BCG( vaccination): consequences, possible complications, contraindications
Tuberculosis is a most 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. To date, the only method of preventing tuberculosis is BCG vaccination. Consequences, complications and contraindications - in the article.
Explanation of the BCG vaccine
What is the abbreviation BCG?The deciphering of the Latin name BCG is interpreted as bacillus Calmette-Guerin. In translation into Russian it means "the bacillus of Calmette-Guérin".Thus, it is not at all abbreviation of BCG.This decoding is a direct reading of the Latin abbreviation written in Cyrillic. BCG vaccine: what is it?
BCG vaccine is a suspension of a weakened bovine mycobacterium with a loss of virulence to humans. There are two varieties:
- BCG - the content of Mycobacterium tuberculosis in the vaccine is too small to cause infection. However, there is enough such quantity that the body could 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 personal conviction that it is better than the domestic one.
- BCG-M - due to the reduced content of microbial bodies( half the size of the usual BCG vaccine), it is vaccinated against tuberculosis of premature, debilitated children. In addition, if the child was "missed" in the hospital for any reason and did not enter the vaccine on time, BCG-M is used in hospitals.
Is it necessary to inoculate?
It's no secret that the vaccine does not give a 100% guarantee that tuberculosis infection will not subsequently occur. So then what is it for, you ask. The fact is that BCG develops anti-tuberculosis immunity, which can provide powerful protection in case of primary infection, as well as with possible subsequent contacts with vectors of tuberculosis infection. If the organism is still weaker than the disease, the vaccine will prevent the development of particularly severe, genitalized forms of tuberculosis( disseminated and miliary form).Thus, not providing full protection against infection, vaccination will somewhat facilitate the course of the disease in the event of infection.
Who is recommended for BCG vaccination?
Vaccination is recommended for people:
- Newborns. For all children BCG per year should already be vaccinated. Especially in regions with a high prevalence of tuberculosis.
- Persons, constantly in contact with infected tuberculosis( usually medical staff of tuberculosis, etc.).At what age is BCG vaccinated?
BCG when do? The primary vaccination is usually done for a healthy newborn child on the 3rd-7th day of life. Previously, the doctor must necessarily examine the child, conduct a thermometry( at an 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 doctor with ready-made blood and urine tests.
The vaccine should be administered intradermally, to the outer surface of the left shoulder, the dose should not exceed 0.05 mg. The technique of the procedure implies a gradual introduction - in order to make sure that the needle has entered the right angle. If everything is done correctly, then a papule with a diameter of 7-9 millimeters, a white color, usually disappearing 15-20 minutes after the procedure, is formed at the site of the injection.
Children who for one reason or another have not been vaccinated in the hospital, are vaccinated at the earliest opportunity. If more than two months have elapsed since birth, the Mantoux reaction is necessarily performed before the vaccination. With a positive result, BCG is prohibited.
In the newborn's medical record, the doctor must make a note about the vaccination, indicating the date of vaccination, the series and the vaccine control number. In addition, the history of the entered product, as well as the manufacturer, is included in the history.
Important! Place the vaccine is prohibited to handle any solutions. The application of dressings is also not allowed.
Why such a rush?
Also, doctors are often asked why it is so early to do BCG.When vaccinated, parents are puzzled why a newborn, still immature child on the third day is subjected to such a test. The fact is that the situation with tuberculosis is such that not all patients know about their problem, continue to lead a habitual way of life. Being carriers of a dangerous infection, they freely visit public places, which causes a big threat, especially for a small child. The risk of meeting a baby with a bacterium is very high. This is why the vaccination is carried out as early as possible, so that at the time of discharge the immunity to Mycobacterium tuberculosis has already begun to form in the child.
Revaccination of BCG
Children who are 7 and 14 years old are subject to re-vaccination, but only if they react negatively to the Mantoux test. The interval between Mantoux and revaccination should not exceed two weeks.
Unfortunately, in epidemiologically unfavorable regions of the country, children are infected with mycobacteria long before the first booster, so they do not undergo another BCG.
What processes in the body occur after BCG?
Macrophages( or monocytes, a kind of leukocytes) that immediately absorb the mycobacterium of tuberculosis immediately begin to arrive at the place of administration of the vaccine. The pathogen dies together with macrophages, resulting in the formation of necrotic caseous masses. Going outside, they provoke scar formation at the site of vaccine administration.
Response to BCG
The reaction is the development of the papule at the site of the injection, which usually appears in newborns 4-6 weeks after vaccination. At the site of the vaccination, a hem should be formed, according to the size of which it is possible to judge the acquired anti-tubercular immunity. So, if after BCG formed a scar 2-4 mm in size, then they say that the organism of the vaccinated will resist the disease within 3-5 years. If the size is 5-7 mm - the body is protected for 5-7 years, and at 8-10 mm - for 10 years.
The vaccine is usually well tolerated, but sometimes reactions appear:
- BCG blushes. 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 are no grounds for concern in this case: thus, the skin reacts to the drug.
