Pros and cons of testing
The advantages include:
- Timely detection of the disease in children, starting from the age of one (including in latent form, in the early stages).
- Low cost method.
- General availability (carried out in almost any medical institution where there is an equipped vaccination room).
- Safety (contrary to myths, this is not a vaccination, not a “live” vaccine).
- Almost painless injection.
- Determining the need for vaccination or revaccination against tuberculosis.
Flaws:
- Low reliability of the results (50-70%) - the result can be affected by age characteristics, recent acute respiratory infections, the presence of worms, food allergens, environmental factors, quality of the drug, violation of the procedure technology, etc.
- Large list of contraindications. These are skin pathologies of a chronic or acute course, the presence of viral or infectious diseases, the presence of an allergic reaction in the body, epilepsy, somatic diseases, bronchial asthma.
- Possible side effects (fever, itching at the injection site, rashes on the skin, headache, insomnia, nausea, loss of appetite, general malaise).
- An allergic reaction to phenol is especially noticeable - skin rashes, and anaphylaxis is also possible, which requires urgent medical intervention.
Is it possible to refuse?
Yes, you can. In our country , it is legally determined that the diagnosis and prevention of tuberculosis requires voluntary consent .
This is reflected in the Federal Law “On the Fundamentals of Protecting the Health of Citizens in the Russian Federation” dated November 21, 2011 N 323-FZ, Article 20 “Informed voluntary consent to medical intervention and refusal of medical intervention.”
Children are examined with parental consent.
There is also Federal Law No. 157 “On Immunoprophylaxis of Infectious Diseases” dated July 17, 1998; last changes were made on December 31, 2014. It says that every citizen of the Russian Federation can refuse to vaccinate children (read more about whether vaccinations are mandatory in kindergarten and how to write a refusal, and in this article you will find a list of mandatory vaccines for children, without which you cannot taken to a preschool educational institution).
Parents will be able to make decisions for their children until they reach the age of 15. Only patients with an identified disease and a confirmed diagnosis are subject to examination and treatment.
The refusal must be issued at the clinic using the appropriate form. Many doctors mistakenly ask parents to fill out a form of voluntary consent to preventive vaccinations and refusal of them.
But, as stated above, this is not a vaccination, but an intradermal test. Therefore, you should fill out a form of voluntary consent (refusal) to medical intervention.
If you don’t yet know how to prepare your child for kindergarten, then read this article carefully.
Fines and experience
Last year, Health Minister Veronika Skvortsova said that the Cabinet of Ministers was considering the possibility of introducing fines for parents who refused vaccinations for their children. Ultimately, after a barrage of criticism, this idea was abandoned. But soon President Vladimir Putin raised this topic. The head of state did not rule out that administrative measures could be taken. “Now it’s some kind of fashion not to vaccinate at all,” Putin noted, recalling that in a number of European countries punitive measures are already in place for this.
It was no coincidence that he mentioned the European experience. Several EU countries have introduced liability for refusal to vaccinate, including removal of children from the family. In Italy, restrictions apply to the presence of unvaccinated children in public kindergartens and schools. If a child goes to an educational institution without vaccinations, his parents will face a fine of €500.
mantu
Assessment of the tuberculin Mantoux test in a child
Photo: TASS/Vladimir Smirnov
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In Germany, from March 2021, parents will be required to provide proof of measles vaccinations before enrolling in schools and kindergartens. Parents will be required to provide proof to the school or daycare that their child is vaccinated. For violating the law, a fine of €2.5 thousand is levied. Staff of kindergartens, schools, hospitals and other public institutions are also required to get vaccinated. At the same time, the decision on compulsory vaccination in Germany is supported by about 70% of the population, according to surveys.
“The threat that European states faced in the form of a return of infections that were considered already defeated warns us that it is dangerous to flirt with preventive vaccinations. And above all in relation to our children. If we erode the herd immunity that has reached a high level thanks to mass vaccinations, then the same threat awaits us. Denying vaccinations is a right that is defined by law today, but your well-being should not affect the well-being of others,” emphasized Andrey Stepanov, Commissioner for Children’s Rights of the Tyumen Region.
Can they not let you into kindergarten and what should they do if they don’t?
They can. The administration of the kindergarten will be guided by Resolution of the Chief State Sanitary Doctor of the Russian Federation dated October 22, 2013 N60.
