BCG vaccination - composition, vaccination rules, reactions and complications

The vaccine contains live mycobacteria of the BCG-1 strain, which, when entering the human body, lead to the formation of long-term immunity to.

The decoding of BCG is a tracing of the Latin abbreviation (BCG), it stands for bacillus Calmette-Guerin, which means “bacillus Calmette-Guerin”.

The BCG vaccine can accommodate a variety of Mycobacteria bovis subtypes. The composition of this vaccine has remained the same since 1921.

The culture of mycobacteria that are used to make the vaccine is obtained by inoculating bacilli on a special nutrient medium. For one week, this culture grows on the medium, then it is isolated and filtered. After this, it is concentrated and made into a mass of homogeneous consistency.

As a result, the vaccine contains a certain amount of both dead and live bacteria. In this case, a single dose of the vaccine can contain a different number of bacterial cells, this depends on the subtype of mycobacteria, as well as on what technique was used in the manufacturing process of the vaccine preparation.

Release form

The BCG vaccine is produced in the form lyophilisate , which is subsequently used to prepare a suspension, which is administered intradermally.

Available in the form of a porous powdery hygroscopic mass, also produced in the form of white or cream-colored tablets.

The vaccination dose contains 0.05 mg of bacteria in 0.1 ml of solvent (sodium chloride 0.9%).

5 ampoules of vaccine complete with solvent (also 5 ampoules) are packed in a cardboard box.

pharmachologic effect

Tuberculosis is one of the most dangerous infections, and it can develop in a child from the first days of his life. Its effectiveness depends on when the BCG vaccination is given. The earlier vaccination is carried out (as a rule, it is done on the third to seventh day), the more pronounced its effectiveness will be under the condition of contact with infection.

In the process of reproduction of live mycobacteria of the BCG-1 strain in the body of a person who has been vaccinated, a long-term form of tuberculosis gradually develops. The formation of full immunity against tuberculosis occurs over the course of about one year.

The response to BCG vaccination in newborns determines whether immunity has developed. Vaccination has been carried out successfully if a scar appears on the shoulder, and in the place where the BCG vaccine was administered, the consequences of locally suffered skin tuberculosis are visible. Accordingly, if the scar is very small and invisible, then insufficient immunization is noted.

When weighing the pros and cons of vaccination, it should be noted that the use of the vaccine does not help reduce the spread of tuberculosis. However, vaccination provides protection against severe forms of the disease, which are especially dangerous for children's health.

Pharmacokinetics and pharmacodynamics

The duration of immunity after vaccination is unknown.

Indications for use

• children of the first year of life staying in places where there is a very high level of tuberculosis;
• children in the first year of life, as well as children of school age who have an increased risk of contracting tuberculosis;
• those who have a lot of contact with people who have been diagnosed with tuberculosis in a form resistant to many medications.

Contraindications for BCG

The following contraindications for BCG vaccination have been noted:

• birth of a child prematurely (provided that the birth weight is less than 2500 g);
• intrauterine infection;
• development of acute diseases (it is necessary to postpone the introduction of vaccination until the exacerbation is over);
• purulent-septic diseases;
• severe and moderate forms of hemolytic disease in newborns;
• primary ;
• the presence of neurological symptoms in severe damage to the nervous system;
• generalized skin lesions;
• the presence of malignant tumors;
• simultaneous use of immunosuppressants;
• carrying out radiation therapy (vaccination can be practiced only 6 months after completion of treatment);
• the presence of generalized tuberculosis in other family members;
• diagnosed in the mother.

The same contraindications are noted for the administration of the BCG-M vaccine.

Revaccination is not carried out in the following cases:

• during acute diseases, both infectious and non-infectious;
• for acute manifestations;
• with immunodeficiency;
• in the event of the appearance of neoplasms and malignant blood diseases;
• when undergoing radiation therapy or taking immunosuppressants (booster vaccination can be carried out only six months after completion of such therapy);
• tuberculosis (also a history of illness or infection with mycobacteria);
• with a positive or questionable Mantoux reaction;
• in case of contact with patients who have infectious diseases;
• when complicated reactions to the vaccine administration occur (in particular, if complications of BCG vaccination were noted in the form of a keloid scar).

