BCG and BCG-M - vaccination against tuberculosis. Tuberculosis trace in art. Vaccine injection site

The prevalence of tuberculosis in many countries around the world and severe course this infectious disease require effective protection healthy children. First of all, this applies to babies in their first year of life, who still have weak immunity. Therefore, BCG vaccination is given to newborns already in the maternity hospital, and revaccination is done at seven years of age.

The causative agent of tuberculosis, mycobacterium or Koch bacillus (M.tuberculosis), can enter the body of a newborn in different ways: with inhaled air, upon contact with objects of the patient, or even in utero (the pathogen penetrates the placenta into the fetus). Before the first symptoms appear incubation period can last from four to 14 or more weeks. Should newborns be vaccinated with BCG? Necessarily. Immunize everyone healthy babies born on time.

Vaccine composition

Parents should know the name of the tuberculosis vaccine for children and take into account its features. The name of the vaccine in Russia is written in Cyrillic letters - “BCG”. But in the original it is designated in Latin letters - BCG (Bacillus Calmette-Guerin). The bacillus is named after the microbiologist Calmette and the veterinarian Guerin. These scientists worked for 13 years to create an extract from several weakened strains of mycobacteria (Micobacteria bovis), which is the causative agent of tuberculosis in large cattle. The BCG vaccine is produced from these strains.

Currently, the drug is produced in many countries: France, Denmark, Japan and others. The vaccine has been used for about 100 years. Many manufactured drugs include three main strains of mycobacteria out of four:

• "Pasterovsky 1173 P2" (France);
• "Danish 1331" (Denmark);
• "Glaxo 1077";
• "Tokyo 172" (Japan).

In Russia, two versions of the vaccine are used:

• BCG - recommended for healthy newborns (one dose);
• BCG-m - prescribed to weakened and premature children (1/2 dose).

Rarely (2%) a baby may have congenital hereditary resistance to mycobacteria. Such children do not get tuberculosis.

The importance of BCG vaccination

Already a few days after birth, the medical staff plans to vaccinate the child with BCG. Parents have a reasonable question about why newborn children are vaccinated with BCG? The pediatrician must explain that it needs to be done for the baby, because in Russia it is possible to become infected with tuberculosis in many places.

According to statistics, about 65-70% of children preschool age are infected with Mycobacterium tuberculosis. But thanks preventive vaccination BCG, rarely do any babies get it. When a vaccine is administered, antibodies are produced that protect the child, even if the pathogen enters his body.

In many underdeveloped countries, tuberculosis is frequent illness. Taking into account the increase in migration processes in last years, vaccination against tuberculosis is becoming especially relevant.

Frequently parenting questions

Many mothers, especially first-time mothers, are interested in answers to the following questions.

• When to get vaccinated. A newborn baby is vaccinated against tuberculosis, if he is born on time and is healthy, three to four days after birth.
• Where is the vaccination given? The vaccine is injected intradermally into the shoulder of the newborn. Healthy children are given one dose of the drug. Babies usually tolerate it well. Sometimes there may be redness at the injection site; this is a normal reaction.
• When to repeat vaccination. Repeated vaccination (re-vaccination), according to the recommended interval, is carried out at the age of seven.

The vaccination schedule for newborns can be found in the table.

Table - BCG immunization schedule

A tuberculin test (Mantoux test) is required before immunization for all children except newborns.

Who should not undergo BCG?

WHO and the Russian Ministry of Health have published a list of contraindications to BCG vaccination for certain categories of children. Namely:

• low birth weight;
• birth injury;
• HIV in the mother;
• presence of a tumor;
• hemolytic jaundice;
• pathology of the nervous system;
• lymphadenitis.

After reaching normal weight or recovery from injury or infection, the child will most likely receive a gentle BCG vaccination (1/2 dose). Before vaccination, you should consult your pediatrician and get his recommendations. It is important to know that no other vaccinations should be given at the same time as BCG.

How is vaccination carried out?

In Russia, all healthy newborns are vaccinated free of charge. In addition, vaccination can be done at home. For this purpose, a special team of doctors visits your home. This service is paid. The procedure itself is carried out in four steps.

1. According to the instructions, the drug solution is drawn into a special disposable tuberculin syringe (0.2 ml).
2. Before injection, 0.1 ml of solution is released from the syringe.
3. Injection site on outside The shoulder of a newborn (or a child during revaccination) is treated with alcohol and dried.
4. Lightly stretching the skin inside shoulder, 0.1 ml of the drug is injected intradermally (one dose).

At proper vaccination A small papule (7-8 mm) appears, which resolves within half an hour.

The vaccination must be done in a separate treatment room at the clinic. If in medical institution There is only one treatment room, then they draw up a schedule that indicates days only for BCG vaccination.

