Btszh spelling. BCG vaccination - composition, vaccination rules, reactions and complications

The main method of preventing tuberculosis in modern Russia is BCG vaccination. Purpose of vaccination- creating immunity to tuberculosis by forming a "small disease" with a favorable outcome.

Mass vaccination against tuberculosis is carried out at a risk of primary infection (RPI) of 0.1% or more. FIR \u003d number of children with a "turn" tuberculin test / number of children examined by tuberculin diagnostics x 100%

The FIR of the last decade in RUSSIA ranges from 1.5 to 2.0%, in young children it does not exceed 0.3-0.5%.

Formation of immunity against tuberculosis

It is possible to create anti-tuberculosis immunity only with the introduction of live Mycobacterium tuberculosis into the body. Mycobacteria of the BCG vaccine take root and multiply in the body of the vaccinated. In the first 2-4 weeks, the bacteria get used to the new conditions of existence - the incubation period. After 3-11 months, mycobacteria are sown from the organs of vaccinated animals in large quantities. When cellular immunity is formed, the number of seeded bacteria gradually decreases.

Important!!! Post-vaccination allergy in the form of a positive Mantoux test indicates the presence of post-vaccination immunity.

Post-vaccination anti-tuberculosis immunity persists for a long time, since

Mycobacteria are transformed into conditionally stable L-forms that can persist for a long time, maintaining avirulence and supporting immune responses;
As a result of the destruction of mycobacteria, bacterial antigens are released, which remain in the body for a long time and stimulate the immune system;
Long-term preservation of immunity without the presence of mycobacteria is evidence of immunological memory.

Domestic TB vaccines

Basic requirements for a vaccine anti-tuberculosis strain: specificity, immunogenicity, low reactogenicity, harmlessness, persistent hereditary apathogenicity.

Schedule. The incidence of tuberculous meningitis (abs. values) in the USSR after the introduction of vaccination

Storage and accounting of BCG vaccine

The vaccine should be stored at a temperature not exceeding 8°C. Vaccine should not be kept on the shelves of the refrigerator door. In the event of a power outage in the freezer compartment, you should have frozen refrigerant bags. When storing the drug in a domestic refrigerator, it is necessary to record the temperature daily.

The diluted vaccine should be protected from light and sunlight with a dark cap and can be stored at room temperature for no more than 2 hours.

Important!!! When storing the vaccine, even for a short time at a temperature of 22-25°C, the number of viable bacteria decreases by 2-5 times, which reduces the effectiveness of immunization and can lead to an increase in reactogenicity.

Unused vaccine is destroyed by boiling for 30 minutes, autoclaving at 126°C for 30 minutes or immersion in a disinfectant solution (5% chloramine solution) for 60 minutes.

Vaccination and revaccination of BCG and BCG-M

Vaccination against tuberculosis is carried out 1-3 days after birth with a vaccine or. Those not vaccinated at the maternity hospital are vaccinated in the clinic with a vaccine after the cancellation of contraindications: at the age of up to 2 months without a preliminary test, and at the age of over 2 months with a negative test (the interval between the test and vaccination is from 3 days to 2 weeks ).

Additions in accordance with the Order of the Ministry of Health and Social Development of the Russian Federation No. 673 of October 30, 2007

Vaccination of newborns is carried out with the BCG-M vaccine. The BCG vaccine is used only for vaccinating newborns in the constituent entities of the Russian Federation with incidence rates exceeding 80 per 100 thousand of the population and in the presence of tuberculosis patients in the environment of the newborn.

The first revaccination is carried out at 7 years, the second revaccination - at 14 years. Revaccination is carried out only with a vaccine, only for children with a negative test. The interval between revaccinations is at least 5 years.

Other vaccinations are possible 1 month after vaccination (revaccination) in the normal course of a local reaction. If there is a local post-vaccination complication, subsequent vaccinations should be postponed until a consultation with a TB specialist.

BCG vaccination algorithm

Vaccination of newborns in the maternity hospital is allowed in the children's ward in the presence of a doctor. Formation of styling for vaccination is carried out in a special room. On the day of vaccination, in order to avoid contamination, no other parenteral manipulations are performed on the newborn.

Preparation of documentation

Select forms 063 / from (026 / from) children aged 7 and 14 years with a negative test;
Compile lists to be immunized.

Vaccine preparation

Inspect the ampoule for compliance with the standard;
Open it according to the instructions;
Add the solvent along the wall of the ampoule, mix without forming bubbles;
Store the vaccine under a dark cap, no more than 2 hours after dilution.