Side effects

The occurrence of side effects is determined by the ingredients of the BCG vaccine, what it is, and how it acts on the body. It should be noted that the drug contains live BCG mycobacteria, therefore, a reaction to BCG vaccination invariably occurs. What such manifestations may look like is clearly demonstrated by photographs of the reaction to the BCG vaccination.

During the normal course of the process, a specific reaction appears at the site into which the vaccine is injected intradermally; a papule with a diameter of 5-10 mm develops. If vaccination was carried out on newborns, a normal reaction will appear after 4-6 weeks. Reverse development of the reaction occurs within 2-3 months, sometimes it is a longer process. During revaccination, the development of a local reaction is observed 1-2 weeks after administration of the drug.

Complications after vaccination may occur at different times after administration of the drug. Symptoms of the consequences of BCG complications are most often observed in the first six months after administration of the vaccine.

In general, complications in newborns and older children can be severe or mild. Heavy complications after vaccination in newborns are associated with generalization of infection. Lungs arise due to non-compliance with the technique of administering the drug or its poor quality.

The most common manifestation after vaccination and revaccination is cold abscesses, and lymphadenitis . The manifestation of lymphadenitis is often associated with the quality of the drug, dosage, and administration technique.

The development of cold abscesses is noted if the vaccine gets under the skin during administration. The quality of the drug also influences the development of such negative manifestations. If a cold abscess was discovered untimely, then it opens spontaneously after the graft has festered. As a result, an ulcer appears at this place. A photo of a cold abscess after BCG clearly demonstrates the features of this complication.

If local reactions after vaccination occur very violently, a infiltrate. Subcutaneous infiltration occurs due to too deep administration of the vaccine. It is important to consult a specialist in a timely manner so that the infection does not have time to move into the bloodstream.

It is also possible that keloid scar , as consequences of chronic inflammation in the proliferation stage. This complication occurs relatively rarely, but it should be taken into account that this complication more often occurs in newborns.

Very rarely appears as a complication osteitis , that is, bone tuberculosis. This disease can appear 0.5 - 2 years after immunization; it, as a rule, indicates serious disturbances in the functions of the child’s immune system.

In rare cases, a child may experience a slight increase in body temperature after an injection, most often this is a small, short-term increase.

If these and other side effects develop, it is important to immediately contact a specialist.

Instructions for use (Method and dosage)

The instructions for the vaccine stipulate that the drug is administered to a person three times in his life. The first vaccination is carried out 3-7 days after the child is born, followed by BCG vaccination at 7 years of age. After this, the vaccine is given at 14 years of age.

In this case, the connection between BCG and Mantoux should be taken into account: revaccination at 7 years of age and at 14 years of age is carried out only if the Mantoux test is negative. Also, revaccination is not carried out in areas where there is a relatively low prevalence of the disease.

If a child has contraindications, the vaccine can be administered to him if his condition returns to normal. Before administering the drug, the child must undergo a Mantoux test. If the test is negative, vaccination should be carried out as soon as possible. If the test is positive, the vaccine is not administered.

Do not use syringes whose expiration date has expired. After the injection, the syringe, needle and used cotton swabs should be soaked in a disinfectant solution, after which all this should be destroyed. Before use, the ampoules must be carefully inspected and determined whether they have been damaged or whether the expiration date has expired.

The vaccine, which has already been dissolved, must be protected from exposure to sunlight; it can be stored after dilution for one hour. Unused vaccine is destroyed at a temperature of 126 degrees by autoclaving.

The drug should be injected into the outer side of the left shoulder. The location is determined so that the vaccine is administered at the border between the upper and middle third of the arm. It is very important to administer the medicine intradermally; other methods of administration are unacceptable. Provided that for certain reasons it is not possible to administer the vaccine into the shoulder, you can choose another place with thick skin. Most often in this case it is injected into the thigh.

BCG should only be administered using a disposable syringe, and the needle should have a short bevel. To prevent complications, you need to administer the drug correctly. Before inserting it, the skin needs to be stretched, and then a little solution is injected. If the needle was inserted intradermally, then the entire solution is injected. Next, a white papule appears at the injection site, which is 5 to 10 mm in diameter. It disappears after 15-20 minutes.

As a rule, BCG and BCG-M vaccines are administered in the maternity hospital or in the clinic where the child is observed. After vaccination, you should carefully care for the area where the drug was administered. Under no circumstances should you lubricate this area of ​​skin with antiseptics.