How long does the vaccine last, and what is its effectiveness? Vaccination against tuberculosis in newborns activates the synthesis of antibodies to mycobacteria, but immunity will not be “lifelong.” The period of stable immunity against tuberculosis is six to seven years. Therefore, children at the age of seven are vaccinated again (re-vaccination) and sometimes the procedure is repeated at 14 years of age. Complications after vaccination are very rare.

Abscess at the injection site: normal or not

After the injection, the reaction to the vaccine occurs only after a month and a half. Parents should be informed in advance about the progress of tuberculosis vaccination in newborns. The appearance of a papule and then an abscess at the injection site should not be scary. This normal reaction for immunization.

Healing of the abscess usually lasts from two to four months. Extremely rare, some children may have low-grade fever(37.2-37.6°C), as a result of suppuration and intoxication. In this case, the child must be given drinks to improve the removal of toxins from the body.

You should also follow rational mode day, monitor body hygiene. You can bathe and wet the abscess, but do not steam it with hot water or use washcloths. You should know that treating an abscess with alcohol and antibacterial drugs no need. Over time it will heal and a small scar will appear. This is how all purulent wounds usually heal.

If a child has a negative reaction to vaccination and there is no trace (scar), this indicates ineffective vaccination. When the Mantoux test is negative, as is the reaction to the vaccine, then you need to vaccinate again. Or carry out revaccination at seven years of age, according to the vaccination schedule.

What are the possible complications?

Complications after BCG vaccination in a child are very rare. But if they appear side effects, then you should consult a doctor. Complications usually occur in children with weakened immune systems. The consequences of vaccination can be local and general.

• Lymphadenitis. This type of complication (inflammation of the lymph node) is typical for children with a deficient immune system. Mycobacteria from the vaccination site enter the lymph node, which becomes inflamed. When the value inflamed lymph node
• reaches 10 mm or more, surgical treatment may be required.
• Osteomyelitis. The reason is the introduction of a low-quality vaccine or a violation of the vaccination procedure.
• Abscess. Occurs at the site of vaccine administration if it was administered subcutaneously rather than intradermally. Ulcer formation. When an abscess turns into an ulcer measuring 10 mm or more, a special local treatment
• . The cause may be hypersensitivity to the drug or poor hygiene, resulting in an infection. Formation of a keloid scar.
• A hyperemic and hypertrophied scar forms at the vaccination site. Such a child is not given BCG again at the age of seven. Tuberculosis of bone.
• May develop with severe immune system deficiency one to two years after vaccination. This happens very rarely, according to statistics the probability is 1:200,000. Generalized infection. Occurs as a complication when there is severe violations

immune system. Occurs in one in a million children.

Contraindications for re-vaccination

• Revaccination according to the vaccination schedule is carried out for a child at seven years of age. However, for some children it is canceled for the following reasons:
• infections;
• allergy;
• immune system disorders;
• hemoblastoses;
• tumors;
• tuberculosis;
• positive or questionable Mantoux reaction;
• complications of vaccination (lymphadenitis);

taking immunosuppressants or radiation therapy.

Do I need to get vaccinated? The advantages of BCG vaccination are that the child will be protected from serious illness tuberculosis, which sometimes develops into. Even if infected, a vaccinated child experiences a mild form of the disease and does not experience such severe complications as meningitis or disseminated tuberculosis, which are almost always fatal.

IN medical literature You can find many reviews about the benefits or harms of vaccinations. Reviews about BCG vaccination for newborns are also contradictory. Therefore, it is imperative to consult a pediatrician about the baby’s health condition and be prepared for the period of development of immunity, when an abscess forms at the injection site, which is the norm. Rarely occurring consequences after vaccination are minor disadvantages compared to the danger of contracting tuberculosis, a serious disease often accompanied by complications.

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In the planned schedule for vaccination of children, one of the first and mandatory ones is vaccination against tuberculosis. This is not surprising, because the mortality rate from the infection is very high, and the number of infected people is steadily growing every year. The disease carrier can be found anywhere: in mall, public transport and other crowded places. It is almost impossible to avoid contact with the pathogen, so immunization remains the most effective method of prevention.

General information

The vaccine against tuberculosis is a culture of the cow's tuberculosis bacillus, which is weakened and has practically lost its virulence for humans. When such bacilli enter the body, they do not cause disease, but stimulate the production of antibodies.
The vaccine is called BCG (Bacillus Chalmette - Gerent, or BCG), in honor of the scientists who managed to create the first vaccine.
Artificial immunization is a preventative measure and does not completely protect against the disease. More effective way protection for this moment does not exist.
Vaccination against tuberculosis allows you to:

• Significantly reduce the number of diseases among children
• Hinders development severe forms illness (meningitis, disseminated tuberculosis).

