Reduce the risk of contracting tuberculosis with BCG revaccination

Revaccination with BCG reduces the risk of contracting tuberculosis. Because after the first vaccine the virus does not always disappear. It seems to enter a state of stasis (L-form) and can manifest itself at any time when the child is no longer breastfed. In Russia, BCG vaccination is given from birth. But every 7 years you have to do a revaccination. This is how long the body’s protection lasts after the first vaccination against Koch’s bacillus.

At what age is BCG revaccination carried out?

Revaccination of children is carried out at the ages of 7 and 14 years. But this applies only to those children who were vaccinated no earlier than one year. If parents refused the first BCG vaccination, but then suddenly decided to vaccinate their child, completely different rules are provided for them.

When a child is born, he receives the first vaccination between 4 and 7 days. But sometimes doctors may delay this process. Over the next 7 years, the child develops strong immunity to tuberculosis. After 7 years, the child is given a Mantoux test. If the body is not infected, revaccination is carried out.

There are two opinions about the age of 14. Usually, vaccination at 14 years of age is given only to those children who were not vaccinated at 7 years of age. But in some regions of Russia, the third revaccination is mandatory. What is this connected with? In fact, at this age, vaccination is done voluntarily.

Since such a scheme has not received confirmation. Until now, many doctors recommend revaccination only twice. But there are force majeure circumstances (for example, epidemiological centers, bad heredity, etc.). Therefore, some doctors take out insurance to avoid unpleasant situations.

Conclusion

Repeated vaccination at 7 years of age is necessary for all children unless they have absolute contraindications. Such a vaccination does not guarantee that a child will not become infected with tuberculosis, but it is a fact that he has less chance of getting sick than an unvaccinated person. Also, when infected, the disease will not take on an open form; it will proceed slowly and without serious complications.

Parents have the right to refuse BCG, but they should think twice about it first. Now the incidence has doubled compared to previous years, and the risk of infection has accordingly increased. The health and life of a child is in the hands of his parents.

Revaccination for adults

The tuberculosis vaccine is given at any age up to 30 years. But there are some nuances:

1. The Mantoux test must be negative (usually 2 TE);
2. The patient must not have a previous disease (tuberculosis);
3. The patient does not have documents confirming that such a procedure was performed;
4. The vaccination is done three days after the Mantoux test, but no later than two weeks;
5. The patient lives in an epidemiological area. That is, the probability of becoming infected is very high.

What vaccine is used for revaccination?

For revaccination, the drug BCG or BCG-M is used. They contain a dried bacterial culture. It retains its structure and is able to provoke the development of immunity. The composition has remained unchanged since 1921. Available in ampoules. Each ampoule is designed for 20 doses and contains 1 mg. BCG solution.

BCG-M is considered a gentle type of vaccine. It is used if the child has an intolerance to one of the components, or if there is a presence of chronic or infectious diseases at this stage. That is, first you need to cure the disease, and then get vaccinated with a mild form of the vaccine.

Mantoux test

Before any vaccination for tuberculosis, the doctor must do a Mantoux test. This is a simple procedure that determines the presence of antibodies that can fight the disease. Even during revaccination, this procedure must be completed. To do this, patients are injected with tuberculin (this is a weak solution with mycobacterium disease). That is, first the doctor does a tuberculin test, then observes the reaction (the size of the button that appears after the injection).

If the body is vaccinated three times (at birth, at 7 years and at 14 years), the Mantoux test must be performed annually, up to 18 years.

Indications for use

The procedure is indicated for children who have not been vaccinated against tuberculosis. If the child was born premature (less than 2 kg), then it is necessary to increase his weight to 2300 g. and vaccinate with the safer drug BCG-M.

The drug is greatly influenced by the Mantoux test. If the reaction is positive, then revaccination is not carried out, otherwise there is a risk of an inflammatory process.

Among children there is a risk group who are likely to transmit Koch's bacillus along the hereditary line. Vaccination is mandatory for such children. If one of your relatives becomes infected with tuberculosis, doctors recommend that all family members be vaccinated.