Please note that there are normal reactions after a child is given a vaccine. So, if the vaccine in a newborn turns red, this indicates the normal course of the process.

After a newborn has been vaccinated, a normal reaction in an infant appears after 1-1.5 months. After repeated administration of the vaccine to children aged 7 and 14 years, the reaction develops earlier, after 1 or 2 weeks. After the reaction develops, you should not rub or scratch the area; you should wash the child very carefully.

The vaccination reaction is as follows: a pustule or papule is formed, and slight suppuration is noted in the place where the vaccine was administered. Gradually, after 2-3 months, the wound heals. A small scar should remain at the site of this wound. If there is none, it means the vaccine was administered incorrectly. The wound can take up to 4 months to heal.

Overdose

When an excessive amount of vaccine is administered, the likelihood of developing purulent lymphadenitis increases. Subsequently, too large a scar may also form.

Interaction

Other preventive vaccinations can be given only at intervals of one month before or after the administration of the tuberculosis vaccine. The only exception is vaccination against viral hepatitis B .

Terms of sale

You can get vaccinated in the maternity hospital after the birth of the child or in the clinic.

Storage conditions

The drug should be stored or transported at a temperature not exceeding 8 degrees.

Best before date

Can be stored for 2 years. After this, the vaccine is unusable.

special instructions

When deciding whether or not to vaccinate their child with BCG, parents should carefully read the recommendations given by experienced pediatricians (for example, Evgeny Komarovsky and others).

All arguments should be taken into account, clearly understanding what the BCG vaccination is for and what the risk will be if parents deliberately refuse to have it.

After vaccination, a child’s immunity can last for about 5 years. To maintain immunity, revaccination is carried out.

The Mantoux test is performed on a vaccinated child according to a schedule and allows you to determine what the child’s anti-tuberculosis immunity is at the moment.

Vaccination and revaccination should be carried out only by specially trained physicians working in specialized medical institutions. It is prohibited to administer the vaccine at home.

Before vaccination in the clinic, the child must first be examined by a specialist.

Analogues

There are TB vaccine options. The difference between BCG and BCG-M is the content of microbial bodies in the composition. The BCG-M vaccination contains a smaller amount of them; it is also used for specific prevention of tuberculosis, but it is used when gentle immunization is necessary - for premature babies, weakened children, etc.

For children

It is used for vaccination of patients in childhood - on the 3rd - 7th day after birth, at 7 and 14 years of age.

It is important to adhere to the vaccination calendar and all rules for administering the drug.

Newborns

Newborns, depending on their condition, receive BCG or BCG-M vaccines in the maternity hospital.

Tuberculosis is a common, severe infectious disease that primarily affects the lungs and, less commonly, other organs and systems.

Russia is one of the countries with the highest incidence of tuberculosis.

Therefore, according to the national vaccination calendar, BCG, in the absence of contraindications, is mandatory for all newborns before discharge from the maternity hospital.

Should a newborn be vaccinated with BCG? What is the right thing to do?

This question worries all parents.

Many fear that vaccination at such an early age may lead to unwanted reactions. The BCG vaccine is a mixture of several types of live, weakened tuberculosis pathogens. It has been used in our country since 1921, that is, for quite a long time and, therefore, has been well studied. Reactions after BCG vaccination in newborns occur for two reasons: due to incorrect injection technique and vaccination without taking into account contraindications. Healthy children tolerate the vaccine quite easily. It is believed that the immune system of newborns is completely ready to form an adequate response.

Another argument against vaccination is the belief that there is no place for a baby to become infected with tuberculosis. However, it is believed that about a third of the entire population of our planet is infected with the tuberculosis bacillus, but only 10% of them develop signs of the disease. Tuberculosis is an insidious disease; its typical manifestations, such as cough and hemoptysis, do not appear immediately. Therefore, many people may not initially realize that they are sick, while infecting others. The causative agent of tuberculosis is quite stable in the environment. Therefore, there are many places where a child can catch an infection: a common entrance, an elevator, a clinic where someone’s sick relative can come. In recent years, tuberculosis has ceased to be the lot of alcoholics, drug addicts, and people returning from prison. Cases are increasingly being recorded among quite prosperous people: young, working, married men and women.

