Live dry tuberculosis vaccine has the appearance of a white mass. One ampoule of BCG contains 1.0 mg of the vaccine (20 doses of 0.05 mg of the drug), one ampoule of BCG - M contains 0.5 mg of the vaccine (20 doses of 0.025 mg of the drug). The BCG vaccine is not suitable in the presence of cracks in the ampoule, wrinkling of the "tablet", discoloration, etc., in the presence of foreign inclusions or non-breaking flakes in the diluted preparation.
Indications: prevention of tuberculosis. It is used from the third day of life to all healthy newborns (BCG vaccine for children weighing 2500 and more, BCG vaccine - M - weighing from 2000 to 2500), then - at the decreed age. BCG - M vaccine is also used for vaccination of premature babies in nursing departments when they reach a weight of 2000 g and for vaccination in polyclinics - children who have not been vaccinated in the maternity hospital.
Method of administration and dosage: the vaccine is diluted immediately before use with the supplied diluent (0.9% solution of chloride sodium). To obtain a dose of 0.05 mg of BCG in a volume of 0.1 ml (for the BCG - M vaccine, to obtain a dose of 0.025 mg in 0.1 ml), 2 ml of solvent is transferred into the ampoule with the vaccine with a sterile syringe with a long needle. The vaccine should dissolve easily and quickly - give a uniform suspension in 1 minute. The diluted vaccine must be protected from the action of the sun and daylight(black paper cylinder) and consume immediately after dilution.
For vaccination against tuberculosis, disposable syringes with a volume of 1 ml are used. For one vaccination, 0.2 ml (2 doses) of the diluted vaccine is taken, then 0.1 ml of the vaccine is released through the needle to displace the air. Before each set of two doses, the vaccine must be thoroughly mixed with a syringe.
The vaccine is administered in the morning hours strictly intradermally on the border of the upper and middle third of the outer surface of the left shoulder. Subcutaneous injection is unacceptable, because this may result in a cold abscess. The needle is inserted with a cut upward into the surface layer of the skin. First, a small amount of the vaccine is injected to make sure that the needle is inserted exactly intradermally, and then the entire dose of the drug is 0.05 mg in 0.1 ml (BCG - M - 0.025 mg in 0.1 ml). At correct technique injection should form a papule of whitish color measuring 6-8 mm in diameter. After 15-20 minutes, the papule disappears. The imposition of a bandage and treatment with iodine and other disinfectants is prohibited. solutions of the vaccine injection site.
Reaction to introduction: in newborns, a normal vaccination reaction appears in 4-6 weeks (after revaccination - already in the first week after vaccination). First, an infiltrate appears (at the age of 1-2 months), then a papule (at 2-3 months), a pustule (at 3-4 months), a crust (at 4-5 months), then from 5 6 months in 90-95% of vaccinated patients, a superficial scar of 2-10 mm in size remains. The site of reaction should be protected from mechanical irritation, especially during water procedures.
Complications: relatively rare, usually local in nature.
1.Subcutaneous cold abscesses (aseptic infiltrates)
2 superficial ulcer
3.Postvaccinal lymphadenitis of regional lymph nodes
4 keloid scars
5.Osteitis (by the type of bone tuberculosis)
6. Generalized BCG - infection (very rare).
Contraindications:
Vaccination of newborns:
1.Prematurity - birth weight less than 2000 g.
2.Acute diseases (including intrauterine infection, purulent-septic diseases)
3.Hemolytic disease of newborns (moderate - severe and severe forms)
4.Severe birth injuries with neurological symptoms
5.Generalized skin lesions
6. Generalized BCG infection found in other children in the family.
To revaccination of children and adolescents:
1.Infected with tuberculosis or tuberculosis in the past
2.Positive or doubtful (up to 4 mm) Mantoux reaction
3. Complicated reactions to previous BCG administration
4. Keloid scars, incl. at the site of the first vaccine administration
5.Malignant blood diseases and neoplasms
6.Primary immunodeficiency states, HIV infection
7.Allergic diseases in the stage of exacerbation - can be vaccinated after recovery or achievement of remission (according to the conclusion of a specialist)
8.Acute diseases (infectious and non-infectious), including the period of convalescence, chronic diseases in the stage of exacerbation or decompensation - vaccinations are carried out no earlier than 1 month after recovery (remission)
9. Treatment with immunosuppressants - 12 months after the end of treatment.
Storage and transportation conditions: at a temperature not higher than + 4 ° С. Unused vaccine cannot be stored. In exceptional cases, the diluted vaccine can be used within
2-3 hours.