Indications for postponing the procedure

The procedure can be done earlier (for example, at six years old), when there is a tuberculosis patient in the family, and the child’s immunity is weak. Also in the absence of a scar on the shoulder.

Revaccination is tolerated if:

1. The person being vaccinated is sick (there is an exacerbation of chronic diseases, acute respiratory infections, ARVI, influenza, measles, etc.). After recovery, at least two weeks should pass. No vaccination is given to a sick child. This is fraught with complications.
2. You are planning a trip that cannot be postponed. Before and after vaccination, it is not advisable to visit crowded places. The post-vaccination period involves a close social circle, a prerequisite is a healthy environment. The immune system at this moment is weakened, and the child quickly falls ill, but treatment will take a long time.
3. If the mantoux test is positive. In this case, the child has already become infected with tuberculosis or has developed innate immunity. Further examination will determine exactly the cause of this reaction. In any case, BCG is not advisable.
4. The vaccine is not given if there is HIV infection or the baby is being treated with immunosuppressants.

Only after all contraindications have been eliminated can revaccination be performed. First, the doctor collects an anamnesis, examines the child, takes a general blood and urine test, and only after receiving the results an appropriate decision is made. The pediatrician makes the verdict; it is he who takes responsibility.

Contraindications to BCG revaccination

Revaccination at 7 years of age is contraindicated for the following problems:

• For intrauterine infections during gestation and other purulent diseases;
• In premature babies weighing less than 2 kg;
• During severe damage to the central nervous system;
• During hemolytic disease of the newborn, when the Rh factor of the blood of the mother and child is incompatible;
• When a child has acute forms of the disease;
• In the presence of immunodeficiency;
• If the child has skin diseases;
• If the patient is sick, has been ill, or has become infected with Koch’s bacillus;
• In the presence of serious acute infections;
• During a serious blood disorder;
• If you had serious side effects caused by a previous vaccine (for example, an allergic reaction to one of the components of the vaccine);
• Malignant formations (tumors).

Popular Everything you need to know about the mandatory vaccination schedule for children

Revaccination at 6 years of age is contraindicated for children who received the first tuberculosis vaccination at birth. This is due to the fact that the child is still protected by the first vaccine.

During quarantine (in the family, kindergarten, school, etc.), vaccination is prohibited. You can start doing it only when the quarantine ends. If the patient has a certificate that temporarily exempts him from vaccinations according to some prescriptions.

Post-vaccination reactions

The vaccine is administered intradermally, so post-vaccination effects are mainly represented by local reactions. The very mechanism of action of the vaccine involves local inflammation with the formation of ulcers and scars (3-10 mm), so it is not entirely fair to consider these effects as side effects. Moreover, such reactions do not require treatment and go away on their own. Reactions to BCG are delayed - in newborns, a local reaction appears after 4-6 weeks, in those who are re-vaccinated - after a week.

Possible complications

According to statistics, the frequency of complications after revaccination is 0.003%, although with the first vaccination this figure is higher (0.002 - 1.2%).

After the vaccine has been administered, complications may occur on the skin. Symptoms may appear as subcutaneous accumulations of cellular elements mixed with blood and lymph (infiltrates), in the form of ulcers, inflamed lymph nodes, or a tumor-like (keloid) scar.

If the vaccine is administered to a patient who has congenital immunodeficiency, then a BCG infection may develop in the body. This is a common virus that primarily affects the lymph nodes and then other organs. The result is death.

Acceptable side effects include:

• The appearance of bright redness of the skin at the injection site;
• Abscess formation;
• Temperature increase from 37°C to 39°C.

If any complications occur, you must inform your doctor. If, due to the negligence of a medical employee, an overdose of the drug occurs, then the patient is given chemotherapy. There are other, gentle methods (local injection of glycosides), but their effectiveness is very controversial.

Adverse reactions and complications

This vaccine is considered reactogenic, so after its administration you can often observe the body's reaction. The types of complications and their complexity depend primarily on the quality of the vaccine, as well as other factors.

After the vaccine is administered, a transparent papule appears at the injection site, which goes away within 20 minutes. At this point, there are generally no complications.

They appear after a few weeks, when the body gets used to the administered drug.