Preparing the patient for vaccination

Medical examination, thermometry;
Registration of admission to vaccination in medical documentation;
Treatment of the vaccine injection area with an alcohol solution.

Administering a vaccine to a patient

Disposable, tuberculin syringes are used to administer the vaccine;
2 doses of vaccine (0.2 ml) are drawn into the syringe;
One dose (0.1 ml) is dropped into a sterile cotton swab;
The remaining dose of the vaccine is administered to the patient STRICTLY intradermally into the left shoulder at the border of the middle and upper thirds.

Vaccinations are registered in the following forms

"Exchange card" (form No. 113 / y);
"The history of the development of the newborn" (form No. 097 / y);
"Card of preventive vaccinations" (form No. 063 / y);
"History of the development of the child" (form No. 112 / y);
"Medical record of the child" (form No. 026 / y);
"Certificate of preventive vaccinations" (form No. 156 / y-93);
"Medical record of an outpatient" (form No. 025-87);
"Insert sheet for a teenager to the medical record of an outpatient" (form No. 025-1 / y).

Contraindications for vaccination and revaccination of BCG

Absolute contraindications for BCG vaccination

Primary immunodeficiency;
Generalized - infection detected in other children in the family.

Relative contraindications for BCG vaccination

Birth weight less than 2000g for vaccine and 2500g for vaccine;
Intrauterine infection;
Purulent-septic disease;
Hemolytic disease of the newborn medium-severe and severe forms;
Severe damage to the central nervous system;
Generalized skin lesions;
Acute diseases;
malignant diseases;
maternal infection.

Absolute contraindications for BCG revaccination

immunodeficiency diseases;
Complications of vaccination.

Relative contraindications for BCG revaccination

Acute infectious and non-infectious diseases;
Exacerbation of chronic diseases;
Allergic diseases in the acute stage;
Malignant neoplasms;
Radiation therapy and treatment with immunosuppressants;
Pregnancy.

Are not contraindications to vaccination (revaccination) BCG

Dysbacteriosis in the absence of clinical symptoms;
An increase in the shadow of the thymus gland on the radiograph;
Stable neurological conditions (Down's disease, cerebral palsy, perinatal encephalopathy, consequences of injuries or acute diseases, etc.);
Anemia is not severe of alimentary genesis;
Congenital malformations;
Topical steroid treatment;
Homeopathic treatment;
Maintenance therapy in the treatment of chronic diseases, including allergic diseases.

BCG vaccination of children with various pathologies

Acute diseases- Vaccination is possible 4 weeks after recovery.

If the newborn was in close contact with a sick mother before vaccination against tuberculosis (birth at home, etc.), vaccination is not carried out. The child is prescribed a course of preventive chemotherapy for 3 months, and only after that, with a negative test and the absence of clinical signs of the disease, they are vaccinated.

Relatives of a newborn who has not been vaccinated against tuberculosis should be examined (fluorography) in order to exclude tuberculosis from them.

Complications after BCG and BCG-M vaccine

Important!!! Parents of the child should be informed about the planned vaccination and the nature of the local vaccine reaction.

Causes of post-vaccination complications

Biological properties of the strain;
Large number of viable units in the vaccination dose;
Violations of the technique of intradermal administration of the vaccine;
Violations of the rules for the storage and transportation of the vaccine;
Violation of indications for vaccination.

1st category of complications - local skin lesions

Subcutaneous infiltrate- develops at the injection site. The size of the infiltrate is 15-30 mm or more, there may be ulceration in the center. May be accompanied by an increase in regional lymph nodes.

Subcutaneous cold abscesses(aseptic infiltrates, -ita) - a tumor-like formation of 10 mm or more without changes in the skin above it, fluctuation is determined in the center, ulceration is possible in case of spontaneous opening. It can be combined with an increase in axillary lymph nodes. Occurs 1-8 months after vaccination. The development of a cold abscess is associated with a violation of the technique of intradermal administration of the drug and the ingress of the vaccine under the skin.

ulcers(superficial and deep) - a defect in the skin and subcutaneous adipose tissue at the site of injection of the vaccine, from 10 to 30 mm in diameter, the edges are undermined, the infiltration around is weakly expressed, the bottom is covered with copious purulent discharge. Appear 3-4 weeks after vaccination.

Lymphadenitis(regional, often axillary, less often supraclavicular and subclavian) - an increase in lymph nodes up to 4 ("bean"), 5 ("hazelnut"), 6 ("walnut") sizes. The consistency is initially soft, then dense, palpation is painless, the skin above them is not changed or pink in color, may be accompanied by caseification with a breakthrough of caseous masses to the outside and the formation of a fistula with moderate or profuse purulent discharge. If post-vaccination lymphadenitis lasts for a long time, the child may develop symptoms of intoxication (periodic low subfebrile temperature, decreased appetite, stop or poor weight gain, etc.). Lymphadenitis appears after 2-3 months.