Information about the harmful components allegedly included in the vaccine, which are actively disseminated on the Internet by opponents of vaccination, does not have any documentary evidence.

You should know that vaccination does not guarantee absolute protection against the disease. Currently, mycobacteria have acquired new properties and become more resistant to the external environment and to drugs.

So why get vaccinated if you still risk getting sick? Tuberculosis is dangerous for young children with a high probability of developing deadly forms: tuberculous meningitis (damage to the meninges) and disseminated (widespread) lung damage. Fortunately, they do not occur in children who have been vaccinated with BCG.

Currently, scientists are developing a new, more effective version of the vaccine against this dangerous disease.

When should newborns not be vaccinated with BCG?

BCG vaccination is contraindicated:

Children whose birth weight was less than 2.5 kg;

Children born to women infected with HIV;

Children whose mothers had primary or secondary immunodeficiency of another cause;

In case of intrauterine infection in a newborn;

For moderate and severe manifestations of hemolytic disease;

For birth injuries with brain damage;

With widespread pustular skin lesions;

If there are people around the child with tuberculosis;

If genetic diseases are detected (various enzymopathies, Down's disease);

If there is information about complications after BCG vaccination in close relatives (parents, brothers, sisters).

Children weighing from 2 to 2.5 kg are given a lighter version of the BCG vaccination - BCG-M, which contains a half dose of the vaccine. If you have a lower weight, the vaccine is not given in the maternity hospital.

In addition to the maternity hospital, a newborn can be vaccinated with BCG in the vaccination room of a children's clinic (as a rule, a separate day of the week is allocated for this) or in an anti-tuberculosis dispensary. It is important for mothers to know that private medical centers do not provide vaccination against tuberculosis.

If the BCG vaccination is not given in the maternity hospital on time, children older than two months in the future must undergo a Mantoux test before it is administered in order to diagnose possible tuberculosis infection. If this test turns out to be positive, the baby has already encountered mycobacteria somewhere and then BCG is not done.

For vaccination in a clinic, the following are added to the list of contraindications:

Any acute diseases;

Oncology, radiation therapy;

Diseases requiring the use of immunosuppressants.

At the age of 7 years, it is mandatory to decide on the need for BCG revaccination, which is carried out in the event of a negative Mantoux reaction.

How to properly vaccinate newborns with BCG?

BCG vaccination is usually carried out on days 3-5 of life for all children in the absence of obvious contraindications. The BCG vaccine is injected into the outer surface of the left shoulder, strictly inside the skin. Incorrect subcutaneous or intramuscular administration will inevitably lead to the development of complications. Therefore, it is so important to know exactly how to properly vaccinate newborns with BCG. The injection site is the border of the middle and upper third of the shoulder. For vaccination, a disposable syringe and a short needle with an oblique cut are used.

Immediately after injection, a small white bump appears on the skin, which disappears after a few hours. There may be slight redness, even suppuration, at the injection site for two to three days, which should then also disappear (after a week).

It is important to know. That BCG cannot be given simultaneously with other vaccinations, therefore, in the maternity hospital, immunization against hepatitis B is first carried out, and only after that BCG.

At least 30 days must pass between BCG and any other subsequent vaccination.

Normal reaction to BCG vaccination in newborns

After vaccination, the temperature may rise to subfebrile levels. Such a reaction after BCG vaccination in newborns is quite rare. In any case, given the imperfection of thermoregulation mechanisms in babies under one year old, it would not be entirely correct to associate low-grade fever with vaccination.

The reaction after vaccination occurs only after one and a half to two months and is classified as delayed. It can manifest itself in different ways: in the form of a small lump, a red vesicle, a crusty pustule, or a dark blue or even brown speck. All these manifestations are considered completely normal and should not cause concern to parents. The body reacts to tuberculosis pathogens in this way, forming immunity.

The crust may periodically fall off, for example, during bathing, and form again. Do not treat the abscess with antiseptic agents, smear it with brilliant green or iodine. This may disrupt the normal post-vaccination process. Do not squeeze out pus. If it leaks out on its own, just blot it with a sterile cloth. The vaccination site can be wetted, but not rubbed.