Shelf life: 2 years.
Notes: 1. Trained personnel are allowed to carry out vaccinations (trained in an anti-tuberculosis institution, having a certificate - admission to conducting tuberculin tests and BCG).
2. Other vaccinations can be carried out with an interval of at least 2 months after BCG.
3. In the first two months of life, BCG vaccination is carried out without a Mantoux test. Children older than 2 months - with a preliminary test of Mantoux with a negative result (and revaccination as well).
4. The interval between the Mantoux test and the introduction of the BCG vaccine (or BCG - M) should be at least 3 days and no more than 2 weeks.
CHARACTERISTICS OF NEW MEDICAL
IMMUNOBIOLOGICAL PREPARATIONS.
Any vaccination has the function of immunoprophylaxis, the purpose of which is to develop immunity in the human body to the causative agent of the disease introduced with the vaccine.
One of the main ones is the BCG vaccination, due to which in the child's body latent infection the disease does not turn into an obvious one, and the occurrence of heavy forms this disease... That is why the first BCG vaccination is administered to children in the first days of life after birth.
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What does the abbreviation BCG mean?
The common name for the BCG vaccination comes from the Latin abbreviation Bacillus Calmette-Guérin (BCG), which means Bacillus Calmette-Guérin, named after the scientists who discovered it. It is prepared from a strain of a weakened tubercle bacillus grown in a special artificial environment. cattle- Mycobacteria bovis of different subtypes. The vaccine itself contains a certain number of live and dead bacteria.
What does the abbreviation BCG-M mean?
BCG-M - this is the name of the dry tuberculosis vaccine against, for primary immunization in a gentle form. It differs from the usual vaccine in low concentration - if BCG contains 0.05 mg of the drug, then BCG-M is 0.025 mg, respectively. This vaccination is intended for primary vaccination:
- Premature newborns (less than 2500g);
- unvaccinated in the hospital due to weakness or some kind of disease (vaccinated in the clinic at the place of residence).
The history of the emergence of the BCG vaccine
The founders BCG vaccines are French scientists Camille Guerin (veterinarian) and Albert Calmette (microbiologist).
- 1908 - the beginning of the work of scientists, during which they established that in a certain nutrient medium it is possible to grow tubercle bacilli of the least activity. After that, they began to develop a strain to create a vaccine.
- 1919 - scientists receive a vaccine with non-virulent bacteria, not disease causing in animals.
- 1921 - Received the BCG vaccine for humans.
- 1925 - the strain was transferred to Moscow to the scientist L.A. Tarasevich, as a result of which the effectiveness of the vaccine was revealed.
- 1928 BCG is adopted by the League of Nations.
- Mid 1950 - Neonatal vaccination becomes mandatory.
- 1985 - BCG-M began to be used.
Which countries are vaccinated against tuberculosis
BCG vaccine is used in many countries. In the USSR, in 1962, it was customary to vaccinate all newborns en masse in the maternity hospital, which is happening to this day. Currently, this approach to vaccination is preserved in Ireland, Belarus, Romania, Portugal, Hungary, Latvia, Estonia, Lithuania, Moldova, Poland, Bulgaria, Brazil, Azerbaijan, India and Slovakia. In Germany, the vaccine was canceled in 1998. 
Since 2001, in Singapore and Malaysia, BCG has only been administered at birth. Mass vaccination has never been used only in the United States and the Netherlands.
