The difference between bczh and. Tuberculosis vaccination schedule

From the first hours of life, the baby gets acquainted with the mandatory routine vaccination. In the maternity hospital, all babies are vaccinated against tuberculosis - BCG. This vaccine has protective properties against a dangerous virus and is designed to protect the baby from a deadly disease that can be fatal. What is BCG vaccination for newborns, and why is it given in the maternity hospital? Let's consider in detail in the article.

Importance of TB vaccine

Tuberculosis is considered a dangerous disease, the treatment of which is very difficult and not always successful. Almost all people on earth are carriers of the Koch tubercle bacillus, and it has not yet been possible to eliminate these bacteria from the human population. What is the BCG vaccine for? A vaccinated child can get tuberculosis, however, with proper care, the disease will not cause life-threatening and health-threatening pathological consequences:

bone tuberculosis;
inflammation of the cerebral cortex - meningitis.

The child's body tolerates this disease very hard, the disease develops instantly and can lead to the death of the baby. A vaccinated child suffers the disease in a more benign form, and does not suffer from the severe consequences of the disease.

Vaccination Method

When and where is BCG given to newborns, and is there a temperature after vaccination? Are there any contraindications to vaccinating against tuberculosis, or are all babies vaccinated at the maternity hospital in a row? BCG vaccination is carried out immediately after an injection from hepatitis B, a virus dangerous for babies. An injection is made into the deltoid muscle of the left shoulder, and subsequently a scar remains for life. This is a normal reaction to the vaccine, and a vaccinated person can be identified by the mark.

When, on what day from birth, do babies get vaccinated at the maternity hospital? Usually, babies are vaccinated before being discharged home so that they are protected from possible infection when they enter the human environment. Why are babies vaccinated against tuberculosis after a hepatitis vaccine? Because the hepatitis vaccine adapts faster to the baby's body, and it takes two months to develop immunity against tuberculosis.

When does a child get revaccinated against tuberculosis? According to the national calendar, children are revaccinated at the age of seven. Between the age of one month and the age of seven, testing is regularly carried out using mantoux - a test for infection with Koch's sticks.

Complications

When does a vaccine reaction occur, and how does it manifest itself? The reaction to the vaccine does not appear in the hospital, but after discharge home. A small swelling and abscess appear at the puncture site. Sometimes this abscess is covered with a crust, which is forbidden to disturb or treat with brilliant green! The wound will heal for several months, and this is also a normal reaction to the vaccine. In this state, the baby's temperature can rise to 37.5 ° C.

Approximately six months after vaccination in the maternity hospital, a small scar with a radius of one centimeter forms at the puncture site. By the age of one, this scar will finally form and acquire its permanent shape. This is all considered a normal response of the body to the introduction of the vaccine.

Is fever considered normal after BCG vaccination? In most children, the temperature may rise, and this is not considered a pathology. The temperature can "jump" up to 38C. But if the thermometer scale shows a higher degree, you should give an antipyretic and seek medical help.

Important! If the temperature persists for a long time, the baby needs to be monitored.

Pathological complications include such a reaction of the body as:

the formation of a keloid growing scar;
the formation of an ulcer and abscess at the puncture site;
uncontrolled spread of the inflammatory process over a large area up to limb edema;
enlarged lymph nodes;
osteomyelitis - damage to the bones.

Important! If there is any suspicion of a pathology of the child, it is urgent to show the pediatrician.

Withdrawal from vaccination

In what cases are babies not vaccinated at the maternity hospital and vaccination is postponed? In some cases, there is a temporary ban on TB vaccination and contraindications. These include:

absolute prematurity;
pathologies of an infectious nature;
hemolytic disease.

There are also absolute contraindications to the introduction of BCG:

CNS lesions with major complications;
severe congenital pathologies of a hereditary nature;
severe immunodeficiency;
congenital fermentopathy;
severe complications to the vaccine in relatives of the newborn.

Contraindications to the introduction of BCG are prescribed if the mother has an HIV infection. Also, contraindications to immunization are caused by local neoplasms in a newborn.

For premature babies weighing less than two and a half kilograms, vaccination is postponed until later and it is carried out after being discharged home, in stationary conditions. Babies are given a lightweight formula - BCG-M. It contains bacteria in a lower concentration than in the main vaccination.