In Russia, according to the vaccination calendar, BCG is given to children three times:

• Newborns (in the first week of life)
• At 7 years old
• At 14 years old.

First BCG vaccination

Vaccination of a child against tuberculosis begins in the first year of the baby’s life. BCG vaccination, if there are no contraindications, is given to newborns in the maternity hospital. At the request of the parents, vaccination can be postponed to a later date. late date, but doctors recommend vaccinating the baby in the first days of life. Such measures allow the child to avoid infection immediately after birth and prevent the development of severe forms of the disease, which in almost 100% of cases in children under five years of age are fatal.

Vaccination against tuberculosis is absolutely contraindicated when the baby is diagnosed with immunodeficiency or malignant neoplasms. In addition, there are a number of temporary contraindications, in the presence of which newborns are not vaccinated in the first days:

• Body weight less than 2 kg (for premature babies)
• Severe birth trauma
• Any acute infection
• Skin diseases
• Purulent-septic ailments
• Infant jaundice.

If the vaccination was not given in the maternity hospital, then after eliminating contraindications, vaccination can be carried out at the clinic at the place of residence. Children under two months of age do not require preparation before BCG.
When a child is more than two months old, a Mantoux test must be done before vaccination. Only a negative test reaction will allow immunization.

You cannot give other vaccinations together with BCG! After the introduction of the tuberculosis vaccine, at least 1-1.5 months should pass before the next vaccination.

Children's reaction to vaccination

When administered correctly and vaccination rules are followed, tuberculosis vaccination is well tolerated by newborns and does not cause complications. It is done subcutaneously in the upper third of the left shoulder. The first couple of days after immunization, children may have a fever, but if it does not exceed 38C, there is no cause for concern.
Typically, a reaction to the vaccine begins to develop 30-45 days after injection. On the spot administration of BCG a tubercle with liquid inside appears, reminiscent of a mosquito bite. Some children develop suppuration, which is also normal. By the fourth month, the bubble bursts and a crust forms in its place. After another month, a small scar forms, which indicates the formation of antibodies to pathogenic microbes.
All this time there is no need to change the baby’s usual lifestyle. The shoulder can be wetted with water, and the injection site does not need to be treated.
Reactions within normal limits include:

• Redness in the injection area
• BCG abscess and suppuration
• Inflammation and swelling of the vaccination site
• Desire to scratch and rub top part shoulder

It is impossible to say exactly how long the reaction to the BCG vaccination will last in each specific case and when a scar will form. In children, all changes must be monitored by a local pediatrician. It is the doctor who will be able to distinguish the normal response of the body from the pathological process.
Most BCG complications (90%) are recorded in children with persistently decreased immunity. The remaining 10% is due to poor-quality vaccine or errors during drug administration.
Possible complications after immunization:

• Cold abscess. Occurs when the drug is administered subcutaneously (incorrectly) after 30-40 days. Treated surgically.
• Extensive ulcer at the injection site. Appears in children with hypersensitivity to the components of the vaccine. The ulcer exceeds 1 cm in diameter. Treatment is local, symptomatic.
• Lymphadenitis. Inflammatory process develops when bacteria enter the lymph nodes. In some cases, surgery is required.
• Bone tuberculosis (Osteitis). Usually develops in the second year after the vaccine is administered. Signals about problems in the child’s immune system. It is extremely rare.
• Keloid scar. Skin reaction to the vaccine, which is a bright red protrusion of the skin at the injection site.

If a child, after vaccination, does not have a trace at the site of vaccine administration, then immunity to the tuberculosis pathogen has not formed. According to statistics, the vaccine does not work in 5-10% of cases. In the first year of a child’s life, you can repeat the injection (re-vaccination), after having done the Mantoux test. But there is no need to rush; the next routine immunization is carried out at age 7.

Revaccination

In Russia, BCG vaccination is repeated for children aged 7 and 14 years. Revaccination is possible only with a negative Mantoux test. After 14 years of age, as a rule, immunization against tuberculosis is not carried out. This is due to the fact that the second revaccination protects a person for 10-15 years, and possibly more. long term. Everything is individual, and depends on how long antibodies to tuberculosis pathogens remain in a person’s blood.
Adults are vaccinated against tuberculosis before the age of 30. Typically, revaccination is carried out between the ages of 23-29 years.
Required conditions:

• Negative Mantoux test
• No contraindications.

BCG vaccination after 30 years is rarely done, at the request of the patient, due to objective necessity– the person was not vaccinated in childhood or for epidemic reasons.
Main contraindications for vaccination in adults:

• History of tuberculosis
• Severe skin diseases
• Tendency to allergies
• Epilepsy
• Stroke
• Serious heart disease
• Diabetes
• Complications after vaccination in the first year of life
• Malignant neoplasms
• Cirrhosis of the liver
• Pancreatitis.