After about 4 - 6 months, the grafting site heals, the crust finally disappears, and a small white scar, no more than a centimeter in size, forms. Its final formation ends by the year. Subsequently, if medical documents are lost, by looking at it, it will be possible to understand whether the baby has been vaccinated with BCG or not. In some children, a scar does not form, which indicates the ineffectiveness of BCG vaccination. However, there is a group of people (about 2%) with congenital immunity to mycobacteria.

What reactions to BCG vaccination in newborns are considered pathological?

After any preventive vaccination, unwanted reactions and complications may occur, and BCG, unfortunately, is no exception in this regard. Complications after vaccination include conditions requiring special treatment.

If swelling and redness of the skin appears around the pustule, parents should seek advice from a phthisiatrician, since this condition, although not a complication, requires medical supervision.

Complications are considered:

1. Cold abscesses - occur if the BCG vaccination of a newborn was not done correctly, and the drug got under the skin. The typical time for their appearance is considered to be 1-1.5 months after vaccination. They require surgical treatment, although they can open on their own.

2. Infiltrates - the reason for their development lies in individual characteristics, when the body reacts too violently to the introduction of a pathogen or as a vaccine itself.

3. Extensive ulcer at the injection site. It occurs for the same reasons as infiltration.

4. Lymphadenitis - inflammation of the lymph nodes on the left, develops when infection spreads from the skin. If the node is significantly enlarged, the help of a surgeon may be required.

5. The formation of a keloid scar is a rough change in the red color of the skin at the injection site; predisposition to keloidosis is programmed at the genetic level

6. BCG infection (or BCGitis) is the most severe complication that can be fatal. Tuberculosis, which developed due to the introduction of pathogens into the body. It occurs extremely rarely and only in immunodeficiency states.

7. Post-vaccination syndrome - belongs to the category of late complications, and manifests itself in the form of various skin rashes.

8. Tuberculous osteitis – bone damage due to the tuberculous process.

Information about any adverse reaction is recorded in the child’s medical record and is a contraindication for subsequent BCG revaccination.

Most complications occur in the first six months after vaccination.

In any case, the final decision is up to the parents. The expectant mother signs informed consent to receive vaccinations or refuse them in the maternity hospital at the antenatal clinic, so before giving birth she has time to think, weigh the pros and cons and make the right decision.

Today, one of the most common diseases in our country and throughout the world is tuberculosis. It affects approximately 9 million people every year, more than a third of which are fatal.

To reduce the risk of tuberculosis and mitigate its consequences, the child is vaccinated with BCG in the first days of life.

In this article we will tell you why the BCG vaccination is needed, when the first and subsequent vaccinations are given, and what they protect the child’s body from.

What is BCG vaccination?

The BCG vaccine is a serum containing live and dead bacteria. When they enter the body, immunity against severe forms of tuberculosis is developed.

BCG decoding is a translation from the Latin language BCG, stands for bacillus Calmette-Guerin and its composition has not changed since the 20s of the last century.

Frequency of BCG serum administration

Vaccination with BCG vaccine in newborns is performed in the first year of life. As a rule, it is done directly within the walls of the maternity hospital in the first days after birth.

Before vaccination, preparations must be made, during which doctors find out whether the child has contraindications for the administration of serum.

The next vaccination is given after 7 years. To prepare for re-vaccination, the child is given a Mantoux test. If the test taken shows a negative result, then administration of the vaccine is a mandatory procedure. It is also recommended to re-vaccinate children who have regular contact with people with tuberculosis or who are its carriers.

The third vaccination is performed at the age of 14, but it is not mandatory. As a rule, almost no one does it.

Infant vaccination technique

BCG vaccination for newborns, according to WHO (World Health Organization) standards, is performed on the outer side of the left shoulder. Serum is a powder that is diluted in saline before BCG. Newborns are vaccinated with BCG using a special tuberculin syringe. The injection is made under the upper and middle layers of the skin. It is pierced either in one place, or several punctures are made next to each other.

The vaccine reaction in an infant to the administration of serum begins to appear after a month and lasts up to 4 months. A small spot forms at the site where the BCG vaccination is given. The norm is a spot whose diameter is less than 1 cm. Then a small swelling appears, inside of which there is pus. Under no circumstances should you squeeze out the abscess and treat it with brilliant green or iodine solution. It will soon heal on its own, and its surface will become covered with a crust. It is also forbidden to remove it from the skin; it will fall off on its own as it heals.