Outcome

The TB vaccine is essential to building immunity to the dangerous, deadly disease. The reaction of the body to the administration of the drug, as a rule, does not lead to pathological consequences. The temperature may rise when a small abscess appears at the vaccination site, however, this condition does not apply to pathology. Temporary contraindications to immunization are not a reason for parents to worry: soon the baby will be vaccinated, and everything will be fine.

What vaccinations do children need at 7 years old? Description of ADSM, BCG and Mantoux.
BCG M - vaccination to prevent the development of tuberculosis
Bathing a child after BCG vaccination: is it possible or not

From the moment of birth, a little man is prone to infections. Among them, tuberculosis is a dangerous infectious disease caused by Mycobacterium tuberculosis. It can rapidly develop and affect the human body.

BCG vaccination is one of the first in life. It helps to develop immunity against this insidious disease. It is vital to carefully examine the child and properly carry out the vaccination procedure.

BCG vaccination is included in the national calendar of preventive vaccinations

BCG: how does the abbreviation stand for and what is this vaccine for?

What is BCG? The name comes from the Latin abbreviation BCG - bacillus Calmette–Guerin, written in Cyrillic. In Russian, the decoding sounds like "Bacillus Calmette-Guerin", after the names of the French scientists who created the vaccine in 1920. Vaccination is necessary to prevent the disease at an early age.

BCG does not protect the body from infection with the causative agent of tuberculosis. But in 70% of cases, it does not allow the latent course of the disease to turn into an obvious one and almost completely prevents death and the development of severe forms of the disease (tuberculosis of the lungs, bones and joints, tuberculous meningitis).

The composition of the vaccine used

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The composition of the vaccine includes live attenuated Mycobacterium tuberculosis, obtained by inoculation in a nutrient medium. Their content is negligible and cannot cause infection, but it is enough to form immunity to the disease. There are two types of vaccine with different dose content of the drug:
0.05 mg (BCG);
0.025 mg (BCG-M).

BCG-M is given to weakened and premature babies in the maternity hospital or later, in hospitals, when for various reasons the schedule was violated and the baby was not vaccinated on time. The composition of the vaccine is standard for all manufacturers. It is believed that domestic is preferable, since it is more recent (no need to go through customs procedures) and pediatricians have gained a lot of experience working with it.

Vaccination schedule for newborns and older children
How many times do you get vaccinated? In Russia, there is a National Calendar of preventive vaccinations for children. In accordance with it, BCG vaccination is done 3 times:
3-7 days after birth in the hospital;
at 6-7 years (according to indications);
at 13-14 years old (according to indications).

Since the country has developed an acute situation with tuberculosis infection, primary vaccination is prescribed in the maternity hospital in the absence of contraindications for all newborns. The child is under the supervision of doctors, which allows you to track and eliminate the negative reactions of a small organism. In countries with a higher standard of living, only newborns who are at risk are vaccinated.
The parents of the baby may refuse to be vaccinated, but in doing so they will expose the child to a high degree of risk of infection.
TB doctors strongly recommend getting vaccinated in the first year of life. If there were contraindications and the terms were violated for some reason, pediatricians, together with immunologists, draw up a vaccination schedule for each child individually.
Starting from the age of two months, before vaccination, it is required to perform a subcutaneous Mantoux test for the presence of antibodies in the blood to the causative agent of the disease. If the reaction is negative, then the vaccine is given. Positive means that the child is already infected and should be carefully examined. Vaccination is delayed until results are available.
At the age of 7 and 14, children who have a Mantoux test showed a negative reaction are revaccinated (we recommend reading:). This means that immunity was not developed during previous vaccinations.
It is not allowed to administer BCG together with other drugs. You can not put other vaccines on the same day as BCG and for 4-6 weeks after, while the reaction is taking place. Prior to vaccination against tuberculosis according to the Calendar, on the first day of life, a newborn is vaccinated against hepatitis B.
How is the vaccination procedure?
Before vaccination (revaccination), the doctor informs parents about the upcoming immunization and the consequences of vaccination, after which they must confirm in writing their consent to the BCG procedure. Vaccination (revaccination) is carried out by a doctor and a specially trained nurse. They must first study the instructions for use of the drug and the labeling on the package and ampoule.