Calcification in the lymph node more than 10 mm in diameter is considered as a post-vaccination complication.

Category 2 complications - persistent and disseminated BCG infection without a lethal outcome

Ostites- damage to the skeletal system. Clinically, they proceed as bone disease, usually the disease is limited to one bone of the limb, sternum, collarbone, ribs, vertebrae, skull bones, and pelvis are less commonly affected. A weak local reaction is sometimes noted at the injection site. The criterion for suggesting a post-vaccination etiology of damage to the skeletal system is the age of the child from 6 months to 1 year and the limited focus of the lesion. The diagnosis is made on the basis of histological and bacteriological studies - sowing a vaccine strain from the affected organ.

Lymphadenitis generalized- two or more localizations. The clinical picture is the same as in case of regional lymphadenitis, however, the phenomena of intoxication develop more often and earlier.

Lupus erythematosus, allergic vasculitis and others are rare.

Category 3 complications - disseminated BCG infection with a fatal outcome in congenital immunodeficiency

Severe general disease with polymorphic clinical symptoms due to damage to various organs, mostly ends in death. At autopsy, the vaccine strain can be isolated. Among the factors contributing to its development include immunodeficiency states, in particular, deficiency of the T-cell link of immunity, chronic granulomatous disease.

4th category of complications - post-BCG syndrome that occurred shortly after BCG vaccination, mainly of an allergic nature (erythema nodosum, rashes, etc.), keloid

Keloid scar- can be of various sizes. It is formed at the site of a healed post-vaccination reaction and is a connective tissue tumor-like formation. It rises above the level of the skin, dense, sometimes cartilaginous, the surface is smooth, vitreous, color from pale pink to cyanotic and brown. Accompanied by a feeling of itching, pain is possible. More often they appear in revaccinated prepubescent girls and adolescents with an allergic mood of the body or in the case of a very high vaccination (in the area of the shoulder joint), which leads to irritation of the post-vaccination scar with clothing fabric. Usually post-vaccination keloids do not tend to grow. In some cases, their slow growth may begin, accompanied by pain in the form of tingling in the scar area with itching or burning sensation, a pink “corolla” appears around the keloid, and a vascular network appears in its thickness.

The rate of post-vaccination complications in Russia is 0.02% or 21.1 per 100 thousand vaccinated, of which 30.7 per 100 thousand vaccinated in the vaccinated, and 10.9 per 100 thousand vaccinated in the revaccinated.

Distribution of the frequency of complications by type:

Lymphadenitis - 0.01% (11.5 per 100 thousand vaccinated);
Cold abscesses - 0.0006% (5.9 per 100 thousand vaccinated);
Infiltrates - 0.0015% (1.5 per 100 thousand vaccinated);
Ulcers - 0.002% (1.7 per 100 thousand vaccinated);
Keloid scars - 0.004% (0.4 per 100 thousand vaccinated);
Osteitis - 0.00006% (0.06 per 100 thousand vaccinated).

Monitoring and registration of post-vaccination complications

Observation of the vaccinated and revaccinated is carried out by doctors and nurses of the general medical network 1, 3, 6, 12 months after vaccination - they evaluate the local vaccination reaction and the state of regional lymph nodes. The information is included in the medical records.

If you suspect post-vaccination complications, you must:

Refer the child for a consultation with a phthisiatrician;
Information about the nature of complications is recorded in accounting forms;
Inform the head of this medical institution about the identified complication;
Send an emergency notice (form No. 58/1) to the territorial center of the State Sanitary and Epidemiological Supervision;
Draw up a “Registration Card for a Patient with a Complication after Immunization with Tuberculosis Vaccine” and send a copy of it to the Republican Center for Complications of the Anti-TB Vaccine of the Ministry of Health of the Russian Federation at the Research Institute of Phthisiopulmonology, MMA named after I.I. THEM. Sechenov;
Report all cases of complications or inconsistencies in the physical properties of the tuberculosis vaccine to the L.A. Tarasevich and to the enterprise that manufactured the drug.

With the development of severe post-vaccination complications that led to the disability of the child, the state is obliged to pay the child a one-time allowance and a disability pension.