According to this document, children who have not undergone tuberculin diagnostics are admitted to a children's institution only if they provide a certificate from a TB doctor confirming the absence of this disease.
Such a certificate will need to be provided every year. In addition to the examination and passing all standard tests, the final conclusion of the TB specialist will require the result of an alternative diagnostic method.
The court did not allow a child to be allowed into kindergarten without a Mantoux test
A resident of the Chelyabinsk region Elena Teplykh , who wanted her child to be admitted to kindergarten without a Mantoux test, lost in the court of first instance. The woman intends to challenge the decision and is ready, if necessary, to go to the Supreme Court, reports 74.ru.
“Personally, I was not at all surprised by this decision. When I asked why the judge made just such a decision, she replied: “I will not take responsibility and allow such a child to attend kindergarten, because then everyone will want to refuse, and what - everyone will go unexamined?” Elena said Warm.
“As a child, I myself had some allergic reactions to this tuberculin diagnostic. The hyperemia was very great. Some kind of rash appeared on my hand. Almost every time, after a week or a week and a half, I got sick. I don’t wish the same for my child. I don't want to do experiments. “What if everything turns out worse for him,” she explained the reasons for her reluctance to subject the child to a medical procedure to 31tv.ru correspondents.
According to the woman, she is not going to seek recognition of the requirements of sanitary rules for the prevention of tuberculosis as illegal, but she intends to prove that the ban on visiting child care institutions established there should not apply to her son.
“He does not belong to a risk group and does not live in a hotbed of tuberculosis, within which only new cases of the disease can arise. No minibuses, elevators or sandboxes are recognized as hotbeds of tuberculosis by any official document,” said Elena Teplykh.
The woman also said that she does not intend to perform the T-SPOT test, an alternative to the Mantoux test and Diaskintest, for her son if it is not provided free of charge as part of compulsory health insurance - she does not agree to regularly pay for an expensive procedure. However, regardless of the outcome of the trials, Elena Teplykh’s son, who is supposed to go to school in the fall of 2021, will be educated at home, she said.
In November 2021, Anna Kuznetsova, . According to her, it is also important to explain to parents the need for diagnosis and prevention of tuberculosis.
“The Commissioner under the President of the Russian Federation for Children’s Rights constantly receives requests from parents with complaints about refusal to enroll in an educational institution due to the lack of a Mantoux test.
Current legislation does not provide for any consequences of refusing the Mantoux test or performing a fluorographic examination; it also does not provide for additional examinations by specialists of unvaccinated children, taking additional tests or undergoing additional procedures.
If they do not want to conduct an examination of the child using the Mantoux test, parents or legal representatives of the children can indeed not do it by writing a refusal, like any medical intervention,” the commissioner’s office said then.
According to its employees, the practice of children’s access to educational institutions depending on the presence of a tuberculin test varies in different regions.
At the same time, experts are concerned about a significant increase in the number of cases of newly diagnosed active tuberculosis among children under 14 years of age in a number of constituent entities of the Russian Federation.
The Mantoux test will be replaced with Diaskintest
“If parents, for various reasons, refuse to give their child a Mantoux test, it is necessary to provide for the possibility of conducting other studies and secure it in regulatory documents,” representatives of the department believe.
“In many countries around the world, the Quantiferon test is widely used to diagnose tuberculosis. In Russia, it is also widely used to diagnose the disease along with other existing immunological tests (T-SPOT, Tubinferon, Diaskintest).
However, these tests are mandatory only in the algorithm for diagnosing the disease in risk groups and with clinical symptoms and, according to experts, are not a worthy alternative to the Mantoux test,” the Children’s Ombudsman’s Office recalled.
The Mantoux test will be replaced with Diaskintest
Earlier it became known that in the fall of 2021, new rules for diagnosing tuberculosis will come into force in Russia, according to which the Mantoux test will be gradually replaced by Diaskintest. It is assumed that the innovations will first affect schoolchildren, and then will be extended to pupils of preschool institutions.
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Alternative tuberculin tests
We list them in order of popularity:
- Diaskintest.
- X-ray of the lungs.
- T-SPOT.
- Quantiferon test.
- PCR diagnostics (polymerase chain reaction).
- Linked immunosorbent assay.
- Sputum analysis.
- Urine analysis for mycobacteria.
- Pirquet's test.
If you need a detailed list of doctors and tests for the garden, follow the link. In the article you will find detailed information on this issue.
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