Where are they vaccinated? The vaccine in the amount of 1 dose is injected intradermally into the outer side of the left shoulder, on the line that mentally separates the upper and middle thirds. If there is no possibility of setting BCG in the shoulder, then it is usually placed in the thigh. To avoid complications, you can not administer the drug subcutaneously or intramuscularly.
The injection is made with a new disposable tuberculin syringe with a volume of 0.2 ml. Before the introduction of the skin area is slightly stretched. To check the correct entry of the needle, a small amount of vaccine is first injected. After making sure that it is in the proper position, the remainder of the drug is administered.
A flat white papule 7-9 mm in size appears at the injection site, which will resolve within 20 minutes.
On the day of vaccination (revaccination), the doctor makes a detailed record of the vaccination in the child's medical record, indicating the method of administration, dose of the drug, series, number, expiration date of the BCG vaccine, manufacturer's name and other information. In the maternity hospital, this information is entered in the discharge epicrisis of the newborn.
Contraindications for vaccination at different ages
Factors that prohibit primary BCG vaccination for newborns are:
the weight of the baby is less than 2.5 kg (2-4 degrees of prematurity);
the presence of acute diseases or deterioration in chronic pathologies (the procedure is postponed until recovery);
incompatibility of the blood of mother and baby (hemolytic disease);
intrauterine purulent-septic infection;
severe pathologies of the nervous system;
skin diseases;
oncological diseases, including leukemia, lymphoma (we recommend reading:);
therapy with drugs that suppress the immune system;
the state of immunodeficiency in mother and child;
tuberculosis of close relatives.

BCG has its own contraindications for conducting (low weight and diseases of the newborn), which the doctor must take into account when prescribing vaccination
Re-vaccination is carried out after a complete examination, during which contraindications are identified that can cause subsequent complications. Reasons for stopping revaccination include:
acute or chronic disease in the period of exacerbation;
state of immunodeficiency;
allergy;
oncology;
a positive response to the Mantoux reaction (we recommend reading:);
complications caused by primary vaccination;
tuberculosis or contact with sick people;
taking certain medications.

Normal response to vaccination

This is what the injection site may look like in the absence of complications
What reaction is considered normal? The correct course of the process is characterized by the following features:
6–8 weeks after the vaccination, a reaction begins - a small seal forms at the injection site, which rises above the skin and looks like a mosquito bite.
Then an abscess appears with a head filled with a yellowish liquid. After 1.5-2 months, it bursts.
In place of the abscess, a crust appears, which disappears several times within 4-5 weeks and reappears, resulting in a scar 2-10 mm in size.
Sometimes this process takes longer. This means that the child has developed immunity against the disease.

If during the reaction the BCG vaccination turned red, inflamed, slightly swollen, festering, body temperature ranges from 36.4 to 38 degrees, then do not worry. These manifestations are normal. Why is this happening? The body fights pathogenic bacteria.
The injection site must not be treated with iodine, brilliant green or ointments, so as not to kill the still weak strain and not upset the natural course of the reaction to the vaccine.
During the period of active healing, the wound itches. In case of severe itching, it should be isolated with clothing or a bandage.
Possible complications and side effects
If the drug was injected subcutaneously, and not intradermally, as required by the rules, then after 1-1.5 months a hard pea forms under the externally cyanotic skin - suppuration (cold abscess). This complication is treated surgically.
If there is a strong sensitivity to the drug, an ulcer appears at the vaccination site. In diameter, its dimensions can reach 10 mm or more. The doctor prescribes local treatment and enters information about the increased susceptibility into the child's medical record.
Tuberculosis bacilli contained in BCG can cause inflammation of the lymph nodes. If the diameter of the lymph node exceeds 10 mm, then surgical intervention will be required.
Occasionally, a keloid scar forms at the injection site, the skin turns red and swells. In the presence of such a reaction, revaccination at the age of 7 years is contraindicated.
It is extremely rare (1 case per million) in children to have a generalized BCG infection. This is a complication caused by immunodeficiency problems, which is detected at the age of 5-6 months in the form of pustules on the skin, lesions of the lymph nodes, then organs (liver, kidneys, and others).
Very rarely (1 case per two hundred thousand vaccinated) osteitis develops - bone tuberculosis that occurs in the period from six months to two years after vaccination. The reason lies in the pathologies of the immune system.

Very often, mild complications occur during BCG - the vaccination site does not heal for a long time
Features of care after vaccination
How to feed a child? Can you bathe him? Are outdoor walks and games allowed? After BCG vaccination, it is required to carefully monitor the condition of the injection site and not interfere with the natural process of scar formation.
The baby is allowed to bathe, but you should not rub the vaccination area, you can gently rinse it with water from your palm. The diet remains the same so as not to cause allergic reactions. You can not take antihistamines - the body must defeat mycobacteria on its own. You can walk with the baby.
The consequences of vaccination may be a short-term increase in body temperature, loose stools, vomiting. If the child is healthy, at a temperature of over 38.5 degrees in the evening, he should be given Paracetamol. For children prone to febrile convulsions, start lowering from 37.5 degrees or give an antipyretic until the temperature appears. The neurologist will instruct the parents on how to behave when seizures occur.