On the basis of 5 Federal Law of the Russian Federation No. 157 of July 17, 1998. "On Immunoprophylaxis of Infectious Diseases" citizens have the right to:

Free preventive vaccinations included in the national calendar of preventive vaccinations;
Free medical examination, and if necessary, medical examination before preventive vaccinations in public health institutions;
Free treatment in public health institutions in the event of post-vaccination complications.

Refusal of preventive vaccinations

When implementing immunization, citizens are obliged to:

comply with the instructions of medical workers;
confirm in writing the refusal of preventive vaccinations.

The fact of refusal to vaccinate, indicating the consequences of refusal to vaccinate, is recorded in the "History of the development of the newborn" (form No. 097 / y), "History of the development of the child" (form No. 112 / y), "Medical record of the child" (form No. 026 / y) and signed by the parents or the person replacing him, as well as the head of the medical institution and the district doctor.

If the relative of the child who refuses does not want to put his signature on the document. This is done by at least 2 health workers in his presence.

In the absence of preventive vaccinations, it is possible

temporary refusal to admit citizens to educational and health-improving institutions in the event of mass infectious diseases or the threat of epidemics;
refusal to hire citizens for work or removal of citizens from work, the performance of which is associated with a high risk of contracting infectious diseases.

The best way to protect against the disease today is BCG vaccination (translated from Latin - Bacillus Calmette-Guerin). Once in the human body, the tubercle bacillus remains in it forever, so the disease is considered one of the most difficult for treatment.

The drug used in this case consists of dead and live bacteria that cause the disease, and contributes to the rapid development of anti-tuberculosis immunity.

Cells for the manufacture of the vaccine are obtained from the tubercle bacillus of a cow, weakened to such a state that it is not capable of causing harm to the body. Accordingly, the vaccine is absolutely safe for health, and cannot provoke the development of the disease.

Photo 1. The injection is placed in the child's thigh: this happens when there are contraindications that do not allow an injection, as usual, in the forearm.

The drug is injected into the upper part of the shoulder, and in the presence of contraindications - into the thigh. The procedure is usually carried out in the hospital, on 3-7 day after the birth of the child.

Attention! BCG vaccine does not protect person from contracting tuberculosis, but prevents serious complications and the transition of the latent disease to open shape.

What should be the reaction of the body to BCG

The BCG drug provokes an allergic reaction in the body: T-lymphocytes accumulate under the skin, which begin to fight tuberculosis pathogens, which causes a corresponding reaction from the skin. The vaccine is injected strictly into the inner layers of the skin (in no case subcutaneously), after which a white flat papule with a diameter of about 10 mm, which is absorbed through 18-20 minutes- this means that the drug was administered correctly.

AT first days any changes in the skin at the injection site are not noticeable, but sometimes a slight reddening, thickening or inflammation of the skin can form - this is considered a normal variant. It is important to note that such reactions can continue for 2-3 days, after which the injection site (before the formation of a papule and a scar) in its appearance should not differ from the surrounding tissues.

When it appears

Approximately within a month after the injection (depending on the individual reaction), a small papule, which looks like a bubble with a slight suppuration.

This is a normal reaction and indicates that the vaccination was successful, the body "gets acquainted" with the pathogens and develops immunity.

In some cases, the formation of a papule and its healing is accompanied by severe itching, but it is strictly forbidden to comb it so as not to introduce an infection under the skin. Sometimes a person may experience a slight fever, but if the numbers on the thermometer do not rise above 37-38 , no need to worry.

Three months after vaccination, the papule becomes covered with crusts and heals, and in its place an even scar of white color appears, sometimes with a pink or reddish tinge. The size of the scar can be different, and depends on the individual characteristics of the organism and the quality of the formed immunity. The best option is a scar from 7 to 10 mm in diameter. Scar formation less than 4 mm indicates that vaccination has not achieved its goal and there is no anti-tuberculosis immunity.

Important! There are certain rules for caring for the injection site of the BCG vaccine - the resulting papule it is forbidden lubricate antiseptics, squeeze out of it pus, delete crusts or wrap tightly bandage.

Deviations from the norm: photo

The most common abnormality after BCG vaccination is the absence of any reaction. Absence papules and a scar at the injection site indicate that the vaccine was expired or the body did not respond to its introduction with the formation of anti-tuberculosis immunity. In this case, it is necessary to conduct a tuberculin test (Mantoux) and re-administer the vaccine.

Photo 2. Usually, after an injection, a papule is formed - a vesicle with suppuration. This is normal, a deviation from the norm is the absence of any reaction at all.

In some cases, a scar forms after vaccination, but then suddenly disappears - this indicates the disappearance of anti-tuberculosis immunity, and requires revaccination person. Approximately 2% people on the planet have innate immunity against tuberculosis, so they also do not form a scar - the presence of such immunity can also be determined using the Mantoux test.

