Tuberculosis is a common severe infectious disease in which the lungs are mainly affected, 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 done to all newborns without fail before discharge from the maternity hospital.
Should I get a BCG vaccine for a newborn? What to do?
This question worries all parents.
Many fear that vaccination at such an early age may lead to undesirable reactions. BCG vaccine is a mixture of several types of live attenuated pathogens of tuberculosis. It has been used in our country since 1921, that is, for a long time and, therefore, has been well studied. Reactions after BCG vaccination in newborns arise for two reasons: due to improper injection and vaccination techniques, without taking contraindications into account. In healthy children, the vaccine is tolerated quite easily. It is believed that the immune system of newborns is fully prepared to form an adequate response.
Another argument against vaccination is the belief that the baby has nowhere to get tuberculosis. However, it is estimated that about a third of the entire population of our planet is infected with tubercle bacillus, but only 10% of them develop signs of the disease. Tuberculosis is an insidious disease, its typical manifestations, such as coughing and hemoptysis, do not appear immediately. Therefore, many people may first not 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 staircase, an elevator, a clinic where someone with a sick relative can come. In recent years, tuberculosis has ceased to be the lot of alcoholics, drug addicts, people who have returned from places of imprisonment. Increasingly, cases are recorded among quite prosperous people: young, working, family men and women.
Information about the harmful components allegedly included in the vaccine, which are actively distributed on the Internet by opponents of vaccination, have no documentary evidence.
You should know that vaccination does not guarantee absolute protection against the disease. Currently, mycobacteria have acquired new properties, have become more resistant in the external environment and to drugs.
So why get vaccinated if you still have a risk of 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. In children who have been vaccinated with BCG, fortunately, they do not occur.
Currently, scientists are developing a new, more effective version of the vaccine against this dangerous disease.
When should you not be vaccinated with BCG?
BCG vaccination is contraindicated:
• children than birth weight was less than 2.5 kg;
• children born to women infected with HIV;
• children whose mothers had primary or secondary immunodeficiency for another reason;
• with intrauterine infection in a newborn;
• with moderate and severe manifestations of hemolytic disease;
• with birth injuries with brain damage;
• with common pustular skin lesions;
• if there are persons with tuberculosis in the environment of the child;
• if genetic diseases are detected (various fermentopathies, Down's disease);
• if there is information about complications after BCG vaccination in close relatives (parents, brothers, sisters).
Children weighing 2 to 2.5 kg are given a lightweight version of BCG vaccine - BCG-M, which contains a half dose of the vaccine. At a lower weight, they are not vaccinated in the hospital.
In addition to the maternity hospital, BCG vaccination can be given to a newborn in the vaccination room of a children's clinic (as a rule, a separate day of the week is allocated for this) or in a TB dispensary. It is important for mothers to know that in private medical centers they are not vaccinated against tuberculosis.
If BCG vaccine is not given at the hospital on time, children over two months of age must be given a Mantoux test before diagnosis to diagnose possible tuberculosis. If this test turns out to be positive, the baby has already managed to meet with mycobacteria somewhere and then BCG is not done to him.
For vaccination in the 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, the issue of the need for BCG revaccination, which is carried out in the case of a negative Mantoux reaction, is mandatory.
How to vaccinate BCG in newborns?
BCG vaccination is usually carried out on 3-5 days of life for all children in the absence of obvious contraindications. The BCG vaccine is found in the outer surface of the left shoulder, strictly inside the skin. Erroneous subcutaneous or intramuscular administration will inevitably lead to the development of complications. Therefore, it is so important to know how to properly vaccinate BCG with newborns. The injection site is the border of the middle and upper third of the shoulder. For vaccination use a disposable syringe and a short needle with an oblique cut.
Immediately after administration, a small white tubercle is inflated on the skin, which disappears after a few hours. At the injection site for two to three days, there may be slight redness, even suppuration, which should also disappear later (in a week).
It is important to know. That BCG can not be done at the same time as other vaccinations, therefore, the hospital is first immunized against hepatitis B, and only after that BCG.
A period of at least 30 days must elapse between BCG and any other next vaccination.
Normal reaction to BCG vaccination in newborns
After vaccination, a temperature increase to subfebrile values is possible. Such a reaction after vaccination with BCG in newborns is quite rare. In any case, given the imperfection of thermoregulation mechanisms in babies up to a year, it would not be entirely correct to associate subfebrile condition with vaccination.
The reaction after vaccination occurs only after one and a half to two months and refers to the delayed. It can manifest itself in different ways: in the form of a small seal, a red bubble, an abscess covered with a crust, or a speck of dark blue or even brown. All these manifestations are considered completely normal and should not cause concern among parents. The body reacts in this way to the causative agents of tuberculosis, forming immunity.
The crust may periodically fall away, for example, during bathing, and form again. You should not treat the abscess with antiseptic agents, smear with brilliant green or iodine. This can disrupt the normal post-vaccination process. You can not squeeze pus. If it leaks on its own, just pat it with a sterile cloth. The vaccination site can be wetted, but not rubbed.
After about 4 to 6 months, the vaccination site heals, the crust finally disappears, and a small white scar is formed, no more than a centimeter in size. 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 is vaccinated with BCG or not. In some children, the scar is not formed, which indicates the ineffectiveness of BCG vaccination. However, there is a group of people (about 2% of them) with congenital immunity to mycobacteria.
What reactions to BCG vaccination in newborns are considered pathological?
After any preventive vaccination, undesirable reactions and complications can occur, and BCG is unfortunately no exception in this regard. Complications after vaccination include conditions requiring special treatment.
When edema and redness of the skin appear around the abscess, parents need to consult a phthisiologist, since this condition, although not related to complications, requires the supervision of a doctor.
Complications are:
1. Cold abscesses - occur if the BCG vaccine was not given to the newborn correctly, and the drug got under the skin. A typical period of their appearance is considered 1-1.5 months after vaccination. They require surgical treatment, although they can be opened on their own.
2. Infiltrates - the reason for their development lies in individual characteristics, when the body reacts too violently to the introduction of the 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, develop with the spread of infection from the skin. With a significant increase in the node, you may need the help of a surgeon
5. The formation of a keloid scar is a gross change in red skin at the injection site; predisposition to keloidosis is programmed at the genetic level
6. BCG infection (or BCG) is the most serious complication that can result in death. Tuberculosis, developed due to the introduction of pathogens into the body. It is extremely rare 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 - damage to the bones by the tuberculosis 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 future mother signs the informed consent to vaccinations or refusal of them in the maternity ward at the antenatal clinic, therefore, before giving birth she has time to think, weigh the pros and cons and make the right decision.
