a weakened bovine mycobacterium with a 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 the manufacturer, the composition of the vaccine is the same. That is why it is inappropriate to arrange a "race" for foreign products on the personal conviction that it is better than domestic.
BCG-M - due to the reduced content of microbial bodies (two times less than in the conventional BCG vaccine), it is used to vaccinate premature, debilitated children against tuberculosis. In addition, if for any reason the child was “lost sight” in the maternity hospital and the vaccine was not administered on time, it is BCG-M that is used in hospitals.

Is it necessary to get vaccinated?

It's no secret that the vaccine does not give a 100% guarantee that subsequently TB infection will not occur. So then what is it for, you ask. The fact is that BCG develops anti-tuberculosis immunity, which can provide powerful protection during primary infection, as well as during possible subsequent contacts with carriers of tuberculosis infection. If the body still turns out to be weaker than the disease, then the vaccine will prevent the development of especially severe, generalized forms of tuberculosis (disseminated and miliary forms). Thus, while not providing complete protection against infection, vaccination will somewhat alleviate the course of the disease in case of infection.

Newborns. All children should be vaccinated with BCG a year. Especially in regions with a high prevalence of tuberculosis.
Persons who are constantly in contact with those infected with tuberculosis (usually the medical staff of tuberculosis dispensaries, etc.).

At what age is the BCG vaccination given?

When is BCG done? Primary vaccination is usually carried out healthy at 3-7 days of life. Beforehand, the doctor must necessarily examine the child, conduct thermometry (at an elevated body temperature, the procedure is contraindicated), take into account the history data and all possible contraindications. In addition, BCG vaccinations for children are carried out only after consultation with a specialist doctor with ready-made results of blood and urine tests.

The vaccine should be administered intradermally, into the outer surface of the left shoulder, the dose should not exceed 0.05 mg. The technique for performing the procedure involves a gradual introduction - in order to make sure that the needle entered at the right angle. If everything is done correctly, then a papule with a diameter of 7-9 millimeters is formed at the injection site, white in color, usually disappearing 15-20 minutes after the procedure.

Children who, for one reason or another, were not vaccinated at the maternity hospital are vaccinated at the earliest opportunity. If more than two months have passed since birth, then before vaccination it is mandatory to carry out. If the result is positive, BCG is prohibited.

In the medical record of the newborn, the doctor must make a note about the vaccination, indicating the date of vaccination, series and control number of the vaccine. In addition, the expiration date of the administered drug, as well as the manufacturer, are entered into the history.

Important! The place of the vaccine must not be treated with any solutions. Bandages are also not allowed.

Why such a hurry?

Also, doctors are often asked why BCG is done so early. When they are vaccinated, parents are perplexed why a newborn, still a fragile 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 and continue to lead their usual way of life. 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 has already begun to form immunity to Mycobacterium tuberculosis.

BCG revaccination

Children aged 7 and 14 are subject to re-vaccination, but only if the reaction to the Mantoux test is negative. The interval between Mantoux and revaccination should not exceed two weeks.

Unfortunately, in epidemiologically unfavorable regions of the country, children become infected with mycobacterium long before the first revaccination, so they are not re-exposed to BCG.

What processes in the body occur after BCG?

Macrophages (or monocytes - a type of leukocytes) immediately begin to arrive at the site of vaccine administration, absorbing the causative agent of the disease die along with macrophages, resulting in the formation of necrotic caseous masses. Coming out, they provoke the formation of a scar at the site of the vaccine.

The reaction is the development of a papule at the injection site, which usually appears in newborns 4-6 weeks after vaccination. At the site of vaccination, a scar should form, by 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 body of the vaccinated 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 with 8-10 mm - for 10 years.

Usually the vaccine is well tolerated, but sometimes there are reactions:

BCG blushed. If the redness does not spread to the surrounding tissues and is observed only during the period of the vaccination reaction, then this is the norm. In rare cases, in addition to redness, swelling may form and there can be no cause for concern: in this way, the skin reacts to the drug.
BCG fester. Suppuration and abscesses are a normal reaction to the components of the vaccine, which will pass soon. It is worth consulting a doctor if, in addition to suppuration, redness and swelling appear around the vaccination site: it is possible that the wound has become infected, which must be treated.
BCG is inflamed. It is worth worrying and consulting 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 over the wound to keep the child from scratching.
Temperature after BCG. An increase in body temperature in a newborn up to 38 degrees is the norm, but if a seven-year-old child has an increase in temperature after revaccination, you should immediately consult a doctor.

