What the BCG vaccine is from - indications and contraindications

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Tuberculosis is an infectious disease caused by mycobacteria, called Koch's stick. The disease affects the lungs, less often other organs are exposed to the disease. Effective prophylaxis of tuberculosis - timely passage of medical examinations and vaccination of children. Consider the main provisions regarding the introduction of the vaccine, when the BCG vaccine is given, how it proceeds, what are the consequences, so that everyone can weigh the pros and cons of such vaccination.


Contents:
  • vaccine composition
  • Indications
  • vaccination rules
  • reaction to the vaccine
  • suppuration or abscess
  • Redness
  • temperature
  • Swelling
  • Inflammation
  • Itching
  • Next vaccination is not
  • Contraindications
  • Possible complications
  • Compatibility with other drugs

vaccine composition

TB vaccine developedin 1923 two French scientists Kelmett and Geren - Bacillum Calmette Guerin - BCG.

The lyophilizate( soft-dried substance) for the suspension consists of live mycobacteria( weakened live bovine tubercle bacillus) and sodium glutamate. The vaccine does not contain antibiotics and preservatives.

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Indications


BCG is a mandatory vaccine, thanks to which the body develops immunity against tuberculosis. It is shown:

  • Children aged 3-5 days from birth who are constantly in areas with a high prevalence of tuberculosis. Usually it is done in the hospital.
  • Newborns and school children who are at increased risk of tuberculosis infection, provided they live in areas with a low prevalence of this disease.
  • Staff who work with patients with tuberculosis-resistant, multi-drug resistant.

Children in case the BCG vaccine has been contraindicated, sparing primary immunization - BCG-M vaccination is used.

BCG-M vaccine is made:

  • in the maternity home of premature newborns 1 day before discharge( for children born weighing 2000 grams or more and gaining initial weight by this time);
  • for children before discharge from a medical hospital( for children born to the weight of 2300 grams or more and previously treated in a hospital);
  • in the children's polyclinic, if the inoculation in the hospital was postponed for medical contraindications;
  • for children born in regions with a satisfactory epidemiological situation regarding tuberculosis.

Parents can refuse BCG vaccination to both a newborn and a child of school age, but it should be noted that no one is immune from this insidious disease, especially a defenseless baby.

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Vaccination rules

Vaccination is usually performed in the hospital. Healthy children are vaccinated for 3-7 days from birth. If the vaccine has been postponed, it can be obtained in a pediatric outpatient clinic in a specially designated office, at a tuberculosis clinic or at a specialized vaccination center.

Vaccination is mandatory after the child is examined by a pediatrician. The temperature is always measured, medical contraindications are taken into account, and anamnesis is studied.

The basic rules for the introduction of the vaccine include the use of strictly disposable syringes with the correct technique for administering the vaccine to prevent possible complications. When the needle is inserted, the skin is stretched and the vaccine is injected. After injection on the injection site, a small papule of whitish color with a diameter of up to 1 centimeter is formed. Within half an hour she disappears.


The vaccine is administered intracutaneously( not allowed intramuscular or subcutaneous injection) to the outside of the left shoulder between the upper and middle part. If there are reasons why it is not possible to introduce the vaccine into the shoulder, it is inserted into the hip.

If the child is not given the vaccine during the newborn period, then the BCG-M vaccine is used( the vaccine is only given after the Mantoux pre-test).

Children 7 and 14 years of age are revaccinated( with a negative Mantoux test result).

During the time that the vaccination reaction takes place, it is necessary to pay special attention to the place of injection: protect from any damage, do not rub, do not tear off the crusts formed, squeeze out the contents, do not smear with any medical means, in a word, do not interfere with the development of the vaccination reaction.

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Response to

vaccine BCG is a delayed type vaccine, which means that the response to the vaccine does not develop immediately, but after some time after injection. Usually this vaccination is well tolerated.

After 4-6 weeks at the injection site, a reaction occurs in the form of an infiltrate( accumulation of cellular elements with lymph and blood in the cells), then a papule( a kind of rash), after a pustule( a rash develops as a result of a purulent process), andulcer with a diameter of 5-10 millimeters. The subsequent reverse development takes from 2 to 3 months or more.

