Vaccination against BCG tuberculosis is the need and validity of vaccination, a feature of the formation of immunity
Immediately after the birth of the baby, after evaluating his condition, conducting anthropometric measurements of the newborn, the puerpera will be asked a very important question: do you agree to the child’s vaccination against hepatitis and tuberculosis.
And what to do if the baby was born prematurely, if sick, is it possible to vaccinate. And to help the mother answer these questions, consider the features of vaccination against tuberculosis.
The composition of the vaccine.
BCG vaccine consists of various Mycobacteria Bovis subtypes. To date, the composition of the vaccine has been supported by unchanged since 1921. The IH stores all the series of subtypes of mycobacteria, which are used for the production of BCG. To obtain a culture of mycobacteria intended for the production of vaccine drugs, a bacillus sowing method is used to a nutrient medium. The cell culture grows on the medium for a week, after which it is distinguished, filtered, concentrated, then turned into a homogeneous mass, which is diluted with clean water. As a result, the finished vaccine contains both dead and living bacteria. Today, in the world, 90% of all drugs contain one of the three following strains of mycobacteria: French "Pasteur" 1173 P2; Danish 1331; Strain "Glackso" 1077; Tokyo 172. The effectiveness of all the used strains in the BCG vaccine is the same.
In our country, a single centralized purchase of a vaccine against Tuyurculosis is produced. Therefore, in a certain period of time, all Belarusian healthcare institutions work and use only one type of vaccine. There are no private purchases of vaccine against tuberculosis in the Republic of Belarus.
Why you need to vaccinate.
The opinion that the newborn has nowhere to “meet” with mycobacteria of tuberculosis in order to get sick is erroneous, given that about 2/3 of the adult population are carriers of this mycobacteria, although they do not get sick. Micobacteria carriers are sources of microorganisms, which, when coughing and sneezing, can fall into the environment. And since even a newborn child has to be taken out of an isolated room to common places (impatiently common corridor, staircase, elevator) where, especially in cities and apartment buildings, there are constantly many people, the probability of infection of the baby with mycobacteria is very high. According to statistics, by the age of 7, 2/3 children are infected with mycobacteria of tuberculosis. Everyone can get sick, but the child has a high risk of forming severe forms of the disease such as tuberculosis meningitis, male tuberculosis and other very dangerous conditions, the mortality of children in which is very high.
Therefore, in our country, a decision has been made on the vaccination of all newborns, since the prevalence of tuberculosis is very high, and measures taken to treat and early detect cases of infection will not be able to reduce the incidence.
Why it is preferable to instill in the early days of life.
The World Health Organization recommends that the BCG vaccine be introduced to children as early as possible. That is why in Belarus the BCG vaccination is the first in the national calendar.
But many parents have a question - is it bad, maybe it is better to wait? In response to this difficult question, it is worth talking about the features of the formation of immunity in a newborn.
And you need to start with the explanation of the immune relationships of the fetus and mother. In the immune system of women during pregnancy, significant physiological changes occur, due to the development of the fetus and serious endocrine shifts. It would seem that the mother’s immune system should answer the natural reaction of the rejection of foreign cells. However, with the normal course of pregnancy, this is not observed.
Moreover, the organisms of the mother and fetus are actively “exchanged” by immune information. So, maternal antibodies of the IgG class (memory of all contacts with infectious agents) freely penetrate through the placenta. Especially active transplatic transport of maternal immunoglobulins occurs at the end of pregnancy. It is this that explains the very high level of protective maternal immunoglobulins in the blood of full -term newborn.
Products of their own antibodies with an immune system of the fetus during normal pregnancy also occur, but with very low intensity and their concentration by the time of birth is small. Therefore, no newborn child can answer a stormy, inadequate reaction to the introduction of an alien agent, which is very important during vaccination.
Thus, by the time of the birth of a healthy child, the main protective functions perform passively acquired antibodies that made a transplacental transition from the mother. The protective spectrum of maternal immunoglobulins is very wide and directed against a variety of infectious agents, including against tuberculosis. Therefore, it is laid that a healthy newborn in a healthy mother, provided that a well -leaving pregnancy is in the first week of life, is most protected from all infections and at the same time cannot violently respond to the introduction of various infectious agents. And it is precisely this period, as the most optimal that was selected and approved by the vaccination calendar adopted in the country for the first vaccination of the newborn against tuberculosis.
Naturally, in prematurely newborns, the level of protective maternal immunoglobulins is significantly lower. And a sick child can unusually answer the introduction of a vaccine. But at the same time, this is a group of children, most vulnerable and unprotected when meeting with infection. Therefore, after treatment in the pediatric department, assessing all risk factors for the development of post -vaccination complications, we try to vaccinate our small patients and use a weakened form (BCG m) for vaccination.
Features of vaccination.
Given the feature of the vaccine (this live vaccine), immunoprophylaxis is carried out only in healthcare institutions that have permission and tolerance to this VILE VECCINATION. The receipt, transportation, storage and use of the vaccine is carried out as part of strict compliance with all the required modes. Therefore, vaccination against tuberculosis is not carried out in any private center of the republic.