Before vaccination, consultation with a TB doctor is required! Only a qualified specialist can make a decision about vaccination.

Becomes topical issue about total control over compliance preventive measures , the main one of which is timely vaccination.

If for one reason or another it was not done in childhood, or if there is a need for revaccination according to indications, It is advisable to administer BCG to adults.

BCG vaccination for adults - main points

It is a generally accepted fact that the tuberculosis epidemic has captured not only our country, but also states former USSR. This was facilitated by the absence of the BCG vaccine in some countries for several years, the “anti-vaccination campaign” that followed it (entirely invented and introduced to the masses by journalists), as well as the imperfection of the preventive measures carried out among the adult population.

Many people do not suspect that they have tuberculosis, and continue to remain socially active: going to work, school, riding public transport, putting others at risk of infection.

Why do adults need a tuberculosis vaccine?

Due to the prevalence of tuberculosis, the issue of total control over compliance with preventive measures, the main of which is timely vaccination, becomes relevant.

In the case of tuberculosis, this is the BCG vaccination, which is given in childhood, and medical documentation Data on the immunoprophylaxis performed is saved.

Considering the issue regarding preventive vaccinations It is specifically for the adult population (in relation to tuberculosis) that it is necessary to note that no special difficulties arise (provided that people over 18 years of age are considered adults).

The reason is very simple - at a time when this age category it was necessary to get vaccinated, there were practically no interruptions in compliance with the vaccination schedule (and especially with such an important vaccination), except for serious reasons accompanying pathologies medical exemptions were made. However, you still have to face situations where an adult is not vaccinated against tuberculosis, and in that case, he needs to be vaccinated with BCG. There are very few actual contraindications to this, so unvaccinated people should undergo immunoprophylaxis.

Indications and contraindications for BCG in adults

Leading immunologists and phthisiatricians recommend that adults under the age of 30-35 be vaccinated against tuberculosis, which is due to the characteristics of the formation of immune defense. However, this approach is not true for everyone - there is a list of cases in which additional vaccination against tuberculosis is indicated in mandatory(except for situations with serious medical contraindications):

Patients who do not have any information about vaccination. Unfortunately, the majority of such people are a phenomenon was a consequence of imperfect organization health systems, because all the information that was in medical documents in a person, before the age of 18, it is lost in the vast majority of cases. Thus BCG should be administered to all adults, but in fact this does not happen, since the population pays very little attention to immunoprophylaxis.

If the lack of data in the medical documentation regarding the administration of the anti-tuberculosis vaccine becomes the reason for revaccination, then this is most likely due to the need to undergo medical commission before hiring. One more point is relevant - vaccination data is very difficult to falsify, since information about the series and number of the administered vaccine, as well as its packaging, is added to the record of the fact of its implementation.

Constant contact with socially disadvantaged segments of the population. Most likely it's a certain way associated with character labor activity person. For example, on duty have to come into contact with sick people open and closed form tuberculosis or just with big amount people daily(teachers, workers medical field, sellers, drivers). These categories of the population, even after BCG was carried out in childhood according to all the rules and all information was preserved, will still need to be revaccinated with BCG and carry out the Mantoux test (in order to detect morbidity);

Lack of BCG vaccination childhood for one reason or another.

Photo 1. The remaining trace of a vaccination that was given in childhood. They bet on outside left shoulder. The injection is performed intradermally between the upper and middle third of the shoulder.

In this situation, it is necessary to consider the possibility of vaccinating an adult, given his current condition, since it is possible that the reason for the medical withdrawal will be relevant at the time of the need for BCG in adulthood.

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In what situations should an adult not undergo BCG in any case?

If one of the following conditions is diagnosed, vaccination against tuberculosis is out of the question:

• A positive Mantoux test (a trace of more than 10 mm) indicates that the person is suffering from tuberculosis at the time of the test. Taking into account the fact that, at its core, the BCG vaccine is an inactivated live pathogen, its administration will only aggravate the situation, with high probability leading to a clinical manifestation. Also, the option of a hyperergic Mantoux reaction cannot be excluded - an indicator allergic process;
• Previous history of tuberculosis regardless of its form;
• Mantoux test turn;
• Doubtful Mantoux test(sample diameter 2 - 4 mm);
• Skin diseases(eczema, neurodermatitis, psoriasis);
• Oncological diseases;
• Autoimmune processes;
• Generalized allergic and pseudoallergic reactions;
• Severe cardiac pathology, including acute heart attack myocardium, endocarditis and pericarditis;
• Epilepsy;
• The presence of a keloid scar after a previous BCG;
• Complications after other vaccinations;

In any case, even if the person is sick chronic pathology, which is not included in this list, to him it is necessary to consult with a phthisiatrician and immunologist regarding the possibility of BCG vaccination. It is necessary to emphasize that this live vaccine, the likelihood of a complication after which is an order of magnitude higher.