The color of the skin at the injection site may change - this is also normal. Then, over the course of six months, the baby develops a scar. Its length varies from 3 to 10 millimeters. The resulting scar indicates that the vaccination was successful and the baby has developed immunity against mycobacteria.

How to care for your baby after vaccination?

If the vaccination took place without negative consequences for the baby, it is still impossible to make changes to the baby’s diet at the same time. Do not conduct experiments on a child by changing his formula if the baby is bottle-fed. If the baby is breastfed, then the nursing mother should also refrain from eating new foods. Otherwise, the child may be at risk of allergies.

A newborn after BCG may experience vomiting, loose stools and elevated body temperature. In this situation, you should not rush to see a doctor - this is the norm. It is necessary to provide the baby with plenty of fluids, since significant fluid loss occurs during this period. The child may experience a decrease in appetite for several days, but this is not dangerous to his health.

A slight increase in temperature is usually associated with a reaction from the immune system to the drug. If the temperature does not go beyond the normal range, this does not indicate the ineffectiveness of the vaccination, because all children have their own reaction to the serum.

If the baby is not sick with anything, then there is no need to immediately. Taking medications is recommended only when the temperature rises above 38.5 C°. should be given to the newborn at night. If a baby has a temperature, it is necessary to reduce the temperature when it rises to 37.5 C°.

If a child is prone to allergic reactions, the doctor may prescribe it as a preventative measure.

Parents should not independently decide whether their child should use this or that drug; only a pediatrician can make a diagnosis.

Often the area where the injection was given becomes red or swollen. In some cases, it can become inflamed, accompanied by suppuration, and an ulcer forms in this place. Its healing can take a long time. Even if the wound from the injection is red and inflamed, there is no need to treat it. Sometimes newborns attempt to comb the area where the drug was injected, then it is recommended to apply a gauze bandage to it.

Parents may have a reasonable question: when can you bathe your baby? If his body temperature is not elevated, then swimming is not contraindicated. You can't bathe a baby if he... Water procedures are allowed only after receiving the result.

It is recommended to seek medical help if it is not possible to bring down a high temperature for a long time, even with the help of medications. Calling a doctor is also necessary if the baby is in a restless state, has a long period of decreased appetite, convulsions appear and the BCG site festers.

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It must also be said that not all babies can be vaccinated with BCG. There are contraindications that prevent the vaccine from being administered to a newborn. First of all, this applies to children born ahead of schedule and babies with weakened immune systems. These are quite serious contraindications and vaccination should be rescheduled or performed after 7 years. Before revaccination, you need to make sure that the child has not been in contact with bacteria. This can be seen by a negative Mantoux test.

In addition, BCG vaccination is contraindicated in the following cases:

1. Lack of weight in a newborn - it should not be lower than 2.5 kg;
2. Contact with mycobacteria before vaccination;
3. Active form of chronic diseases.

Children whose weight does not exceed 2.5 kilograms are allowed to receive a lighter vaccine, called BCG M. In the lighter version of the serum, the content of antibodies of the tuberculosis pathogen is two times less than in the regular vaccine.

Sick children are not vaccinated; vaccination is performed only when the baby recovers. Vaccination does not make sense if the baby has already had contact with a person with tuberculosis. It is worth noting that a child cannot always become infected during the first contact. Some babies begin to produce antibodies in their bodies.

Vaccination is not done if the following serious contraindications exist:

1. HIV infection;
2. presence of complications in close relatives after BCG vaccination.

The administration of BCG to such children can have quite serious consequences. Mycobacteria contribute to the spread of infection in children's bodies. Such babies do not receive any vaccinations.

List of complications after BCG vaccination

Immunity is not developed

The reaction to BCG in each newborn is expressed differently. In some cases, complications may occur, the most common of which is immature immunity against tuberculosis. This indicates that the reaction to the serum did not go as expected. Either the baby’s immune system is weakened, or the baby is not genetically susceptible to mycobacteria. The last factor means that it is impossible for a child to become infected with tuberculosis.