Photo 3. The vaccination site may become very red. If this is not expressed too strongly, there is no reason to worry.

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Photo 4. Not too high a temperature in a child after BCG is normal, you do not need to call a doctor.

Other reactions from the skin and the whole body (severe redness, induration, temperature) occur due to the characteristic features of the human body or sensitivity to the drug, and, as a rule, do not require medical intervention. If they are too strong, a specialist consultation is necessary.

Reference! In some cases, a scar after the introduction of the BCG vaccine is not formed on the surface of the skin, but in the deep layers. Its presence can be determined by changing colors skin and small compaction.

What symptoms should cause anxiety after vaccination

Serious complications after an injection develop quite rarely - they are usually observed in people with lowered immunity or positive HIV status. Most often, these are abnormal reactions from the skin, but in isolated cases, pathologies can occur that threaten the health or even life of a person.

Ulcer at injection site. With individual sensitivity to the BCG vaccine, an ulcer may occur at the injection site, accompanied by severe itching.

If she has less than 1 cm in diameter, there is probably nothing to worry about, but the patient is advised to consult an infectious disease specialist.

cold abscess. The reason is a violation of the technique for administering the vaccine (the drug can only be administered intradermally, not subcutaneously). The complication develops after about 1-1.5 monthsafter vaccination and looks liketumorswith liquid content inside.

As a rule, it does not cause discomfort, but sometimes lymph nodes may increase in patients and ulcers on the skin may appear. Most often, cold abscesses open on their own through 2-3 years, but sometimes surgery is required (the abscess is opened and drained, after which the wound is sutured).

Lymphadenitis. An individual reaction of the body to the introduction of pathogenic microorganisms, which is characterized by an increase in lymph nodes, subclavian or supraclavicular. The patient needs to consult an infectious disease specialist and specific therapy.
Osteomyelitis. A dangerous disease that develops through several months or years(average one year) after injection. First, there is swelling of the tissues adjacent to the injection site, after which the joints of the hands are involved in the pathological process, then the lower limbs, ribs and collarbones. The patient does not experience severe discomfort - a slight increase in temperature and stiffness in the joints are possible.
Keloid scars. Develop after wrong introduction of the vaccine. Keloid scars begin to form one year after the vaccine is administered and do not differ in appearance from burn scars. Growing scars are considered the most dangerous - they look like bright purple formations, often accompanied by itching and pain. Therapy is aimed at inhibition or complete cessation of scar growth.
BCG infection. Develops exclusively in people with lowered immunity, and is manifested by inflammation around the injection site.

The most dangerous complications after BCG are osteomyelitis and BCG infection - they can lead to disability and even death, therefore, at the first symptoms of these diseases, you should consult a doctor as soon as possible. It should be noted that such complications occur in 1 case out of 100,000 therefore, TB vaccination is considered a relatively safe health procedure.

Attention! Any complication after BCG injection should be documented in the child's medical record and must be taken into account when revaccinating .

How to distinguish a normal reaction from a pathology

The reaction of the body to the introduction of the BCG vaccine is a sign that the body correctly "meets" the causative agents of tuberculosis and learns to deal with them. But since any vaccine can cause side effects, after the introduction of the BCG drug, you should carefully monitor the condition of the person, especially when it comes to infants.

The papule formed at the injection site should be small ( up to 1 cm in diameter), and the tissues around it look healthy, with no signs of inflammation or ulceration.

Normal skin color white, pink or reddish- bright red or brown indicates the development of complications or side effects.

In addition, specialist advice is necessary in cases where the papule does not heal longer. 3-5 months.

Fever, which may occur after the injection, continues no more than 3 days and is not accompanied by any additional symptoms (diarrhea, cough, pain) - otherwise, an increase in temperature indicates an infectious disease.

To date, BCG vaccination is considered optimal and most safe way to protect the population from tuberculosis. In rare cases, the drug can cause adverse reactions in the body, but strict monitoring of the condition and proper care of the injection site significantly reduces the risk of serious complications.

Useful video

Check out the video, which tells about the reaction to BCG, which it should be normal after vaccination.

The BCG vaccine is given to the child one of the first - even in the hospital. Deciphering the abbreviation BCG - Bacillus Calmette Guérin (Bacillus Calmette - Guérin). What is it, what is included in its composition, and why does it need to be done to a newborn baby at all?

