The BCG vaccine is the second vaccine a baby encounters after birth, and is BCG. Therefore, all parents should learn more about BCG.
What are they vaccinated against?
This vaccine is aimed at a disease such as tuberculosis. Due to the high prevalence of this disease and the constant contact of people with mycobacteria, BCG is given to all newborns, because it is in childhood that there is a high risk of developing severe forms of tuberculosis.
The disease is classified as social, since it develops when the body is exposed to such factors as unfavorable living conditions, poor sanitary conditions, the presence of bad habits, insufficient nutrition and the like. Most often, tuberculosis occurs in the lung tissue, causing a cough, but mycobacteria can spread almost throughout the body, which is life-threatening.
Pros
- The introduction of BCG will help reduce the risks of developing the primary form of tuberculosis infection, as well as life-threatening severe forms of the disease.
- The vaccine has been in use for decades, so its effects on newborns are well understood.
- With adequate examination of the child, vaccination by newborns is easily tolerated.
- There is a sparing version of the vaccine (BZhTS-M) with half the concentration of mycobacteria, which is administered to weakened children.
Minuses
- The vaccine does not protect against infection with the tubercle bacillus.
- Because of its introduction, post-vaccination complications are possible.
Contraindications
The vaccine is not administered in such cases:
- The newborn weighs less than 2.5 kg (with a weight of 2 kg to 2.5 kg, BCG-M is indicated).
- The child has an acute illness or a chronic illness has worsened. Vaccination is not carried out for intrauterine infection, neurological problems, hemolytic disease and other acute pathologies.
- The baby has an immunodeficiency.
- Close relatives of the child had a generalized infection.
- The mother of the child was diagnosed with HIV.
- The child has a neoplasm.
- The Mantoux test gave a positive or questionable result.
- A keloid scar appeared at the site of BCG injection, or lymphadenitis developed as a result of the first injection of the vaccine.
Possible complications
First of all, all parents need to know that the reaction to the tuberculosis vaccination in the form of an abscess is not a complication. It is extremely rare after vaccination to develop:
- Cold abscess - appears if the drug gets under the skin, requires treatment from a surgeon.
- Ulcer formation at the injection site with a diameter of more than 1 cm - indicates a greater sensitivity of the child to the drug, it is treated locally.
- Lymphadenitis - develops when mycobacteria enter the lymph nodes, needs surgery if the lymph node enlargement exceeds 1 cm.
- Keloid scar - the skin at the injection site becomes red and swells, in this case, revaccination is not performed.
- Osteomyelitis - damage to bones by mycobacteria, occurs in one child out of 200 thousand vaccinated, is caused by immune disorders.
- Generalized BCG infection - develops in one baby in a million vaccinated, is associated with severe immunity disorders in the child.
The reasons for the emergence of complications during BCG vaccination are most often a decrease in immunity in a child or a poor-quality vaccine. Therefore, it is especially important to take into account the presence of contraindications to immunization.
There is no special preparation for this vaccination. It is only important to make sure that there are no contraindications for immunization, which is done by a neonatologist in a maternity hospital, a pediatrician in a polyclinic or a phthisiatrician in a tuberculosis dispensary.
Should you get vaccinated?
Many parents are alarmed by the fact that with universal vaccination, tuberculosis is still very common. They need to understand that BCG is not aimed at preventing infection with mycobacteria. However, this vaccine has been shown to be effective in reducing illness in young children.
Thanks to the introduction of BCG, cases of dissemination of tuberculous bacillus in the body, as well as tuberculous meningitis, have become rare. And since it is they who usually end in death in children under 2 years of age, the introduction of BCG is justified at an early age.
E. Komarovsky's opinion
A well-known pediatrician classifies tuberculosis as a very dangerous disease, which must be vaccinated against. He is sure that it is better to vaccinate the baby with weakened bacteria than to allow the child to meet with the active ones. And since there is such a risk almost everywhere - from the store to the bus, vaccinations are essential.
How is the injection done?
A disposable syringe is used for immunization. The vaccine is injected into the skin in the left shoulder, in the place between the middle and upper third of it. Often, the entire dose of BCG is administered in a single dose, but there is also a technique that provides for several injections at points located close to each other. The injection of the vaccine into muscle tissue or under the skin is not allowed. If it is not possible to get the vaccine in the shoulder, they choose another place in which the skin is quite thick (usually the thigh).