- BCG suppurates. Suppuration and abscesses - a normal reaction to the components of the vaccination, which will take place in the near future. It is worthwhile to see a doctor if, in addition to suppuration around the vaccination site, redness and swelling appeared: perhaps, infection of the wound has occurred, which must be treated.
- BCG inflamed. To worry and to address to the doctor costs or stands only in case of distribution of an edema and an inflammation on a skin of a brachium, for limits of a place of vaccination.
- BCG itches. Itching at the injection site is normal, but doctors advise to apply a gauze napkin to the wound to keep the child from combing.
- Temperature after BCG.The 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, a doctor should be consulted immediately.
What is the lack of response?
If, after vaccination, a scar has not formed at the injection site, 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: after a while after receiving a negative reaction to the Mantoux test, a revaccination can be carried out, without waiting for a 7-year-old age.
The lack of response to the first vaccine is infrequent, observed in 5-10% of children. In addition, about 2% of the population on the planet have an innate immunity to tuberculosis. This means that in the course of life they can not get sick.
Contraindications to vaccination
Contraindications to BCG are not so extensive, they include:
- The body weight of the newborn is less than 2500 g( with a 2-4 degree of prematurity).
- Acute illness or 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 will be final.
- Congenital immunodeficiency.
- The presence in the family of a newborn generalized infection of BCG.
- Mother's HIV infection.
- Therapy is an immunosuppressant drug.
Contraindications to revaccination of
Contraindications to revaccination are:
- Exacerbation of chronic diseases or any acute illness at the time of BCG vaccination. Body temperature( elevated) is a serious argument for vaccine transfer. Usually the revaccination is carried out a month after recovery.
- Malignant neoplasms.
- Immunodeficiency status.
- Tuberculosis( including at the stage of recovery).
- Positive reaction to the Mantoux test.
- Complications after primary vaccination.
Persons temporarily released from vaccination due to contraindications should be supervised and accounted for by the medical staff until they are fully recovered and vaccinated. Those who underwent revaccination are also under observation and should be on check for the vaccination reaction 1, 3, 6, 12 months after the procedure.
What does the vaccine response check include?
This check is carried out after 1-3 months, half a year and one year after vaccination and revaccination, it includes:
- Registration of the size of the local response.
- Registration of the nature of the reaction( it is estimated whether the formation of papules, pustules with a crust, or a hem).In addition, pigmentation at the inoculation site is checked. BCG Inoculation: Complications Possible? Is the vaccine completely safe? Is there any complication of BCG vaccination? The consequences can appear in the form:
- Osteitis - tuberculosis of bone. The development of the disease usually occurs 0.5-2 years after vaccination, it causes serious damage to the immune system.
- Generalized BCG infection - is formed when a child has congenital immune disorders.
- Inflammation of the lymph node - immediate surgery 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 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 inoculation. In the presence of a scar, revaccination at the age of seven is not performed.
- Extensive ulcer indicates a high sensitivity of the child to the components of the drug. Usually, local treatment is prescribed.
Compatibility with other vaccinations
BCG is a specific vaccine, concomitant use with which other drugs is unacceptable. In addition, additional vaccinations are not permitted on the day of BCG administration, but also for 4-6 weeks after the reaction to the drug. After injection of BCG before any other inoculation must pass at least 35-45 days.
Before vaccination BCG is allowed to inoculate a child from hepatitis B. The only condition is the period of immunological rest, that is, until the age of 3 months, any vaccine is contraindicated to the baby.
Baby care after BCG
Usually there are no consequences after vaccination, however, something should be done to "re-insure":
- First, the baby's diet should remain the same. After vaccination, the baby may have a loose stool, a fever, and vomiting. All these consequences are considered normal, they do not represent the dangers to life and health.
- Antipyretic( provided that the child is not sick) should be given overnight at a temperature above 38.5 degrees. With febrile convulsions, heat can be reduced at 37.5 degrees.
- The use of antihistamines is highly undesirable. Redness and swelling should pass by themselves: a healthy body will cope on its own.
- Bathing is not prohibited.
Consult a doctor if the temperature can not be brought down by febrifugal( paracetamol) if the child is restless and refuses to eat for a long time. With convulsions, unconsciousness and a purulent boil at the injection site, immediately call an ambulance.
Refusal of BCG
Today, more and more parents of children express discontent about some or other planned vaccinations, considering them harmful. The fashion includes the practice of refusing to vaccinate. BCG vaccination, the consequences of abandonment of which are very deplorable, is no exception.
From the vaccine against tuberculosis can be discarded as well as from any other. The legislation of the Russian Federation confirms this right, thereby shifting responsibility for children to their parents.
What would you like to note about this? Today, in the open access is a lot of information about everything. Everyone is able to independently study questions concerning the life and health of him and his family, make decisions and be responsible for their beliefs.
If you decide not to vaccinate your own child - no one will say anything against it. You only need to write your own refusal in the card, always indicating that you will not have any claims to the medical staff afterwards.