Consent for Mantoux is written by a parent or guardian if the test will take place centrally in a kindergarten or school.
There is no standard form, so the adult writes the application in any form, but it is important to indicate the surnames, first names and patronymics of the representative and the child, sign and date. This is enough so that if a conflict situation arises, the nurse has documentary evidence of the correctness of her actions. If you agree, you do not always need to write a statement; the administration of the school or kindergarten can replace it with a signature on the information notice.
You need to take refusal much more seriously, especially if you have an allergic reaction to tuberculin. If the child was given Mantoux without permission, and complications arose, then the parents can write a complaint to the head doctor of the clinic about the actions of the nurse or contact the prosecutor's office.
What does consent to Mantoux mean?
Consent to Mantoux means that the child’s parent or guardian is informed about the diagnostic test for tuberculosis and has no objections to its implementation in the children’s team. This precaution is due to the fact that health workers from the clinic come to the kindergarten or school and carry out the manipulation centrally.
The second reason why a nurse should obtain written permission is due to unfounded prejudice against vaccinations and the Mantoux test. If a conflict arises, parents can file a complaint with law enforcement agencies, and the nurse will be required to provide a signed statement.
We recommend reading an article about what an alternative to Mantoux may be for children. From it you will learn when you need an alternative to Mantoux, the advantages and disadvantages of Diaskintest, T-SPOT analysis, PCR, and quantiferon test. And here is more information about what the Mantoux vaccination is.
Consent to Mantoux: sample
To carry out the Mantoux test, you can write a statement of consent with the diagnosis in any form, there is no standard form, the sample may look like this:
I, Ivan Ivanovich Petrov, agree to perform the Mantoux test on my daughter Svetlana Ivanovna Petrova, born in 2011. Date and signature with transcript (full name)
You can download the document here.
How to write correctly for a voluntary test
The Mantoux test is always completely voluntary; you must write an application indicating the following data:
- last name, first name and patronymic in full of the parent (guardian);
- last name, first name and patronymic of the child and year of birth;
- date of application, month and year required.
If a parent writes, then it is enough to indicate the degree of relationship with the child (for example, “my son” or “my daughter”), and if consent is needed from the guardian, then he indicates that he is the legal representative. The most important thing in a statement is the word “agree” or “refuse.” All other data is needed only for identification, that is, to establish for which child the consent was written.
Consent for mantu vaccination sample filling
Is consent always necessary?
Since the test is not strictly mandatory (with the exception of the diagnosis of tuberculosis), the nurse always requires confirmation of the refusal of Mantoux, and with voluntary consent, it is only necessary to convey the information to the parents. Not all child care institutions insist on written permission for diagnosis. Most often, this procedure is needed to prevent conflict situations.
The statement should always be written so that you can then refer to its presence before injecting tuberculin into the skin of the forearm or justify the absence of a Mantoux test in case of late detection of tuberculosis infection.
Mantoux test
Each mother at least 2 times a year faces such a problem as the Mantoux test. Some people think that it is necessary to get a “vaccination”, others doubt it, and still others don’t do it at all. The last one is the most difficult: the management of the child care institution refuses to accept children into kindergartens or schools without Mantoux. How legal is this?
Another option that you may be offered instead of MANTU is DIASKINTEST. It has proven itself in determining the activity of tuberculosis infection, but does not allow identifying primary tuberculosis infection.
➡Mantu is not included in the vaccination calendar, as it is not a vaccine.
| Of course, Shakespeare never dreamed of such problems. Actually, because of this, tuberculosis was one of the most terrible diseases that claimed hundreds of thousands of inhabitants of Medieval Europe. We'll talk about today: is it possible to refuse Mantoux? Will they let you into kindergarten or school without this “vaccination”? |
➡You can refuse Mantoux, but you must visit a physiatrist to get an opinion on the child’s health condition (the child will undergo a Diaskintest or x-ray).
For the answer, let us turn to the Resolution of the Chief State Sanitary Doctor of the Russian Federation dated October 22, 2013 N 60 (as amended on February 6, 2015) “On approval of sanitary and epidemiological rules SP 3.1.2.3114-13 “Prevention of tuberculosis” and Article 8 of the Federal Law dated March 30, 1999 N 52-FZ “On the sanitary and epidemiological welfare of the population”:
➡The management of a school or kindergarten has the right to prevent a child from visiting the institution in order to protect the rights and health of other children with whom contact is possible in the group or class.
Why do you need consent for Mantoux at school?