Purpose of vaccination

The causative agents of tuberculosis are transmitted by airborne droplets, which means that it is very easy to pick them up. They are present in an inactive state in at least a quarter of the world's population, but only a tenth of them develop into a disease. This happens with a combination of adverse factors - they include stress, unsanitary conditions, improper or insufficient nutrition, bad habits, etc.

The death rate from tuberculosis is comparable only to that of HIV/AIDS. In general, the disease is considered the lot of socially disadvantaged segments of the population, but this does not mean that there are no exceptions.

BCG cannot completely prevent infection with tuberculosis bacterium, its goal is different - to significantly weaken the course of the disease if the child does get sick in the first years of life, and also to exclude the chance of contracting meningitis and other most dangerous forms of tuberculosis, which quickly lead to dangerous complications and death. exodus.

Vaccination procedure

BCG vaccination for newborns is given 3-7 days after their birth. If at this moment the baby has contraindications, vaccination is done after they disappear. Further, revaccination is provided, carried out at 7 and 14 years. In regions with a low prevalence of the disease, re-introduction of the vaccine is optional, in disadvantaged regions it is mandatory. Those places where there are more than 80 cases per 100 thousand of the population are considered unfavorable. Also, re-vaccination is mandatory if among the relatives and other environment of the baby there are patients in contact with him.

Where is the vaccination done? The drug is injected intradermally into the left shoulder approximately between the second and third of its third. Do not administer intramuscularly or subcutaneously. If for some reason it is impossible to vaccinate in this place, then it is done in another part of the body with a fairly thick layer of skin. Usually it is the thigh. The entire dose of the drug can be administered immediately in one place or in several adjacent points. There is no confirmed evidence that any of these options is more effective.

No other vaccinations can be administered either along with BCG, or for a month and a half, while a reaction to it develops and the wound heals. Therefore, this vaccine is usually given last in the hospital. Before it, vaccination against hepatitis is done, the reaction from which passes in 2-3 days, and after that there is a period of immunological rest until the child reaches the age of 3 months.

How does the vaccine react?

The body's response to a vaccine is not immediate. Within a month and a half, an abscess forms at the injection site, which heals quickly, becomes covered with a scab, and after it falls off, a small spot in the form of a depression remains on the skin. It allows you to understand whether the child was vaccinated, even if for some reason there is no documentary evidence of this.

The vaccination site should not be tightly bandaged. If the child tries to actively comb the shoulder, it is allowed to tie a loose gauze bandage. In the case when ichor or pus is actively released from the wound, it is covered with a clean napkin, which is changed regularly. The abscess is in no case lubricated with antiseptic agents. Also, you can’t actively rub it with a washcloth when bathing a baby or try to tear off the resulting crust before it falls off by itself. The healing of the abscess proceeds naturally.

The formation of a scar indicates that the BCG vaccination worked and the child received protection from severe forms of tuberculosis. In rare cases (1-2%), the scar does not form due to the baby's innate immunity to the disease. In other cases, this indicates the ineffectiveness of the vaccine and not developed immunity. You should not panic, on the recommendation of a doctor, the vaccine is given again or revaccination is expected at 7/14 years.

In the future, every year the so-called. Mantoux test (which, like vaccination, has contraindications) for the diagnosis of the disease and the presence of immunity to tuberculosis. Tuberculin protein is included in the intradermal mixture administered intradermally. A skin seal is formed at the injection site, which is measured after 3 days. The absence of a reaction indicates insufficient immunity, in which case revaccination is recommended ahead of time. A normal size (5-20 mm) indicates a good immunity of the child, and too large - a possible disease. In this case, a consultation with a phthisiatrician is required, after which the child is often sent for a chest x-ray.

Where is the vaccination done?

As already mentioned, vaccination against tuberculosis usually takes place in the maternity hospital. If for some reason it was not done there, then you should contact the children's clinic. There must be one or more vaccination rooms. If there are several of them, then BCG is given in one, and all other vaccinations in the rest. If there is only one room, then a separate day is allocated for vaccinating babies against tuberculosis, on which other vaccinations are not given. It is forbidden to put BCG in treatment rooms where intramuscular and intravenous injections are made, blood is taken for analysis, etc.

In addition to the polyclinic at the place of registration or residence, vaccinations against tuberculosis can be done at the tuberculosis dispensary and specialized centers (they must be licensed).

If the vaccination in a medical institution is done free of charge, since it is part of the services provided under the MHI policy, then for an additional fee you can call a doctor with all the necessary equipment and preparations for vaccination at home.

At least within 15-20 minutes after the introduction of the vaccine, you should not leave the medical facility. This time is usually enough for acute allergic reactions to manifest themselves. If they occur, doctors will immediately provide the necessary assistance.