If after BCG a high temperature has risen and does not go astray, the baby must be shown to the pediatrician
At high temperatures, bathing a child and walking with him is not recommended, so as not to aggravate his condition. Symptoms that require medical attention:
during the reaction, the skin at the injection site became very swollen, reddened, edema formed, the process spreads over a large area (may be the result of infection of the wound);
high temperature does not subside for a long time.

All the pros and cons of BCG
Tuberculosis is an insidious and dangerous disease that is difficult to cure. The risk of infection is great. Thanks to compulsory treatment, the incidence of tuberculosis in the Soviet Union was at a low level. Currently, parents have the right to refuse to vaccinate their children.

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 who are 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 100,000 vaccinated, of which 30.7 per 100,000 vaccinated are vaccinated, and 10.9 per 100,000 vaccinated are 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 lump-sum 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 BCG vaccine is the first vaccine that all babies face before they leave. Despite the fact that it is mandatory for everyone, many parents refuse it because they read somewhere on the Internet or heard from friends about the terrible consequences for the child. But because of this, it is impossible to immediately abandon this one, because it is not in vain that everyone does it. First you need to learn everything about BCG, its decoding, what it is in general and in what cases it is needed. This is what we will talk about in this article.

BCG transcript

BCG is the Latin abbreviation of BCG, read in Cyrillic, which means bacillus Calmette–Guerin, which means “Bacillus Calmette-Guerin” in Russian.

This special anti-tuberculosis vaccine is prepared from a strain of tuberculosis bacillus, but weakened. The source is a sick cow. The vaccine does not pose a danger to humans, as it is grown in an artificial environment.

What is she doing:

prevents the development of the most dangerous form of tuberculosis - open;
significantly reduces the chances of a heavy stroke;
Thanks to vaccination, the percentage of sick children has significantly decreased.

Given such positive factors, BCG vaccination in newborns is carried out on the third or fourth day of life, if no contraindications have been identified. If necessary, it is done two more times, but more on that later.

Important! The vaccine is diluted exclusively with the attached solvent, otherwise it will lose its effectiveness.

BCG-m

BCG-m is the same vaccine as the regular one, only it contains half the dose of microbacteria. She is made premature or contraindications to the full version have been established.

It is also vaccinated with children older than one week in the event that for some reason this was not done before.

Babies under one year old who live in an area with a very high prevalence of tuberculosis all the time.
Toddlers and children studying at school because of the high chances of contracting this dangerous disease due to individual reasons.
Adults, when they are constantly in contact with patients with a resistant form of tuberculosis.

When to get vaccinated: vaccination schedule

BCG vaccination is mandatory in all CIS countries, as these countries are in a zone of high prevalence of tuberculosis, so parents should be aware of when it is done.

From what age?

The first vaccination is done even within the walls of the maternity hospital under the careful guidance of doctors, and in case of any negative reactions, they are immediately eliminated.

Important! Parents have every right to refuse vaccination if they feel it is not necessary.

How many times?

The vaccination schedule is as follows:

3-7 days from birth;
7 years from birth;
14 years from birth.

At the age of 7 and 14, not everyone is vaccinated against tuberculosis.

First, children are vaccinated and all children at school face this.

Based on its results, a decision is made on revaccination.

If the diameter of the papule turned out to be larger than required, then the child is at risk and he is sent to do BCG again.

Did you know? According to the WHO, about one third of the world's population is infected with the bacterium tuberculosis, but only in a small part of them the disease begins to progress and develop.

How and where is the injection given

The standard injection site is the outer part of the upper arm of the left arm. The vaccine is injected only into the skin, and subcutaneous and intramuscular injections are prohibited.

It happens that it is impossible to make an injection in the shoulder, then they choose a place on the body that has the same thick skin.

Contraindications

BCG vaccination should not be done if:

prematurity (baby weighs less than 2500 g);
the presence of severe (in this case, the injection will be done when the child recovers);
intrauterine infection;
purulent-septic diseases;
acute;
skin lesions;
malignant neoplasms;
primary immunodeficiency;
radiation therapy;
the presence in the child's family of patients with tuberculosis;
taking immunosuppressants;
maternal HIV infection.