Keloid scar

Sometimes it happens that wound healing occurs with certain difficulties. A child may develop a keloid, which is a hereditary disease. It is characterized by the growth of scar tissue when the skin is damaged. When a keloid scar appears after the vaccine is administered, blood vessels become visible through it. The scar takes on a bright color, and its appearance may be accompanied by burning and itching.

Fever

Often, as a complication after BCG, children experience elevated body temperature. This is an absolutely normal reaction of a child’s body to the administration of BCG.

Redness, skin irritation

The reaction to the BCG vaccination can manifest itself in the form of slight redness and swelling at the injection site, which are short-term. Also, the site where the vaccine was administered can fester and become inflamed, and point inflammation and scabies may occur.

Inflammation of the lymph nodes

After the BCG vaccination, the child's lymph nodes may become inflamed. Mothers usually notice enlarged lymph nodes in the armpits of a newborn when they bathe their baby. Lymph nodes can reach the size of a walnut, and in exceptional cases, be the size of a chicken egg.

If a baby’s vaccination has become infected or any of the symptoms described above are observed, this is considered a serious reason to consult a doctor as soon as possible.

The following severe complications occur less frequently from the administration of the BCG vaccine:

• Bone tuberculosis (osteitis);
• Generalized BCG infection.

Both diseases occur due to malfunctions of the infant’s immune system.

The vaccine may also cause:

• Cold abscess - formed when the technique of administering the vaccine is violated. To eliminate such a problem, surgical intervention is required;
• Osteomyelitis - suppuration occurs at the injection site, which subsequently affects the bone tissue.

Why should you get the BCG vaccine?

Today, there is an increasing debate about whether newborns need BCG vaccination? Since the situation with the incidence of tuberculosis can hardly be called favorable, children are vaccinated already while they are in the maternity ward.

Among vaccination supporters, there is an opinion that vaccination can protect babies from more severe forms of the disease. These include:

• extrapulmonary form of tuberculosis;
• disseminated tuberculosis;
• tuberculous meningitis.

Phthisiatricians, who in their line of work have to deal with this disease every day, are of the opinion that even if a child becomes infected, his recovery will occur without negative consequences. In infants who do not receive BCG, if they become infected with one of these forms of tuberculosis, death is inevitable.

Despite this, there is also a large army of opponents of vaccination. They ask the question that if maternity hospitals carry out universal vaccination of infants, and the incidence rate does not decrease, then is this not a reason to reconsider the very principle of protecting children from disease?

Today, parents have the right to make their own decision whether to vaccinate their child against tuberculosis. If they nevertheless decide to refuse it, then it is possible to formalize the refusal in writing. The text, as a rule, contains the phrase that the parents assume responsibility for the child’s health, and they have no complaints against the staff of the medical institution.

Often, parents want to refuse vaccination of their newborn, but they do not want to take responsibility on their own shoulders, shifting it to medical workers. Before refusing a vaccination, you need to carefully consider all its pros and cons. We must not forget that the child’s health will depend on the choice made by the parents in the future.

BCG M is a gentle vaccine against tuberculosis, which is used to vaccinate weakened and premature children in the maternity hospital. It differs from the ordinary BCG vaccine in its special, lightweight composition; the vaccine contains only half of the inactivated mycobacterium tuberculosis. Indications for vaccination with this drug are considered to be prematurity and low birth weight of children; such vaccination is also indicated for newborns who have an Rh conflict with their mother or have neurological disorders after a difficult birth.

Indications for use of vaccines

There are two types of drugs to prevent tuberculosis. One of them is the BCG vaccine, which is administered to the majority of newborns in the maternity hospital. Revaccination is carried out according to indications, first at 7 and then at 14 years.

BCG M vaccination is used for primary gentle immunization. This drug is recommended for use in the following cases:

• If the weight of a newborn baby is less than 2 kilograms and he needs to increase his body weight.
• If the baby is premature, but weighs more than 2.3 kg. In this case, the vaccine is given at the second stage of nursing, a couple of days before discharge home.
• Weak children who, for medical reasons, were not vaccinated in the maternity hospital.
• This drug can be used to vaccinate all newborn children in regions where the situation with tuberculosis is unfavorable.

The drug BCG is named after its developers (Bacillus Gelmette–Guerin). The letter M indicates that the drug is modified.

The only effective protection against tuberculosis is vaccination. Even if a person gets sick, his illness is mild and rarely causes complications.