Complications

In most children, the reaction to BCG proceeds normally. However, there are exceptions when the child does not feel very well, and there are also such reactions to the vaccine that should not be. In this case, in order to avoid complications, in no case should you self-medicate, you should immediately consult a doctor.

What is a normal reaction to a vaccine?

Immediately after the injection, the injection site may swell slightly, but this swelling subsides quickly (maximum within 1-2 days).
Redness after the injection, which should not extend very far down the arm.
Suppuration. The presence of a small abscess at the injection site is not a complication. That's the way it should be.
Itching at the injection site, the intensity of which depends on the individual characteristics of the baby's body. To prevent the child from combing the vaccine, it is hidden under clothing or a gauze bandage is made.
A short-term increase in temperature to 37.5–38 ° C during the formation of an abscess.

Abnormal reactions to vaccination:

swelling that does not subside for a long time at the injection site, as well as edema during the appearance and healing of the abscess;
severe redness during the development of the abscess (may be the result of infection in the wound);
high temperature for a long time.

There are complications that greatly affect the health of the baby and require serious treatment.

With the introduction of the drug not intradermally, but subcutaneously, there is a high probability of developing the so-called. cold abscess - inflammation requiring surgical intervention.
Ulcer at the injection site. It is the result of a child's hypersensitivity to the components of the vaccine. In this case, local treatment is carried out, and information about the baby's reaction to the drug must be entered in his medical records.
Inflammation of the lymph node. Occurs in the case of the spread of pathogenic bacteria from the vaccine through the circulatory system. With a significant increase in the size of the node, surgical treatment is necessary.
Keloid scar. It looks like a reddened area protruding above the skin at the injection site. When it occurs, keloid is not allowed to re-vaccinate at 7 and 14 years.
Generalized BCG infection. Leads to a complex defeat of all body systems and death. It is extremely rare (1 case per million vaccinated) and occurs only in case of serious problems with the immunity of the baby (for example, immunodeficiency).
Ostitis (tuberculosis of the bones). It is also very rare (on average 1 time per 200 thousand vaccinated).

Contraindications

Vaccination should be postponed if:

infectious diseases;
severe prematurity (in this case, BCG-M vaccination with half the pathogen content in the composition may be recommended);
hemolytic disease due to the incompatibility of the blood of the mother and child.

BCG vaccination is not performed at all under the following conditions:

immunodeficiency in a child and close relatives;
serious complications from vaccination in close relatives;
severe hereditary diseases;
serious birth injuries, including those with damage to the nervous system.

Contraindications for revaccination:

tuberculosis in the process or in history;
malignant tumors;
positive Mantoux test;
serious complications after the last vaccination.

The immune system of an adult can cope with many things. But the baby is at risk, children become infected more easily, and the disease is much more severe. And it is necessary to protect the baby from a deadly disease and its complications!

Judging by nutrition, you absolutely do not care about immunity and your body. You are very susceptible to diseases of the lungs and other organs! It's time to love yourself and start getting better. It is urgent to adjust your diet, to minimize fatty, floury, sweet and alcohol. Eat more vegetables and fruits, dairy products. Feed the body with the intake of vitamins, drink more water (precisely purified, mineral). Harden the body and reduce the amount of stress in life.

You are prone to lung diseases at an average level.

So far, it’s good, but if you don’t start taking care of it more carefully, then diseases of the lungs and other organs will not keep you waiting (if there were no prerequisites yet). And frequent colds, intestinal problems and other “charms” of life accompany weak immunity. You should think about your diet, minimize fatty, starchy foods, sweets and alcohol. Eat more vegetables and fruits, dairy products. To nourish the body by taking vitamins, do not forget that you need to drink plenty of water (purified, mineral). Harden your body, reduce the amount of stress in life, think more positively and your immune system will be strong for many years to come.

Congratulations! Keep it up!

You care about your nutrition, health and immune system. Keep up the good work and problems with the lungs and health in general will not bother you for many years to come. Don't forget that this is mainly due to the fact that you eat right and lead a healthy lifestyle. Eat the right and wholesome food (fruits, vegetables, dairy products), do not forget to drink plenty of purified water, harden your body, think positively. Just love yourself and your body, take care of it and it will definitely reciprocate.

Every newborn baby gets acquainted with the vaccine under the short name BCG (in the Latin abbreviation BCG, Bacillus Calmette-Guérin) in Russia in the first days after birth. Children during their stay in the maternity hospital (3-7 days), in the absence of indications for medical withdrawal and with the consent of the baby's parents, are given a tuberculosis vaccine, in other words, BCG. The reason for such early vaccination for children lies in the risk of contracting tuberculosis, a worldwide infectious disease transmitted by airborne droplets that affects the lungs and, under unfavorable circumstances, can lead to death.