Revaccination is not carried out with:

acute diseases of an infectious and non-infectious nature;
severe;
immunodeficiency;
positive or questionable Mantoux reaction;
malignant blood diseases and neoplasms;
radiation therapy;
taking immunosuppressants;
tuberculosis;
complicated reactions to past vaccinations;
contact with tuberculosis.

Important! The doctor must clarify the presence of the above contraindications, otherwise the occurrence of deviations from the norm and complications is not excluded.

Reaction and possible complications: how the vaccination proceeds

BCG vaccination can cause a certain reaction in a particular child, and therefore parents must be aware of how it proceeds and what it can be from the norm.

After the vaccination, the baby has a characteristic injection mark with a diameter of about 1 cm of white color. After a few months, it disappears and a scar appears instead.
But it happens that after the injection some additional reactions may occur, but which are also the norm:

the area around the injection turned red and inflamed;
pus and abscess form at the injection site;
rise in body temperature to 38 ° (such a reaction is rare, but if it does occur, you should immediately go to the hospital).

All these reactions are normal, the child's body fights the infection and develops immunity to it. Sometimes there is no reaction to the injection. This means that the desired effect of the vaccine is not achieved.

Important! If your child does not have a reaction to the BCG vaccine, this does not mean that your child has tuberculosis.

Most likely, your child's body is simply not yet ready to develop a protective barrier against tubercle bacillus. In such cases, the vaccination is carried out again.

What you should be afraid of is the complications that may appear due to doctors ignoring the presence of contraindications.

They may be as follows:

inflammation of the lymph nodes (indicates that the vaccine has entered the lymph nodes, surgery is likely to be required);
too large area of suppuration (with weak immunity);
osteomyelitis (poor vaccine quality);
cold abscess (begins 1-1.5 months after injection due to subcutaneous injection of the vaccine);
an ulcer with a diameter greater than 10 mm (appears in children sensitive to the components of the vaccine, is treated locally);
keloid scar;
general BCG infection;
osteitis (bone tuberculosis; a serious complication that occurs after 0.5-2 years due to impaired functioning of the immune system).

Many parents change their minds about a vaccine just when faced with a list of possible complications.

However, do not forget that such things can only arise due to the incompetence of the doctors who vaccinate.

Therefore, it is worthwhile to find out in advance about the condition of your child, talk with the doctor who will vaccinate and find out all about the vaccine that will be administered.

If you are well aware of the upcoming procedure, then the risk of complications will be minimal.

BCG vaccine: pros and cons

Let's summarize and consider all the pros and cons of BCG. To begin with, we list the clear advantages of the procedure:

minimizes the chances of contracting tuberculosis;
if a person does become infected, then the disease will be mild with a minimum of consequences;
excludes death at;
the injection site does not require special care, it just does not need to be touched once again.

But despite these significant advantages, this vaccine has many opponents and there are certain reasons for this:

the appearance of severe complications due to a violation of the injection technology, poor quality of the vaccine itself, or unidentified contraindications;
the area where the injection was given can take a very long time to heal;
the trace of the vaccine remains forever.

OK it's all over Now. Now you know everything about the BCG vaccination, why and from what it is needed. Before making a decision, talk with experts and study in detail all the features of this vaccine. We hope that our article helped you make the right choice. Health to you and your children!

Throughout the existence of mankind, it has constantly faced a huge number of epidemics that could claim millions of lives. Of course, some diseases have remained only memories, but even today there is enough that can destroy a person. It was for this purpose that a variety of vaccines were invented, which are mandatory and are quite capable of protecting a person from a particular disease.

Tuberculosis and BCG - an excursion into history

One of the most common and old diseases is tuberculosis. It was because of him that a huge number of people around the world died in the 19th century. In those days, tuberculosis was called consumption and absolutely everyone suffered from it, regardless of their status in the state or age. Today, nothing has changed and many people still face this serious disease.

Tuberculosis is transmitted by airborne droplets. Initially, the development of the virus in the body remains invisible, but after a short time, the disease began to threaten the life and health of a sick person. First of all, human lungs, bone tissue, joints, and so on suffered. If we talk about newborn children, then tuberculosis is accompanied by anemia or dystrophy, in especially severe cases it affects the brain and tuberculous meningitis. It is in such cases that you need to act immediately, because in just a few weeks the disease can kill a weak creature.