The school requires an application from the parent for Mantoux, since the test is carried out in the absence of an adult, and a minor child cannot decide for himself whether he can undergo tuberculin diagnostics. In order not to take him individually to the clinic later, it is recommended to write the consent in 2 copies. One will be in the hands of the parents, and the second will remain in the school’s medical office.
The parent copy must be marked with the entry number, since it is registered in the journal, and the nurse or authorized person also puts a date and signature. It is especially important to obtain registration data when refusing Mantoux.
Can they not admit me to kindergarten or school without vaccinations?
ℹ️ Thus, if there is no threat of an epidemic in your region, then you must be admitted to school or DS.
These intradermal tests are not vaccines and are not subject to the statutory right of refusal. Vaccination.
In accordance with clause 9.5 of the Sanitary Rules 3.1.2951-11, in DSs and schools, children who do not have information about immunization against polio or who have received less than 3 doses of polio vaccine are paired with children vaccinated with the OPV vaccine within 60 days, with 60 days. d͟n͟e͟y with m͟o͟m͟e͟n͟t͟a p͟o͟s͟l͟e͟d͟n͟e͟y p͟r͟i͟v͟i͟v͟k͟i͟.͟
| But! This is a medical intervention, and therefore you, as the legal representative, have the right to refuse. |
Part 1 of Article 5 of the Federal Law “On Immunoprophylaxis of Infectious Diseases”, citizens in the implementation of immunoprophylaxis and ͟m͟e͟yu͟t p͟r͟a͟v͟o on ͟t͟k͟a͟z from prof. Vaccination. Part 2 s͟t͟.͟5͟ Lack of vaccinations entails a temporary refusal to admit citizens to educational institutions in the case of ͟o͟z͟n͟i͟k͟n͟o͟v͟e͟n͟i͟ya m͟a͟s͟s͟o͟v͟y͟kh i͟n͟f͟e͟k͟ts͟i͟o͟n͟n ͟ы͟х з͟а͟b͟o͟l͟e͟v͟a͟n͟i͟y i͟l͟i ͟r͟i ͟g͟r͟o͟z͟e v͟o͟z͟n͟i͟k͟n͟o͟v͟e͟n͟i͟ya ͟p͟i͟d͟e͟m͟i ͟й͟.͟
No vaccinations in kindergarten or school.
The TB specialist will conduct additional examinations (X-rays).
Who is responsible after Mantoux vaccination and consent to it?
There is no special responsibility after consenting to vaccination (or rather the Mantoux test), since:
- a minimal amount of tuberculin is administered (0.1 ml);
- the vast majority of children have no consequences from the diagnosis;
- no significant restrictions are required after Mantoux (if you have a food allergy, do not exclude the allergen; the injection site should not be rubbed, sealed or lubricated with drugs).
Parents are responsible only if they deliberately hide the child’s illnesses that are contraindications for Mantoux:
- viral or bacterial infection;
- exacerbation of a skin, allergic or chronic disease;
- tuberculin intolerance;
- epilepsy.
It is important to fully understand that the only absolute contraindication to a tuberculin injection is an allergy to its administration. In this case, there is a risk of developing a dangerous reaction to the sample. All other diseases will not become more severe, complications will not appear, but a false positive result will occur. Then the child will be unreasonably prescribed an examination.
What to do if you made Mantoux without parental consent
If the Mantoux test was done without the consent of the parents, but it has no contraindications, then you can write a complaint to the head physician of the clinic about the actions of the nurse. The situation is much more serious if there is a ban on the administration of tuberculin due to an allergy, and as a result a general reaction occurs:
- skin rashes,
- itching,
- swelling of the face,
- paroxysmal cough,
- general weakness,
- headache,
- malaise.
A medical commission will then be created to investigate the consequences, and if a connection is established between Mantoux and the symptoms, the administrative responsibility of the nurse begins. If the child’s health seriously deteriorates, you can contact the prosecutor’s office, but since the test is extremely rarely so dangerous, in most cases it is limited to the management of the clinic.
We recommend reading the article about the age at which Mantoux is made. From it you will learn how often the Mantoux test is done in kindergarten and school, the test schedule, and alternative diagnostic methods in older age. And here is more information about whether Manta is worth doing after an illness.
Consent to Mantoux is written arbitrarily, but it (unlike refusal) is not always required by a child care institution. The nurse then refers to it in a conflict situation. If, despite the lack of permission confirmed by a signature, a test is given and there are consequences, then the parents can appeal the actions of the medical staff.
Mantoux or Diaskintest: the right to choose and the right to refuse
Mantoux - optional. The famous immune test to detect tuberculosis infection, according to children's ombudsman Anna Kuznetsova, should not be mandatory when admitting children to kindergartens and schools. She does not call for completely abandoning the examination, but testing may be different - without an injection. Although you will have to pay a lot for it. Vesti FM correspondent Sergei Artemov found out the opinions of specialized doctors on the early diagnosis of a dangerous disease.
