What is BCG
BCG refers to preventive measures that prevent the spread of infection and have significantly reduced the number of cases of the disease and, especially, deaths among them. At one time, consumption claimed up to a quarter of the population and almost wiped out Europe.
The BCG vaccination protects only children from infection, since the validity of the vaccine to maintain immunity against infection lasts only 5 years, and even then the strength of the action depends on the individual characteristics of the body and the vaccine does not completely protect anyone from infection.
BCG plays its main role in the prevention of tuberculosis by preventing its transition to the open form. The closed form of the disease is characterized by minimal release of bacilli into the environment by the patient, and when it flows into the open form at a later date, the patient begins to actively infect others. It can be said that BCG protects an unvaccinated person from illness, and healthy people from it in case of illness.
In addition, the significant positive effect of vaccination is achieved due to the fact that vaccination contributes to a smoother course of the disease, reduces the development of complications and promotes faster healing, as it prepares the body to meet mycobacteria, which include all forms of tuberculosis.
Yes, the causative agent of tuberculosis really has several species that can cause disease only in humans or only in animals, as well as in both. The most dangerous type of bacteria for humans is the well-known Koch bacillus, which cannot yet be used for vaccination.
The BCG vaccine contains live bacteria that cause the disease in cattle, the second most dangerous for humans, which can be transmitted through dairy products and through contact with a sick animal. This bacterium is weak enough to be used for vaccination in a weakened or killed form, depending on the strain.
Contraindications for carrying out
Vaccination is contraindicated in newborns weighing less than 2000 g, in acute diseases, in immunodeficiency states, during therapy with drugs that suppress the immune system, in leukemia and lymphoma.
There are many articles on the Internet discussing various vaccinations, including the BCG vaccine. There are many arguments about the futility of vaccination against tuberculosis. In short, the main arguments against vaccination include complications after vaccination, tuberculosis despite the use of the vaccine, and the possibility of contracting tuberculosis from BCG.
Yes, complications do occur, but mostly in children with immunodeficiency, and generalized tuberculosis after BCG occurs exclusively in children with severely impaired cellular immunity. Yes, BCG vaccination does not protect against tuberculosis 100%, but it reduces the risk of developing the disease upon contact with a tuberculosis infection and prevents the development of generalized forms of tuberculosis.
The benefits of BCG vaccination are obvious.
Staging rules
The vaccination is given almost immediately after birth, on the third or fourth day, and sometimes later, if there are reasons for this due to the baby’s health. Before vaccination, you must make sure that the child is completely healthy and has not yet become infected with tuberculosis. If you have chronic ailments, you need to wait until your condition is completely stabilized and your well-being is stable for several days before and after the procedure.
It is also necessary to observe the maximum possible measures to prevent accidental infection with any infections, for which swimming, visiting public places, contact with strangers, walking, etc. are contraindicated.
During the fight against the injected drug, the child is especially susceptible to infection, and the presence of hidden or acquired infections can provoke serious complications.
Dosage, packaging and storage rules
Before starting vaccination, the specialist conducting it must make sure that it is intact and be able to open it correctly. The BCG vaccine is contained in hermetically sealed ampoules with a capacity of 0.5 or 1.0 mg (10 and 20 doses, respectively), BCG-M - with a capacity of 0.5 mg (20 doses). The ampoules are packed in boxes complete with solvent. Each box contains 10 ampoules: 5 ampoules of the vaccine and 5 ampoules of its solvent. The dosage of the BCG vaccine for 1 vaccination is 0.05 mg in 0.1 ml of solvent, BCG-M is 0.025 mg in the same amount of solvent. Shelf life at temperatures not exceeding +8 Celsius: BCG – 2 years, BCG-M – 1 year. If the vaccine is expired, the body may not react correctly after the injection.
What should be the reaction to the BCG vaccine in the room?
A normal reaction to BCG contains certain side effects in the form of fever, a slight deterioration in health and, most importantly, the formation of a scar at the injection site, which indicates the effectiveness of the vaccination.
After administration of the drug, a papule with slight redness and suppuration forms at the injection site. Sometimes, if the vaccination technique is violated, when the nurse misses and injects the drug not subcutaneously, but intradermally, the suppuration is more severe, since it occurs not inside, but on the surface. After the wound suppurates, a scar in the form of a scar or pockmark remains in its place.
Also, the size of the scar indicates the level of acquired immunity and the larger it is, the better. If the size of the scar is less than 4 mm, then the effect of the vaccination will end not after five, but after 3 years. A huge scar up to 8 mm indicates a strong effect that will last for seven years.
What should a BCG vaccination look like?
What does the BCG vaccination look like, or rather, the place of its administration on the human body? After the injection, the formation of a papule is observed on the skin, the diameter of which does not exceed one centimeter. These manifestations indicate that vaccination was completed successfully. After a quarter of an hour, the papule disappears and resolves.