There are no vaccinations with BCG at once with BCG! In the maternity hospital, a vaccination against tuberculosis is done a few days after vaccination against hepatitis B. Before vaccination by the doctor, the general condition of the newborn is necessarily evaluated, as well as all possible features of the course of the post -vaccination period.
It is important to understand that the BCG vaccine does not protect a person from infection with mycobacteria of tuberculosis, does not reduce the spread of tuberculosis in any way. The BCG vaccine is intended only for the prevention and prevention of a severe, deadly type of tuberculosis. However, it has long proved its effective effect in a significant weakening of the severity of the course of tuberculosis in children under the age of 2 years. BCG vaccination allows excluding the likelihood of the development of meningitis and disseminated forms of tuberculosis, which almost always end in fatal outcome. The repeated administration of the vaccine does not lead to increased protection against the disease, so revaccination has been recognized as inappropriate in recent years.
Reaction to the vaccine.
Vaccination of BCG on the development of reaction belong to the type of delayed. Immediately after the introduction, the child is well transferred, and reactions to the vaccine develop some time after administration and look like inflammation. The peculiar course of the post -vaccination period makes many consider these reactions to the negative consequences of the BCG. This is absolutely incorrect, since these changes are the normal course of the formation of post -vaccination immunity.
What does the BCG vaccination look normal.
The vaccine is administered intradermally into the middle third of the shoulder of the left handle. The introduction in the area of the deltoid muscle is used due to the least pain in the development of local adverse reactions.
Immediately after the introduction of the vaccine, the injection site may swell slightly. Such swelling does not last long - a maximum of two to three days, after which it passes on its own. After such a primary reaction, the place of administration of BCG should be absolutely ordinary, indistinguishable from neighboring skin. This time is called the period of immunological peace, lasts an average of 3 to 4 weeks and other vaccinations are not made for this entire period of time. And only after this period does the development of a vaccination reaction begin, which is characterized by the appearance of an abscess, after its independent opening, the development of sores covered with a crust, the final stage is the formation of a scar.
What you need to pay attention to.
The vaccination site was inflamed. Redness and light suppuration of the injection site is a normal vaccination reaction. The redness of the injection site is normal only during vaccination reactions. Redness should not apply to surrounding fabrics. If the BCG has the appearance of an abscess, a red pimple, or a bubble with a liquid, and the fabric around this place is normal, then you should not worry, there are simply different options for the course of the vaccine reaction. Redness can also be during the formation of the scar on the skin.
BCG is festering or. Supervision of BCG during the development of the reaction is normal. The vaccine should look like a small abscess with a crust in the middle. Moreover, the surrounding fabrics (the skin around the abscess) should be absolutely normal, that is, there should be no redness and swelling around the suppurate BCG. If there is redness and swelling around the suppurate BCG, then you need to consult a doctor, since the postpoint reaction may be treated that should be treated.
The formation of a rough scar.Sometimes a rough scar is formed at the place of administration of the drug - then the skin acquires a red color and gnaws a little. This is not a pathology - the skin thus reacted to the BCG.
BCG itches. The place of BCG vaccination can scratch, since the active process of healing and regeneration of skin structures is often accompanied by various similar sensations. Their development, as well as the degree of severity depends on the individual properties and reactions of the human body. However, you should not comb and rub the place of vaccination - it is best to restrain the child with a gauze napkin in the injection site, or putting on mittens.
Complications on preventive vaccination.
The anti -TB BCG vaccine is a drug from a living culture of mycobacteria, so it is not possible to avoid post -vaccination complications. Complications during BCG vaccination have been known for a long time and accompany it from the beginning of its mass application. Their total number after BCG vaccination is 0.02–1.2%.
The complications of the BCG include such states in which serious disorders of the child’s health are developing, requiring treatment.
Most often, complications in the form of local reactions are noted - subcutaneous infiltrate,Cold abscesses,Lympadenitesand keloid scars.
Subcutaneous infiltrate- A dense painless area at the site of the introduction of the vaccine, soldered with the skin, is accompanied by an increase in the lymph nodes. It occurs 1-2 months after vaccination depends on the technique of the introduction and the special reaction of the child.
Ulcer-a defect in the skin and subcutaneous tissue at the place of administration of the vaccine, a diameter of more than 10 mm, develops after 3-4 weeks.
The occurrence of lymphadenitis- inflammation of the lymph nodes, often axillary, cervical or subclavian on the left. The most common adverse reaction depends on the quality of the vaccine, its dose, the age of the vaccinated, do not depend on the technique of intradermal administration. The term of occurrence is 2-3 months after vaccination.
Cold abscesses- As a rule, the result of a violation of the introduction of the vaccine when the drug falls under the skin. However, one cannot completely deny the influence of the quality of the vaccine on the occurrence of this complication. The time of the occurrence of Ch-Z 1-6 months after the introduction of the vaccine
Keloid scar- a consequence of the characteristics of the body and dominance in the process of chronicinflammatory reactionStagesProliferation, instead of the stagealterationsAndexudation
Complications of BCG vaccines are extremely rare, and most of these cases occur in children with a persistent innate decrease in immunity.
It should be remembered that the vaccine prevention of tuberculosis is one of the significant achievements of medicine. This is a pillow of humanity - from birth and for life. And we try to give a chance to each baby to be healthy.
Pediatric department of the second stage
nursing newborn children.