Frequency of BCG vaccination in adults

Anyway, Tuberculosis vaccination for adultsbefore35 yearsonly one can be made. Regardless of whether this person has been vaccinated against tuberculosis before or not.

This feature was identified by immunologists associated with the peculiarities of the formation of specific protective body reactions, implemented in response to the introduction of the BCG vaccine.

Taking into account the fact that this vaccine is a live inactivated vaccine, the recommendations given should be strictly adhered to. A single vaccination for an adult will be sufficient to form reliable immunity against this infection.

How is an adult prepared for BCG vaccination?

Before deciding to immunize a patient, it is necessary to perform a Mantoux test with 2 TU. This will determine the state of immunity person (specific) in relation to tuberculosis - in the case if it will be positive test, then this is a true indicator of the disease or the transferred process(V the latter case a false positive sample cannot be excluded).

Upon receipt negative result Mantoux reactions The vaccination can be done no earlier than three days later. Evaluate the result Mantoux reaction should only be in 5 days, and therefore it is recommended to carry out the procedure By standard scheme :

1. Monday— carrying out the Mantoux reaction;
2. Friday— assessing the Mantoux reaction;
3. Next Monday— carrying out the BCG reaction;

BCG vaccination can be carried out later, but at the same time it is necessary to understand that from the moment the result is assessed tuberculin test(Mantoux) and more than 14 days must pass before BCG administration.

One more thing needs to be mentioned important point. Immediately before the vaccine is administered, it will be necessary for the doctor to comprehensive inspection patient, measure body temperature, pulse and respiratory rate.

Lifestyle adjustments before BCG vaccination

Here the most important will reduce body sensitization as much as possible(saturation with allergens), and also exclude drug influence on the immune system. For this purpose recommended:

1. At least three days before vaccination exclude from the diet fruits and vegetables colored red and yellow colors (the most allergenic pigments);
2. If you are taking any medications(primarily this concerns hormone therapy) temporarily suspend it. This decision can only be made after consultation with the attending physician who is guiding the patient on this issue;
3. Avoid the consumption of all synthetic products with dyes, as well as alcohol.
4. Strict desensitizing diet(boiled lean meat, porridge, whole grain bread).

The same recommendations will be valid after vaccination - their compliance is even more important than before it due to the fact that the body’s immune response to the introduced pathogen, which is still virulent, is carried out.
After the vaccine is administered, it should not be soaked for a week to avoid getting a false negative result.

What should the vaccination mark look like?

In that case, if everything went well and the patient did not give allergic reaction, did not turn out to be sick with tuberculosis or another serious disease, then the trace left after the administration of the BCG vaccine, has the appearance of a small flat papule, 0.5 - 1 cm in diameter.

This papule should appear directly at the injection site, she is white in color and visible on the skin for 15 - 30 minutes, after which it goes away on its own, and no traces remain after it. This is what a tuberculosis vaccination should look like when done correctly.

After 4 - 6 weeks during the first injection and in the first week after revaccination, a spot appears at the injection site, and after that an infiltrate (a section of tissue increased density, which is increased in volume). Wherein the diameter of the papule should not be more than 5-10 mm. After this, a bubble appears (its diameter is also within 10 mm) with transparent contents, which will become cloudy after some time. Then a crust appears.

After 5-6 months in most patients a delicate surface scar measuring 3-10 mm remains, which takes on its final form in about a year. The appearance of a scar indicates that vaccination has taken place (in other words, it indicates a history of local cutaneous tuberculosis) and that the body has developed a narrow-profile defense against Mycobacterium tuberculosis.

Important point - do not treat the vaccine site with iodine or other antiseptics, and also wet the area or rub it with a washcloth.

It is possible that the size of the infiltrate will be larger than expected (more than 10 mm). It is also sometimes noted that either a bubble did not appear at the site of vaccine administration, but after 6 months a scar appears. Or enlarged lymph nodes can be felt in axillary area. All these are indications for consultation with a phthisiatrician, since it is possible pathological process.

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Is BCG necessary for adults without exception?

First of all, the person himself needs immunity. The patient is interested in having this vaccination, and if he remembers that He was vaccinated against tuberculosis as a child, then the issue of vaccination can be postponed and Do not think about any vaccinations at the age of thirty.

If a person does not and did not have any serious illnesses, such as lupus erythematosus or tuberculosis, and he cannot remember the fact of undergoing BCG, then he should not undergo BCG again. Repeated revaccination will only need to be done strict indications, which were listed above.

Where can I get the BCG vaccination?

You can only get vaccinated against tuberculosis in public medical institutions. This is explained by the fact that the BCG vaccine belongs to live vaccines, and therefore it requires special conditions for transportation and storage, which owners of private offices are simply unable to provide.