Introduction of BCG: 5 facts about the vaccine

This vaccine is given intradermally into a superficial muscle in the upper arm called the deltoid muscle.
Vaccination against tuberculosis is administered only after the Mantoux reaction. The only exceptions are newborns who do not undergo a tuberculin test before BCG. From the age of six weeks, the Mantoux test before vaccination is a mandatory requirement.

Important! Everyone is familiar with the Mantoux reaction - the nurse “draws a button” on her hand, which must not be scratched and wet until the result is measured. A pronounced reaction to Mantoux is a contraindication to BCG vaccination.

As a preventive measure for tuberculosis, a child after the introduction of the first dose of the vaccine is given two more revaccinations in children - at primary school age (6-7 years) and at 14 years of age.
The vaccination against tuberculosis in children may subsequently affect the result of the Mantoux test, making it false positive; the reaction of the sample in this case is not informative. However, with a pronounced induration of the Mantoux test (˃12-15 mm), there is no doubt that Mycobacterium tuberculosis is either present in the body, or the patient has been in contact with infectious agents.
After complete healing, the drug leaves a cicatricial scar in the child. It serves as proof of the introduction of this vaccination.

Reactions to the BCG vaccine

The true negative effects associated with TB vaccination can occur in three cases:

the introduction of a vaccine in the presence of one or more contraindications in a child;
severe immunodeficiency in a child;
getting the drug under the skin, the wrong injection technique.

The true consequences of BCG vaccination in this case are understood as:

bone inflammation (bone tuberculosis);
keloid scars formed after pathological healing of vaccination in a child;
development of BCG infection in children (spread of mycobacteria from the components of the vaccine in the child's body).

If any of the above consequences of vaccination is revealed in a child, then revaccination of this vaccination will not be carried out; this requires constant monitoring of such children by a phthisiatrician and the prescribed anti-tuberculosis treatment.

Common side effects of BCG vaccination

The vaccination against tuberculosis in the vast majority of cases is tolerated without any consequences, there are no complaints about the introduction, the wound gradually heals, the redness subsides and a scar forms. It is absolutely normal if the baby does not have an active reaction to this vaccine. Normally, after the injection, the body temperature does not rise, the injection site does not bother. But sometimes wound healing in children is atypical, which causes concern in parents. Consider the most common complaints about drug reactions that occur 6-12 days after administration.

Festering wound from BCG

Moms describe it like this: the vaccine at first looked like a red and dense “button”, but then it became covered with a crust, from under which pus comes out. Suppuration of the apex is a normal reaction of the body to this vaccine. Redness of the injection site can also accompany the entire period of wound healing. This forms a characteristic dense scar. The only thing that can alert in this situation is the spread of redness beyond the vaccination.

Note! During the healing period, the wound from vaccination is open to various infections. Try not to leave the injection site open, dress your child in clean, sleeved clothing. In rare cases, the healing process is delayed, but if the wound does not fester for several weeks, but for several months, then a phthisiatrician's consultation is necessary.

Vaccination swollen / swollen

If immediately after the injection of the drug, the vaccination site has a somewhat swollen appearance, then there is no reason to worry. The swelling on the child's arm will disappear in the first three to four days after the injection. Then a grafting reaction occurs, the wound heals, a crust appears, possibly a slight suppuration with the formation of a scar. If the vaccine in children has severe swelling and there is no visible decrease in its size, you should show the cause of your concern to your doctor.

Enlarged lymph nodes after vaccination

Permissible enlargement of lymph nodes - up to 1 cm in size as a response of the body's immune system to a live vaccine. But if the increase reaches a large size, surgery may be required due to the possible entry of mycobacteria into the lymph nodes of the drug, which is fraught with complications.

Scar formation slowly

The wound after the injection is tightened and scarred within 2-4 months. This long process does not depend on external causes, so it remains only to wait and observe the purity of the baby's body. The injection site should not be rubbed hard with a washcloth / soap / rubbed with a towel, when bathing the baby, just avoid this area.

On a note! The vaccine does not need to be treated with anything, there is no need to seal it before bathing, smear it with wound-healing creams, and even more so burn it with alcohol-containing substances. The healing process does not require intervention and manipulation by the parents.

What is BCG: decoding, history of the term and purpose of vaccination
BCG M - vaccination to prevent the development of tuberculosis
The composition of the BCG vaccine: all about the production and components of the drug