Possible body reactions:

• the appearance of an infiltrate up to 10 mm in size;
• enlarged lymph nodes;
• cold abscess;
• superficial ulcer at the injection site;
• keloid scar.

How does the revaccination process work?

To receive a second vaccination against tuberculosis, the patient must have a negative Mantoux test. Only then can a healthcare worker administer the vaccine.

Vaccination of the population must be done by a medical worker or a doctor with medical education (for example, a nurse or a school doctor).

The vaccination should be done with a new sterile disposable tuberculin syringe and rubber gloves. The needles of such syringes are short and have a thin bevel. But in order to mix the solution, you need to use a long thin needle and another disposable syringe. To do this, the medical worker must unpack the new package, put on gloves, and open the package with the syringe.

The prepared vaccine should be transparent. Before injecting the drug under the skin, you need to make sure that the liquid has not changed color and that no other foreign substances have entered there. If this happens, the drug must be changed. You cannot vaccinate with a drug that has expired. Expired syringes, insulin analogues and needleless injectors are not acceptable.

Before breaking the seal of the package, the medical professional must make sure that the ampoule is not damaged and has a natural color. If the vaccine is sealed under vacuum, the upper part of the ampoule is wiped with alcohol, then the neck is sawed off and broken off.

The sawed part is wrapped in gauze. If there is a ring or a break point on the neck, do not file the ampoule, but press it with your thumb and simply break off the top. All other actions are similar.

To obtain a dose of BCG vaccine ((0.005 ml. in 0.1 ml.), for this, 2 ml of 0.9% sodium chloride solution are injected into one ampoule, which is designed for 20 doses. If the ampoule contains 10 ml., then the amount sodium chloride is reduced by half.

Do not expose the drug to direct sunlight. It is usually covered with a paper cylinder. Once it is dissolved in sodium chloride, its shelf life is no more than an hour.

Before the procedure, the skin is stretched a little, then the drug is partially injected to check whether the needle is positioned correctly. If everything goes well, the procedure is completed.

Popular How to prepare a child for DTP vaccination

A button appears at the injection site (size from 5 to 10 mm). At the very top of the seal it should be white. This is a normal reaction and after 15 - 20 minutes. she disappears.

The injection is administered by a medical professional to the outer part of the left shoulder. It is administered intradermally between the second and third parts of the limb. The drug can be administered subcutaneously or intramuscularly (although there is a risk of a cold abscess). In very rare cases, if the child cannot be injected in the shoulder, it is done in the thigh.

Ability to mix vaccines

It is unacceptable to mix one type of vaccine with other drugs in the same syringe. Moreover, two vaccinations cannot be given at the same time on the same day.

After each injection, the used materials (syringes, gloves, cotton swabs, etc.) are soaked in a special solution (5% chloramine or 3% hydrogen peroxide). Then all this is disposed of.

Revaccinated patients are recorded in a special register. The patient's name, date of the procedure, type of vaccine and manufacturer are entered there. They also add the batch number and expiration date of the solution.

Instruments used for BCG vaccinations are prohibited from being used for other purposes. The drug is stored securely in the refrigerator under a sealed lock.

BCG vaccination does not save, but softens the blow

The fact is that tuberculosis has various forms - from mild focal to deadly, the most terrible of which is tuberculous meningitis. So, the BCG vaccination, although it does not guarantee protection against infection and disease, almost completely eliminates the development of severe, deadly forms of tuberculosis

In other words, a baby vaccinated in infancy can theoretically get tuberculosis at any time in his life, but most certainly will not die or suffer significant damage to his health.

The BCG vaccination can be compared to an airbag in a car - it, of course, does not guarantee that the driver will not have an accident (it doesn’t even have such a task!), but it will almost certainly save his life if an accident does happen .

The vaccine itself has been around for almost a hundred years, has several variations with minor differences, and is essentially nothing more than a “cocktail” of weakened tuberculosis bacilli. Reacting to the “planted” tuberculosis bacteria, the body begins to produce special antibodies, which protect a person throughout his life from severe and fatal forms of the disease.

This is a kind of “army exercise” - the body trains on a weakened enemy in order to effectively resist the present enemy in the future.