So, if you see offers about the possibility of BCG vaccination privately, it is better not to go there, due to the fact that the quality of the vaccine will be very questionable.
Go to your local clinic and undergo immunoprophylaxis dangerous disease —You will be examined and, if necessary, will be sent for additional tests.

Important point! Be sure to ask for documentary evidence of the fact that the vaccine was administered to you, since it is for the sake of this paper that very often the employer sends its employees to carry out this procedure.

Useful video

What is tuberculosis. Vaccination against tuberculosis, Mantoux and Diaskintest.

conclusions

BCG is a live vaccine against tuberculosis (it includes an inactivated but still viable pathogen). Has very great importance, since now there is a real epidemic of tuberculosis and nothing protects the human body better than timely vaccination against this disease.

In that case, if for one reason or another it was not done in childhood, or there is a need for revaccination according to indications, it is advisable to carry out BCG Vaccination for adults under 30 years of age.

Also possible Tuberculosis vaccination for adults over 30 years of age. Methodology, preparation and contraindications for carrying out BCG vaccination is universal for every adult, regardless of the characteristics of the organism. Therefore, if it is already allowed, then it is done the same for everyone.

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The causative agent of tuberculosis is a pathogenic mycobacterium that enters the body through Airways. The microorganism can be hidden in the body, but becomes more active when the immune system is weakened. Basically, the bacterium multiplies in the alveoli of the lungs, causing coughing, loss of weight and appetite, night sweats, fatigue. In severe forms, miliary and meningeal forms of the disease occur. Affected:

• Lungs.
• Liver.
• Spleen
• Bone marrow.

Treatment for tuberculosis can last several months, sometimes years. All children must be vaccinated against tuberculosis after birth (parents can write a refusal). This rule applies in all countries with high level diseases, including in Russia. In countries with a low infectious threshold, a child is vaccinated if there is a tuberculosis patient nearby (at risk).

The importance of vaccination against tuberculosis

The TB vaccine does not prevent infection, but it does prevent young children from developing severe forms of the disease that can be fatal. The drug is based on a weakened strain of the causative agent of bovine tuberculosis. What is the tuberculosis vaccine called? It is abbreviated as BSG (English: Bacillum Calmette Guerin). Complications from such a vaccination are quite rare, and the skin injection site is easy to care for. However, if the doctor does not assess the presence of contraindications or administers the vaccine incorrectly, then significant complications may arise, so parents, being afraid, refuse to vaccinate. In any case, it is necessary to carry out comprehensive examination child before making a decision.

Who should be vaccinated against tuberculosis?

The BCG vaccine is recommended for children one year old and up to 7 years of age, living in areas of infection or in case of their travel to unfavorable regions. In Russia, the epidemiological situation is dangerous in many regions, so people are vaccinated almost everywhere. Vaccination is valid for about 5 years. People who are in constant contact with tuberculosis patients also undergo this procedure.

Vaccine composition

The active component of the BCG vaccine is bacterial strain(the causative agent of bovine tuberculosis), specially designed to retain weakened virulence, not dangerous to humans, but enhancing immunity. The bacteria are in the preparation in a lyophilized state in water with the addition of glutamate or monosodium glutamate (1.5%). Lyophilization is the process of gently drying an object, in in this case bacterial cells that maintain integrity and activity.

The tuberculosis vaccine is in a dried state before injection and is dissolved before injection using:

1. Sterile deeply purified water.
2. Saline solution.
3. A special protein substance.

The packaging of the vaccine indicates how to dilute it; the use of other solvents is not allowed, otherwise the effectiveness of the action may be lost.

How to prepare for vaccination

The vaccine against tuberculosis is given after a preliminary standard examination of the child, including weighing and other metric parameters, blood and urine tests. Vaccination should be carried out in special conditions to provide emergency care in case of anaphylactic reactions. If the tuberculosis vaccination was not given in the maternity hospital, then at an age exceeding 2 months, the Mantoux test is first done, since it is impossible to vaccinate a sick child in case of a positive reaction.

Two types of vaccine are used: BCG and BCG-M. Vaccination against tuberculosis of healthy children weighing 2500 g or more is carried out using the first vaccination. The second contains a twofold reduced concentration of antigen. It is administered to children with contraindications.

Where is the vaccination given?

Typically, the tuberculosis vaccine for children is given on the outer side of the left shoulder. The injection is carried out intradermally between the upper and middle third of the shoulder. The drug cannot be administered subcutaneously or intramuscularly. If it is not possible to vaccinate on the shoulder, then the doctor chooses a place on the thigh where there is thick skin.

The vaccine is administered only with a disposable syringe. First, the doctor tightens the injection site, after administering the drug, a pale papule or “button” 5-10 mm in size forms in the area, after 15-20 minutes the formation disappears.