Differences between the two drugs

The BCG M and BCG vaccines have no obvious differences. They are administered in the same way and have the same effect on the human body. Even their composition is quite similar. But there are still some differences, and you should know them.

As can be seen from the table, the differences in the drugs are not very large. For the most part, these vaccines differ only in the content of mycobacteria per dose. The drug BCG M has a gentler effect on a weakened body.

The shelf life of both drugs is 12 months. They should be stored at a temperature from + 5 to +8 degrees. The solution is prepared immediately before administration; this composition can be stored for no more than an hour at temperatures up to +8 degrees.

Children are vaccinated in the maternity hospital, and the effect of the vaccination lasts for more than 15 years. If necessary, individual people are given revaccination. Vaccinations in adults do not have much effect.

Contraindications

In some cases, the use of the TB vaccine is not recommended. There are a number of contraindications. The main contraindications for the drug BCG are:

• Extreme prematurity of the child.
• Acute diseases.
• Intrauterine infection.
• Some blood diseases.
• Severe skin diseases.
• Pathologies of purulent type.
• Immunodeficiency.
• Cancerous tumors.
• Chemotherapy and radiation therapy.
• Taking immunosuppressants.
• Neurological pathologies.
• Tuberculosis in one of the family members.
• Infants born to mothers with HIV.

Do not forget that revaccination with BCG also has a number of contraindications. Revaccination cannot be carried out in the following cases:

• For chronic diseases, in the acute stage.
• For acute pathologies.
• When undergoing radiation therapy or treatment with immunosuppressants.
• For cancerous tumors and severe blood diseases.
• For tuberculosis or atypical Mantoux reaction.
• If there were complications during the previous administration of the vaccine.
• When a child comes into contact with infectious patients.

The instructions for use of the drug BCG M also have contraindications, but there are not many of them. Administration of the BCG M vaccine is prohibited in the following cases:

• If the child weighs less than 2 kg.
• With intrauterine infection.
• For acute diseases.
• With tuberculosis in other family members.
• If the birth was difficult and the newborn has severe damage to the nervous system.
• For the first year and a half, children born to HIV-infected mothers should not be given injections. Then it is used only if no infection is detected in the child.
• For severe blood diseases.
• For pathologies of septic type.

There may be other contraindications to vaccination. In any case, the decision to administer one vaccine or another is made by the doctor. If the doctor has any doubts, a council of doctors may be convened.

Before vaccinating a child, parents are asked to sign a statement stating that they consent to the administration of the drug. Only parents can decide whether or not to vaccinate their child!

Introduction rules

BCG and BCG M vaccines are administered only subcutaneously. The dry vaccine is diluted with saline before administration. Next, two doses of the vaccine are taken with a disposable syringe, then 0.1 ml is released through the needle to displace air. After this, only one dose remains in the syringe.

The injection site is the border between the upper and middle parts of the forearm. The injection site is pre-treated with cotton wool soaked in medical alcohol. The needle is inserted with the cut up, into the taut top layer of skin. The drug is administered slowly, not at once. This is necessary in order to understand that the needle is inserted correctly.

If the drug is administered correctly, a whitish papule about 7 mm in diameter appears at the injection site. She disappears without a trace after 15 minutes.

What to pay attention to

• The interval between the Mantoux reaction and revaccination with BCG should be from 3 days to 2 weeks.
• If for some reason the child was not vaccinated in the maternity hospital, he should be vaccinated during 2 months of life, but only if there are no contraindications.
• If a child has signs of intrauterine infection, after recovery he is vaccinated with the BCG M vaccine.
• The injection site should not be rubbed while bathing the child.

BCG vaccination is carried out only in a clinic setting, since the child must be observed by a doctor for some time.

If a child was born premature, he is given the BCG M vaccine. This drug is more gentle, since it contains only half the mycobacteria compared to the BCG vaccine.

Judging by your diet, you don’t care about your immune system or your body at all. You are very susceptible to diseases of the lungs and other organs! It's time to love yourself and start improving. It is urgent to adjust your diet, to minimize fatty, starchy, sweet and alcoholic foods. Eat more vegetables and fruits, dairy products. Feed the body by taking vitamins, drink more water (precisely purified, mineral). Strengthen your body and reduce the amount of stress in your life.