The most common reactions to vaccine administration are as follows:

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Suppuration or abscess

This need not be feared, this is the norm. You can not treat the pustule with any antiseptic. The abscess can pass and in its place a new one is formed. He can heal up to four and a half months. If the pus freely leaves the wound, you can simply cover it with a clean cloth and periodically change it to a new one.

If there is redness around the abscess, swelling, swelling, then you should consult a doctor, as it can talk about infection.

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Redness

Do not worry if the place of BCG vaccination turns red, as this is a normal reaction. Redness can persist for a year, but it should not shift to surrounding tissues.

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Temperature

Increase in temperature after vaccination indicates the reaction of the body to the introduced bacteria. If the temperature is high and lasts more than 3 days, you should consult a doctor.

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Swelling of

If the swelling of BCG remains on the vaccine site for more than 3 days, this indicates the need for medical examination. Normally, if the site of the injection is indistinguishable from the surrounding tissues before the development of vaccination reactions begins.

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Inflammation of

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Puffiness and inflammation passing to the shoulder - a signal of immediate treatment in the clinic.

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Itching

Vaccination is accompanied by an active healing process and tissue regeneration, which naturally causes a slight itch, a feeling of discomfort. It is important to ensure that the child does not comb the place of grafting, this will help the gloves.

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Vaccination trace missing

About 90-95% of the vaccines vaccinated at the injection site are forming a trace from the graft in the form of a superficial tender hem in the size up to 10 mm in diameter. If the hem was not formed, this indicates inefficiency of the vaccination, the vaccine was introduced incorrectly and immunity to tuberculosis was not formed. In this case, it is necessary to put the vaccine once again after a Mantoux test, or wait for a revaccination at the age of 7 years.

The absence of a trace can also speak of such a rare phenomenon as innate resistance to mycobacteria. Such people have no risk of getting tuberculosis.

During revaccination, the local response appears after 1-2 weeks.

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Contraindications

Administration of the vaccine is contraindicated in the following cases:

  • Birth of a child before the term premature( with weight less than 2500 grams);
  • Presence of intrauterine hypotrophy;
  • Exacerbation of chronic diseases;
  • The presence of acute diseases( purulent-septic diseases, intrauterine infection, severe lesions of the nervous system with severe neurological symptoms, widespread skin lesions, hemolytic disease and the like);
  • Malignant neoplasms, primary immunodeficiency status;
  • Revealed generalized BCG infection in the family in other children;HIV in the mother.
In case there are contraindications listed above, children are given BCG-M vaccine.

Revaccination is contraindicated in the following cases:

  • Acute diseases( non-infectious and infectious), exacerbation of chronic diseases. The vaccine is given only one month after the onset of remission or recovery.
  • Malignant neoplasms, blood diseases, immunodeficiency states.
  • Infection with mycobacteria in case of transferred tuberculosis.
  • With a positive reaction to the Mantoux test or, if there is a doubtful result.
  • Complications caused by previous vaccination with BCG.
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Possible complications of

To post-vaccination complications are:

  • Cold abscess is an accumulation of pus on a small areaskin without redness, fever and pain( 50.8% probability after vaccination and 33.0% after revaccination).When the vaccine penetrates the skin, as a result of a violation of the regulated technique of administration.
  • Lymphadenitis is an inflammation of the lymph nodes( a probability of 71.4% after vaccination in the hospital).
  • The emergence of infiltrates.
  • The appearance of a keloid scar is a crimson or cyanotic color, as a result of excessive tissue overgrowth.

Less common complications are:

  • BCG infections in the form of otitis media, lupus erythematosus and the like;
  • allergies - ring-shaped granuloma, erythema nodosum, rash and the like.

Even more rarely, with the present inherent immunodeficiency, generalized BCG lesions may occur and osteitis - these are very serious complications.

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Compatibility with other drugs

No other preventive vaccinations are given on the day of vaccination or revaccination. It is necessary to observe the interval between vaccinations not less than a month before and after. The only exception is the hepatitis B vaccine.

  • Apr 24, 2018
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