The body's reaction to the vaccine

A small infiltrate appears at the injection site. This is what doctors call the accumulation of cellular components with the presence of blood and lymph. The formation has a crust and a central nodule. When infants are vaccinated, the infiltrate becomes noticeable after 4-6 weeks. Then healing occurs within 2-4 months, with complications the time increases.

What size should the tuberculosis vaccine be? With a positive reaction to BCG, which is normal in all children under 4 years of age, redness up to 17 mm in size is noted. Such a reaction zone indicates the development of an immune response against the pathogen, and, therefore, tuberculosis, if infected, will occur in a mild form.

Sometimes the reddened area is less than 5 mm, then a negative reaction is diagnosed and BCG is offered when the child reaches 7 and 14 years of age. After the graft heals, a scar of 3-10 mm remains. Sometimes its area is less than 3 mm, which indicates the ineffectiveness of the procedure, so the doctor suggests revaccination.

Caring for the injection site

After several months from the moment of injection, an infiltrate appears on the skin, which looks like a compaction similar to mosquito bite. If there is a crust at the injection site, it cannot be removed. Sometimes the crust may fall off on its own and become wet, this is normal. Do not rub the area with a washcloth or soap the area. About a year after the vaccination, a scar forms; during the healing process, you cannot use any aseptic compounds, for example, iodine and brilliant green. The injection site heals slowly over the course of a year, but such difficulties are worth it to protect your child from a dangerous infection.

Contraindications

BCG-M vaccination is used for such contraindications as:

1. Prematurity (body weight is at least 2000 grams, if 2500 and above, then BCG is given).
2. Hemolytic disease, which is caused by incompatibility of the Rh factors or blood groups of the baby and mother.
3. Damage to the central nervous system.
4. Lack of vaccination in the maternity hospital.

A thin layer of skin is also contraindicated; in this case, vaccination is postponed. If there is a complication to the previous vaccination, the child is not vaccinated again.

Vaccination is postponed if:

1. Infectious diseases.
2. Severe forms of hemolytic disease.
3. Severe prematurity.

Children should not be vaccinated against tuberculosis if there are cases of immunodeficiency in the family: congenital or acquired (as a result of HIV). When the child's siblings had serious complications after an anti-tuberculosis vaccination, or the baby has congenital fermentopathy (serious metabolic failure), then BCG is completely canceled.

Other contraindications, as a result of which it is not possible to administer an anti-tuberculosis vaccine: hereditary diseases(Down's disease, in particular), serious pathologies CNS (cerebral palsy).

Are there any complications?

Of course, complications with the introduction of the vaccine due to its mass use periodically arise. Often negative consequences vaccinations are cold abscesses and lymphadenitis as a result of violations of the vaccination technique (need intradermally, not subcutaneously) or the quality (dosing) of the vaccine, respectively. Patient age and intradermal injection technology may also have an impact.

Complications after TB vaccination are divided into 2 categories: mild and severe. The latter are associated with a strong spread of infection. In the absence of sufficient immunity, the live culture in the vaccine can spread, so preliminary tests and assessment of the child’s condition are necessary. Such gaps are much less common than the risk of disease in unvaccinated children.

More common complications associated with incorrect injection are:

1. Ulceration of the infiltrate occurs.
2. A ball appears due to deep injection.
3. A keloid is formed ( rough scar). The complication occurs rarely as a result of the growth of scar tissue, more often in older children. The reason is hereditary defects that cause skin damage. At the site of healing, blood vessels are very noticeable and itching occurs.

If the lymph nodes become infected, then when bathing the child, parents notice an increase in axillary elements lymphatic system. The knots are like a ball, an egg or a nut. Rarely, when an infection breaks through the skin, a fistula occurs. If a child exhibits any strange signs after BCG, they are taken to the doctor.

Children who have had a mycobacterial infection are not vaccinated. If the Mantoux test is positive or doubtful, then BCG is not given.

At what age is vaccination and revaccination carried out?

Vaccination against tuberculosis is carried out immediately after the birth of a child, with the exception of children with contraindications. The parents' task is to accept correct solution about vaccination, based on tests and doctor’s recommendations. The procedure contributes to the formation of the child’s protective immunity. Revaccination against tuberculosis is carried out at 7 and 14 years of age. Newborns are vaccinated because they the immune system is already ready for vaccination, while babies need to be protected from the most dangerous infections. Why are these particular ages important? Children at this age are most likely to become infected. More frequent revaccinations are not advisable, as proven by scientific research.

Vaccination against tuberculosis is usually done when 3-7 days have passed after birth; it is not recommended to be late with the procedure, since the effectiveness of the immune response depends on this. It is recommended to carry out BCG vaccination already in the maternity hospital. The likelihood of violations of the technique in clinics is higher, although it all depends on the specific institution. In addition, hospitals may encounter infected patients, which is dangerous for the newborn. Mantoux is sometimes called the “button shot” and is actually a test for the presence of tuberculosis infection.