When not to use the drug

In addition to contraindications, employees of medical institutions may reject the entire batch or individual ampoules of the drug if:

• The vaccine has expired;
• There is no marking on the label;
• The ampoule is damaged, there are cracks on the body;
• The naked eye can see that the vaccine has changed its properties;
• The seal of the packaging is broken;
• Violation of vaccine transportation rules.

Shelf life of BCG

The drug should be stored in a cool place at a temperature of 0 to 8°C for no longer than two years.

After vaccination it is recommended:

• Do not treat the injection site with any disinfectants. This applies to any reactions to the vaccine (infiltrate, abscess, button, ulcers, etc.)

• Do not scratch, wash or touch the injection site;
• Sit for half an hour near the doctor’s office after the procedure (this is done in order to provide first aid in a timely manner in case of sudden complications);
• If there are any incomprehensible reactions of the body, inform your doctor;
• read the order of the Ministry of Health of Russia No. 109 “On improving anti-tuberculosis measures in the Russian Federation” dated March 21, 2003.”

How does the reaction to vaccination proceed normally in the first few days?

Immediately after the vaccine is administered, a white papule appears on the child’s shoulder. A few hours later there is no sign of her. Then the area may turn red - this is normal. There is no need to treat the injection site with anything. If you experience high fever, weakness or other symptoms, you should immediately go to the hospital. Usually after vaccination there are no symptoms in the first days and the vaccination should not bother the child.

The photo shows what the injection site looks like at the time the vaccine is administered.

When a pathogen enters the skin, the immune system must respond, T-lymphocytes accumulate and give an appropriate response. Redness is a sign that the baby’s body is becoming familiar with the introduced microorganisms, and the process of developing immunity has begun.

On the first day, vaccinations may look different for each child. This is due to the individual characteristics of the body. Immediately after the vaccine is administered, as already mentioned, a papule appears; it usually does not exceed 1 cm in diameter. If after half an hour there is redness or swelling, this is a sign of incorrect administration. The injection site should normally not differ from other tissues. In rare cases, a slight increase in temperature may occur. If it persists for several days or rises to 38 degrees or more, you need to go to the hospital. Usually everything returns to normal on its own within a couple of days.

On the second day, only the injection mark will be present on the arm. There may be slight redness that will be itchy. Even a slight compaction is not considered a deviation. If severe swelling and pain appear, you need to consult a pediatrician; most likely this is a manifestation of an allergy. During this period, you need to monitor the child, since the slightest discomfort may mean the beginning of the development of complications.

On the third day there may also be redness and a thickened area of ​​tissue. This should go away and there should be nothing present on the shoulder within two weeks. After 2-3 weeks, an immune reaction begins, which we will talk about later.

How does a button heal?

Some parents begin to panic when they see what processes are happening at the injection site. After all, such complications could simply not have occurred at birth.

7 years after vaccination against tuberculosis, the first symptoms begin to appear 30-45 days after vaccination. The papule heals within 4 – 4.5 months. But after administering the drug, the injection site begins to turn red. Sometimes a bruise appears that turns black, blue, or purple.

This is a normal reaction of the body to the drug. An abscess appears at the site of redness. Under no circumstances should it be crushed or smeared with antiseptics. Over time, the liquid hardens and becomes covered with a thick crust. Then the abscess heals and an almost invisible scar remains on the skin.

Sometimes the abscess bursts and the collected fluid flows out. This is also a normal condition. Liquid may recollect. To get rid of pus, you need to take clean gauze and make a bandage.

After the suppuration stops, a small convex pimple will appear on the skin, which will heal over time and turn into an invisible scar.

How do you feel about mandatory vaccination?

• Positively, it prevents many diseases. 60%, 2641 votes
  2641 votes 60%

  2641 votes - 60% of all votes

• Negatively, these are all government schemes to make it easier to manage us. 26%, 1157 votes

  1157 votes 26%

  1157 votes - 26% of all votes

• Neutral, I don’t think it has any effect on my health. 13%, 592 votes

  592 votes 13%

  592 votes - 13% of all votes

Total votes: 4390

Votes: 4365

January 17, 2018

×

You or from your IP have already voted.