What does the lack of response mean?

If after vaccination a scar did not form at the injection site, then this is a sign that the vaccine was ineffective, because immunity to the most dangerous disease was not formed. There should be no cause for concern in this case: some time after receiving a negative reaction to the Mantoux test, revaccination can be carried out without waiting for the age of 7.

Lack of response to the first vaccination is rare, occurring in 5-10% of children. In addition, about 2% of the world's population have an innate immunity to tuberculosis. This means that in principle they cannot get sick during their life.

Contraindications to vaccination

BCG contraindications are not so extensive, they include:

The body weight of the newborn is less than 2500 g (with 2-4 degrees of prematurity).
Acute diseases or a period of exacerbation of chronic diseases. Vaccination in this case should be carried out only after a complete cure, when the clinical manifestations of the disease have completely disappeared.
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 for revaccination

Contraindications to revaccination are:

Exacerbation of chronic diseases or any acute diseases at the time of BCG vaccination. Body temperature (increased) 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 under the supervision and registration of medical personnel until complete recovery and vaccination. Persons who have undergone revaccination are also under observation and must come to check the vaccination reaction 1, 3, 6, 12 months after the procedure.

What does a vaccination reaction test include?

Such a check is carried out after 1-3 months, six months and a year after vaccination and revaccination, it includes:

Registration of the size of the local reaction.
Registration of the nature of the reaction (it is assessed whether the formation of a papule, pustule with a crust or a scar has occurred). In addition, pigmentation at the vaccination site is checked.

BCG vaccination: complications are possible?

Is the vaccine really completely safe? Does the Consequences can manifest itself in the form of:

Osteitis is tuberculosis of the bone. The development of the disease usually occurs 0.5-2 years after vaccination, it causes serious disorders of the immune system.
Generalized BCG infection - is formed when the child has congenital immune disorders.
Inflammation of the lymph node - immediate surgical intervention is required if there is a sharp increase in the size of the lymph node (more than 1 cm in diameter).
Cold abscess - requires surgical intervention. This phenomenon is a consequence of the subcutaneous (instead of intradermal) administration of the BCG vaccine. The vaccination, the consequences of which are as follows, was carried out illiterately.
A keloid scar is red, swollen skin at the injection site. 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. Usually local treatment is prescribed.

Compatibility with other vaccines

BCG is a specific vaccine, the simultaneous use of which with other drugs is unacceptable. In addition, it is not allowed to carry out additional vaccination not only on the day of BCG, but also for 4-6 weeks after, during the period of reactions to the drug. After a BCG injection, at least 35-45 days must pass before any other vaccination.

Before BCG vaccination, it is allowed to vaccinate a child against hepatitis B. The only condition is the period of immunological dormancy, that is, any vaccinations are contraindicated for the baby until the age of 3 months.

Caring for a child after BCG

Usually there are no consequences after vaccination, however, something should be done to “reinsurance”:

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.
Antipyretics (provided that the child is not sick) should be given at night at a temperature above 38.5 degrees. When you bring down the heat, you can 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 antipyretics (paracetamol), if the child is restless and refuses to eat for a long time. In case of convulsions, loss of consciousness and a purulent abscess at the vaccination site, immediately call an ambulance.

Refusal of BCG

Today, more and more often, parents of babies express dissatisfaction with certain planned vaccinations, considering them harmful. The practice of refusal, the consequences of refusal from which are very deplorable, comes into fashion, is no exception.

The TB vaccine can be discarded just like any other vaccine. The legislation of the Russian Federation confirms this right, thereby shifting the responsibility for children to their parents.

What would you like to note about this? Today, a large amount of information about absolutely everything is in the public domain. Each person is able to independently study issues related to the life and health of him and his family, make decisions and be responsible for his beliefs.

If you decide not to vaccinate your own child, no one will say anything against it. You just need to write a refusal in your own hand on the card, be sure to indicate that you will not have any claims against the medical staff later.