Today, modern medicine allows many people to avoid this disease by vaccination, which is done with a child as soon as he is born. The tuberculosis vaccine or BCG was invented about 100 years ago in France. Initially, the vaccine caused a lot of complications and after many years and attempts at improvement, today we have a completely safe medicine for the prevention of tuberculosis.

BCG vaccination for a newborn baby

A newborn child is vaccinated immediately after birth, while he is still in the hospital - for about 3-7 days. If for some reason this vaccination was not done in the maternity hospital, then absolutely all doctors without exception recommend doing it in the clinic. This vaccination is mandatory, but according to the legislation of our country, parents can refuse it in writing. When they do this, they must clearly understand that tuberculosis is a very dangerous disease, especially when it comes to newborns and still defenseless children. Vaccination can reduce the risk of contracting tuberculosis by several times.

Of course, at the same time, doctors say that the vaccine does not give a 100% guarantee that in the future the child will not get TB. But you need to understand that the body already has antibodies to this disease, and therefore, in cases of illness, it will be able to quickly start fighting it. The vaccine is administered exclusively subcutaneously in the left shoulder of the child. The vaccine contains weak, semi-living tuberculosis pathogens. Of course, they are not able to cause infections, but they help to develop antibodies. If the child is completely healthy and full-term, then he is given the BCG vaccine. If he is premature, has health problems and is weakened, then doctors use a weakened BCG-M vaccine. Immunity to tuberculosis will be formed during the first year of life and persist for 5-7 years.

If the child is healthy, then he reacts normally to the vaccine, and at about 2-3 months of life, a small seal forms at the injection site, which looks like a mosquito bite. At six months, the seal will turn into a small neat scar, which will be fully formed by the end of the first year of life.

Contraindications for BCG vaccination and possible complications

BCG refers to mandatory vaccinations that are given to a child immediately after birth and which can develop immunity to such a dangerous disease as tuberculosis. Of course, BCG vaccination, like everyone else, is possible only if the child is completely healthy and does not have certain contraindications. Otherwise, not only will you not get the expected result from the vaccine, but you will also have serious complications. As a rule, the harm from vaccination in case of non-compliance with the rules is insignificant, but still quite often you can find a more complex reaction of the body to the vaccine.

To date, there are several contraindications to BCG vaccination, which doctors divide into absolute and relative. The absolute contraindications include the following:

the child has congenital or acquired diseases of the immune system;
there is congenital fermentopathy or severe diseases that are inherited, damage to the central nervous system in severe form;
you can not be vaccinated when relatives had complications after it;
if the child has been diagnosed with tuberculosis.

Relative contraindications doctors include these items:

infectious diseases of varying degrees of complexity;
skin diseases;
the newborn is diagnosed with hemolytic disease;
the child has a high degree of prematurity and a very weak body, low weight.

Complications that may occur after BCG vaccination

The most serious complication after this vaccination can be attributed directly to the infection of the child. Of course, such cases can be found quite rarely, but still they should not be ruled out. They can arise due to incorrect diagnosis of contraindications and the selection of children for vaccination. Also, the result of improper selection of newborns can be serious problems with the immune system. In some cases, you can observe a very rapid development of the inflammatory process in the bone tissues of the child (osteitis). Of course, such cases can also be classified as rare. As a rule, if complications appear in a newborn after BCG vaccination, they are minor and disappear quite soon without the intervention of doctors. These include:

The infiltrate (vaccination injection site) increases significantly in size and may even be expressed.
The infiltrate is formed under the skin - if the infiltrate is formed under the skin, then it will feel like a small ball. This occurs if the vaccine is injected too deeply. If you notice the formation of a subcutaneous infiltrate in a child, you should immediately consult a doctor, because it may break through and then the infection will very quickly enter the child's blood.
The infection can spread to the lymph nodes. Then they can significantly increase in size and get very sick. In some cases, the infection breaks out, forming a fistula - a channel through which pus comes out.
Very rarely in a newborn, but more often in an older child, a keloid can form: an overgrowth of a scar.

Therefore, after your child has been vaccinated with BCG, you need to carefully monitor his behavior and health. If you notice any changes in the behavior of the child or in his well-being, you should immediately consult a doctor to clarify the circumstances. As a rule, if complications are detected quite early, then they can be quickly eliminated and this will not affect the health of your child in any way.

Also, if you have thoughts to refuse vaccination, then in this case, remember how dangerous tuberculosis is, and the BCG vaccination is quite capable of protecting your baby from this disease.