How many days/months does it take for the initial reaction to appear? The reaction to BCG does not appear earlier than after a month. The duration of the vaccination reaction is 4.5 months. A mark appears at the injection site - a pustule with slight suppuration. There is no need to be afraid of this manifestation.
Then, on the skin at the injection site, the formation of a compaction (diameter 0.5-1 cm) is observed, which over time turns into a bubble filled with liquid. After 2-3 months, the blister bursts and a crusty wound appears in its place.
Important point! The resulting crust cannot be removed. When performing water procedures, you should also not get it wet. The injection site does not need to be lubricated with antiseptics.
After some time, a BCG scar with a diameter of 0.3-1 cm forms at the site of the wound. The scar is characterized by a reddish tint. A year later, the mark from the BCG vaccination is completely healed, which indicates that the vaccination was carried out correctly/successfully.
What should be the reaction after BCG? First of all, it should be noted that if the drug was administered correctly, taking into account contraindications, the vaccination period will proceed without any particular cause for concern.
So, with proper vaccination we observe:
- the appearance of a papule after an injection;
- after 1.5 months the injection site turns red;
- the appearance of an abscess or bubble with fluid;
- leakage of pus and its re-formation;
- the appearance of a scar, the diameter of which is in the range of 3-10 mm.
BCG is done three days after the birth of the baby, and then at seven years, but only if there are no contraindications.
A vaccination given to a child when he or she has prohibiting factors often causes complications that can be determined visually.
Vaccination is not carried out if:
- neoplasms were detected in the baby;
- the mother is diagnosed with HIV;
- One of your close relatives is observed to have a generalized BCG infection.
Vaccination is also not given if:
- development of acute diseases, as well as exacerbation of chronic pathologies;
- detection of immunodeficiency;
- undergoing a course of radiation therapy;
- severe diseases of the nervous system.
Also, the vaccine is not given if the baby weighs less than 2.5 kg. If there are contraindications, vaccination is not carried out or is postponed for some time until the child’s condition returns to normal.
Why is there no trace of BCG?
If there is no trace of BCG in a child, this indicates that the vaccination may not have worked due to a violation of the vaccination technology or a poor-quality vaccine (hence, immunity was not formed). This can also occur due to the child’s innate immunity to tuberculosis. There are also cases when there is no scar on the outside after BCG, but there is one under the skin. This can be easily determined by an experienced phthisiatrician. Sometimes a trail initially forms and then disappears. This behavior indicates the expiration of the vaccination period. Usually in such cases the mat gives a negative or questionable result.
If the vaccine is administered incorrectly, keloid scars can form, similar to a burn mark (presented as protrusions above the skin, not pits, have an irregular shape and tend to gradually grow). Most often, keloids are formed during revaccination and do not stop growing on their own. Intensive therapy is used to stop them, but it is best not to touch them at all.
BCG can fester for quite a long time, more than a month, and this is a normal process that does not need to be touched, however, it happens that there is no abscess after BCG. This can happen when the vaccine is administered too deeply, not subcutaneously, but into the muscle, and it is not visible from the outside. If an intramuscular purulent abscess is formed, it can be noticed after 4-6 weeks and removed surgically.
Characteristics of the positive qualities of the vaccine
Possessing high protective properties, the domestic vaccine produces a minimal number of adverse reactions. Among its important qualities it should be noted:
- specific harmlessness. During vaccine production, strict control is ensured over the level of residual virulence of the strain necessary for the formation of immunity, in order to prevent the virulence index from increasing to a value dangerous for the human body;
- purity (this indicator indicates the absence of impurities of foreign microflora in the composition of the drug);
- stability of the total bacterial content, allowing residual virulence to be maintained at the required level, without increasing or decreasing it;
- specific activity - this parameter indicates the number of viable bacteria in the preparation. Any fluctuations in one direction or another can make the vaccine unsuitable for use: a decrease in the number of such bacteria will reduce the vaccine’s ability to develop immunity against tuberculosis in the human body, and an increase in them will make it dangerous;
- high dispersion index - not lower than 1.5. This characteristic shows the degree of presence of suspended particles in the composition of the grafting suspension - the smaller they are, the more homogeneous the suspension and the higher the dispersion;
- thermal stability - the ability to retain the maximum number of viable microorganisms when storing the vaccine in a thermostat;
- solubility - when adding a solvent, the contents of the ampoule should dissolve in it within 1 minute;
- the presence of a vacuum in sealed ampoules with grafting material.
We recommend reading! Follow the link: When is the BCG vaccination given in the maternity hospital?
The BCG vaccination is absolutely harmless. In rare cases, side effects are possible after vaccination in the form of redness and swelling of the arm, and fever. But the risk of their occurrence and the severity of the consequences are incomparable with the consequences of infection with a lethal form of tuberculosis.