If vaccination occurs according to a standard schedule, then the Mantoux test is still regularly performed (checking the condition and effectiveness of BCG is necessary).

Is it possible to get tuberculosis after vaccination? If you have a vaccination, then the disease is possible, but it will be mild, and death and lifelong complications are reduced to zero. Immunity against tuberculosis is formed during the first year of life after a newborn is vaccinated. Antibodies to tuberculosis are produced in the body as a response to a weakened pathogen introduced by injection. The presence in the preparation of such toxic components as aluminum hydroxide, polysorbate, mercury salts, formaldehyde, phenol, etc. is not confirmed by actual data. These are unfounded “horror stories” that ordinary people tend to believe. Successful immunization as a result of BCG is confirmed by the presence of a noticeable scar. Its absence indicates a zero effect.

Tuberculosis is often perceived as a disease more characteristic of the lower strata of society. However, the epidemiological situation contributes to increased likelihood infection of a person of any social status. The number of cases continues to rise. It is permissible for parents to refuse vaccination, but the consequences of not receiving BCG can lead to infection of the baby.

The only way to protect children from the consequences of tuberculosis is timely BCG vaccination. We will tell you in the article where and when the tuberculosis vaccination is given, whether it is possible to get tuberculosis if you already have the vaccination, and what is the validity period of the tuberculosis vaccination.

Vaccination against tuberculosis

Tuberculosis belongs to the group of infectious diseases. It is caused by the so-called MBT (Mycobacterium tuberculosis), better known in popular medical literature as Koch's bacilli. The population of our planet has been suffering from this disease for hundreds of years. Bacteria can infect anyone human organ, but the lungs are most susceptible to their effects. The main symptoms of this disease are:

• cough and copious discharge sputum (in the early stages);
• coughing up blood, exhaustion (late stages).

About thirty percent of the Earth's inhabitants are carriers of this deadly disease. Probably, and even for sure, precisely because of the enormous danger of the disease, the very first vaccination of newborns is the BCG vaccination against tuberculosis.

Do I need to be vaccinated against tuberculosis?

Every mother knows what the tuberculosis vaccine is called. This is a BCG vaccination, which is given in the maternity hospital, because you can encounter the disease bacteria anywhere: in transport and on the street, in a shopping establishment and in children's institution. Even in a clinic or hospital, you are absolutely not immune from this.

People who are either dense or completely irresponsible may be thinking about the question of whether vaccination against tuberculosis is necessary. After all, it is completely clear that better for the body a child will encounter a weakened bacterium and develop immunity to the disease, rather than it being unclear where and when he will receive an active bacterium, which he simply cannot cope with.

A vaccine introduced into the body through vaccination, which includes one of the strains (French, Danish or Tokyo), does not provide a complete guarantee that tuberculosis will not develop in the body. However, it fully guarantees that the baby will not have severe pulmonary tuberculosis.

When to get vaccinated against tuberculosis

Many parents wonder how many times their child should be vaccinated against tuberculosis. Ideally, the TB vaccination schedule looks like this:

• third to seventh day;
• seven years;
• fourteen.

In fact, only the first BCG vaccination is called vaccination, the next two are already revaccination. These anti-tuberculosis measures are carried out only in the absence of contraindications. And the condition for vaccination against tuberculosis at the age of 7 and fourteen years is also negative test Mantoux. The vaccine is injected into left shoulder intradermally.

When children are vaccinated against tuberculosis, only certified drugs are used. They are the same everywhere, so there is no difference between Russian and imported vaccines.

What is the reaction to the tuberculosis vaccine in children?

Many questions arise about the child’s body’s reaction to the tuberculosis vaccine. It should be noted right away that it is slow. If the post-vaccination process proceeds normally, then only after one and a half to two months a whitish nodule, reminiscent of a mosquito bite, appears on the skin where the injection was given. Then in its place a bubble with a yellowish liquid appears, which bursts only when the baby reaches three to four months of age.

A crust forms at the site of the burst bubble. She disappears and reappears several times. This is a natural phenomenon that does not require any external intervention (in no case should it be lubricated with ointments, iodine, or brilliant green).

Complications after tuberculosis vaccination

Like any vaccination, the tuberculosis vaccine may have some side effects. Parents should be alerted to bluish skin and the appearance of a pea under it. This is a suppuration invisible to the eye, which was formed as a result of the vaccine being injected subcutaneously. When properly vaccinated, the vaccine must be administered intradermally.

When bathing the baby, the mother may notice an increase in lymph nodes under the left armpit. In both cases, it is necessary to urgently consult a doctor, since such phenomena may indicate a possible complication.