The skin on the shoulder is pulled and a needle is inserted, and then a small amount of the vaccine is released, checking to see if the needle is inside the skin. As a result of the injection, a flat white papule forms on the child's shoulder. Its diameter is up to 10 mm. After 15-20 minutes, this papule usually disappears.
At what age do you get vaccinated?
BCG is administered while in the hospital - most often on the third or fourth day of the child's life. The official terms for the introduction of BCG in the maternity hospital are considered 3-7 days after birth. If there are contraindications, the vaccination is performed immediately when it becomes possible.
How does it heal?
The reaction to BCG develops within four to six weeks after the injection, manifesting itself after 1-1.5 months to 4.5 months. At first, a change in skin color may appear at the injection site - it may darken, becoming purple, blue or even black. After that, an abscess appears in place of the changed skin. Gradually, it crusts and heals, and when the crust falls off, a small scar remains at the injection site.
In some children, a reddish blister containing fluid appears instead of an abscess. It also crusts and leaves a scar after tightening. If a baby has a pustule, it may burst. The discharge of pus from it and the formation of another abscess are normal variants of the reaction to BCG.
Why does a scar remain?
As a result of the development of a reaction to vaccination, a characteristic scar remains. Normally, its value is from 2 to 10 mm. A scar size greater than 5 mm is considered to be a sign of an adequate response to immunization.
If there is no trace of the injection
The presence of a scar helps to determine whether the child has previously received BCG. If there is no such trace, the vaccination should be introduced in the near future or wait for the periods of revaccination. If the child was vaccinated and the scar did not appear, this indicates the ineffectiveness of the immunization. This happens in 5-10% of children.
In addition, there is a certain percentage of people who are genetically immune to mycobacteria. They do not contract tuberculosis and have no reaction to BCG.
Compatibility with other vaccinations
No other vaccinations are given concurrently with BCG. Also, you should not vaccinate a child while a reaction to this vaccine is developing. At least 4-6 weeks should pass from the moment of BCG introduction to other vaccinations. That is why in the maternity hospital, the child is first vaccinated against hepatitis, and then BCG.
Revaccination
In addition to the first introduction of BCG in a maternity hospital in our country, such a vaccination can be given at 7 years old, and then at 14 years old. The reason for revaccination is a negative Mantoux test, as well as the presence of tuberculosis in people in contact with the child. During revaccination, the drug is also injected into the shoulder using an intradermal injection.
What if the child was not vaccinated at the hospital?
A previously unvaccinated child should be vaccinated as soon as his condition allows. Before the introduction of BCG, in this case, a Mantoux test is done and the vaccine is administered 3-14 days after the negative result of the test. If Mantoux gave a positive result, it is already useless to inject BCG. The Mantoux test is not performed if the baby is less than 2 months old - such babies can be administered BCG in the clinic immediately.
Vaccinations can be carried out in the clinic in the vaccination room, as well as in the tuberculosis dispensary. Usually, other vaccinations are not given in the vaccination room on the day of BCG administration. It is impossible to carry out manipulations in a regular treatment room, where blood is taken and injections are given. If there is an increased risk of a reaction to the vaccine, BCG is administered in a hospital. It is also legally allowed to vaccinate children at home and in specialized centers that have certificates.
What to do if side effects appear?
Suppuration at the injection site at the time when a reaction to the vaccine develops is normal, but the skin around the abscess should not be swollen and red. If the injection site is swollen, red, suppurating many times, or the swelling is widespread, it is important to see a doctor right away.
Also, the child's temperature may rise during the period of suppuration. Often, it is no higher than 37.5 degrees and is considered normal.
Tips
- The injection site should be protected from mechanical irritation - do not rub it, do not scratch, and so on. When bathing, you should not touch it with a washcloth.
- During the healing period of the abscess, the wound on the shoulder should not be smeared or sprinkled with anything. If pus comes out, you can cover the wound with a piece of clean gauze, which is changed frequently. It is forbidden to squeeze out the contents of the abscess.
Reviews
Parents' opinions about TB vaccination are very different. Someone does not doubt the need for the introduction of BCG, and someone is scared of possible complications and in thought whether it is worth loading the immune system of a newly born child. Parents who face post-vaccination complications in their children oppose vaccination in general. However, many parents carefully study all the information about BCG, preferring to protect their babies from tuberculosis with such a vaccine and sleep peacefully.