Disputes about the Mantoux reaction - whether children need it or not - have been going on since 2013, when sanitary rules were issued. They made it mandatory for all children to be tested for tuberculosis before entering nurseries and schools. And although it was not the children themselves who broke the spears around the buttons on their forearm, their parents - doctors did and will continue to do so according to their instructions, says the chief phthisiopediatrician of the Russian Ministry of Health, Doctor of Medical Sciences Valentina Aksenova.
“The current situation is this: all children under the age of 7 undergo an annual Mantoux test. After 7 years, they have a more informative test - Diaskintest. If parents refuse to conduct one or the other test, then let's take blood and use other methods. As recently as March 24, the specialized commission of the Russian Society of Phthisiologists approved other tests - alternative ones that can be done by taking blood from a child.”
Both the Mantoux test and Diaskintest are performed with an injection in the arm. It is best if both options work in pairs, says leading researcher at the Central Research Institute of Tuberculosis, Doctor of Medical Sciences Marina Gubkina.
“All tests like to be compared in terms of sensitivity and specificity. The Mantoux test is more sensitive... Diaskintest is more specific. Simply, traditionally in Russia, before the advent of Diaskintest, a certain tactic had developed for examining children for tuberculosis infection - conducting a Mantoux test annually. This papule, or button, is what they call it. If it has become larger, or was negative, but has become positive, then they are selected into the risk group for further examination using the x-ray method.”
Marina Gubkina also refers to the order of the Ministry of Health, which recommends both types of checks.
“We already have a new regulatory document, order No. 951, which determines the use of Diaskintest from 8 years of age annually, and Mantoux tests from 12 months to 7 years inclusive.”
The age of diagnostic injections apparently differs. And it depends on the accuracy of the readings, explained Valentina Aksenova.
“Diaskintest has a very high specificity. If it is positive, you 100% need to go to the doctor. This means that a virulent mycobacterium is already developing in the body. This is a very dangerous option. He requires testing for tuberculosis. Such children should not be allowed into school. The Mantoux test is not very specific. Its specificity is about 40%. It can give false positive results for allergies, helminthic infestations, and many other such issues. Especially if the child is allergic.”
That is, in practice, a swollen Mantoux button can indicate the presence of a tuberculosis infection, and the child’s very powerful immunity, which immediately actively suppresses even weakened mycobacteria, and the fact that the child may have worms or allergies. And since Diaskintest detects only tuberculosis, it is pointless to carry it out for young children after vaccinations; the reaction will show that the child is supposedly sick with tuberculosis. Many parents are opposed to injections for their children. They argue their position differently, says Valentina Aksenova.
“They think they can infect. Previously, when there were reusable syringes, they were afraid of HIV infection, but now this is a thing of the past. Syringes are now disposable. Plus, they are afraid that the child will be allergic to the injected substance. We know such children - who have allergic reactions. Before he does the Mantoux test, it will have been written in his medical book a long time ago that the Mantoux test is contraindicated for him.”
In recent years, a different diagnostic principle has been spreading in many countries around the world - without injections, but with a blood test, says Marina Gubkina.
“There is a quantiferon test. The child is not given drugs, but blood is taken and then research is carried out in the laboratory.”
The Quantiferon test was also used in Russia, but the license for the drug has expired and now the only alternative to injection tests is the so-called T-spot diagnostics. Parents can insist on it - if they are categorically against Mantoux. Doctors are obliged to meet them halfway. Clinical recommendations for such testing have already been published. One problem, notes Valentina Aksenova, is that this test is done at your own expense and not in every locality:
“This test is done in large centers. Where there are immunological laboratories. It is much easier to do Diaskintest. Those who are against vaccinations and manipulations with the child, let them go to the regional center and do an alternative method.”
Tests for tuberculosis through blood tests have already become the most popular in the United States. But in Germany, for example, children are not tested for this disease at all when entering school. In Russia, the Ministry of Health does not intend to refuse diagnostics. But amendments will be made to BCG vaccination - the first vaccination for infants will remain, but the second at the age of 7 will most likely be cancelled. Then the most accurate Diaskintest can be used as early as 5 years old.
Doctors emphasize that they do not deprive parents of the right to worry about their child, to vaccinate him, to make a diagnosis - or not. But as long as doctors have state responsibility for the prevention of tuberculosis - in groups, be it in kindergartens or schools - they, as before, will not allow potential carriers of the infection.