Vaccine composition
The main component of the vaccine is the various subtypes of Mycobacteria bovis. Bacilli are grown in a special artificial environment for a week. Then they are filtered, isolated and concentrated. Then it is lyophilized in a solution of sodium glutamate (frozen and dried in a vacuum chamber). This is a dry powder that is placed in an ampoule containing approximately 20 doses of the vaccine. Dissolve the strain in 0.9% sodium chloride solution, which is usually immediately attached to the vaccine.
Vaccination of newborns in the maternity hospital
If the newborn has a body weight of 2500 and above, and also does not have such contraindications to vaccination as:
- Damage to the central nervous system;
- intrauterine infections;
- skin diseases;
- hemolytic disease;
- HIV infection;
- malignant formations;
- generalized infection for vaccination,
then on the 3rd-7th day the child is vaccinated with BCG. In other cases, he is vaccinated with BCG-M in the maternity hospital (with underweight) or in the clinic after complete recovery. Children older than 2 months, not vaccinated in the hospital, must be tested before vaccination - tests are taken and the Mantoux test is carried out. BCG is possible with negative reaction Mantoux and good test results. The normal reaction to vaccination in newborns appears after about 4-6 weeks in the form of a pustule measuring 5-10 mm. This scar should not be treated and disturbed.
The vaccination process for babies is very careful - it is carried out separately from other vaccinations, with a special needle and syringe. The date of the vaccination, the series and the expiration date of the vaccine must be indicated in the child's card. Children between 0 and 2 months of age should be supervised by a pediatrician on the day of vaccination.
In Russia and some other countries, it is customary to revaccinate BCG. This happens at 7 and 14 years old. Revaccination differs from the first vaccination in that it is done only after checking the Mantoux reaction - it must be negative. 
In the absence of data on the first vaccination, the decision on revaccination is made on the basis of the presence or absence of a scar on the shoulder - in its absence, the vaccine must be injected. A local reaction to revaccination appears within 2 - 3 weeks.
Possible complications
Percent possible complications after BCG vaccination is not high - from 0.004 to 2.5% cases. The most common complications can occur through 2 — 18
months of vaccination, as a result of which the lymph nodes (subclavian, cervical, axillary and supraclavicular) are affected. Sometimes BCG osteitis is formed, in which bone tissue... According to statistics, from 2005 to 2010, the number of operated children with BCG abscesses increased from 7 to 68 per year. Frequent complication- an increase in temperature within 2 days. The main causes of complications are errors and non-observance of the basic rules when administering the drug, individual intolerance to the drug, not taking into account contraindications to vaccination. A lethal outcome is possible in 1 case in 1 million (0.0001%). 
Thus,
Every newborn baby gets acquainted with the vaccine under the short name BCG (in the Latin abbreviation BCG, Bacillus Calmette-Guérin) in Russia in the first days after birth. Children during their stay in the hospital (3-7 days), in the absence of indications for medical recusal and with the consent of the baby's parents, are given a vaccine against tuberculosis, in other words, BCG. The reason for such an early vaccination for children lies in the risk of contracting tuberculosis - a worldwide infectious disease transmitted by airborne droplets, which affects the lungs and, in an unfavorable set of circumstances, can be fatal.
BCG injection: 5 facts about the vaccine
- This vaccine is injected intradermally into the superficial muscle of the shoulder called the deltoid muscle.
- Vaccination against tuberculosis is administered only after the Mantoux reaction. The only exceptions are newborns who do not undergo a tuberculin test before BCG. Starting at six weeks of age, the Mantoux test before vaccination is a mandatory requirement.
- As a prophylaxis of tuberculosis in a child, after the introduction of the first portion of the vaccine, two more revaccinations are carried out in children - in the younger school age(6-7 years old) and at 14 years old.
- Vaccination against tuberculosis in children may subsequently affect the result of the Mantoux test, making it false positive; the reaction of the sample in this case is not informative. However, with a pronounced induration of the Mantoux test (˃12-15 mm), there is no doubt that either mycobacterium tuberculosis is present in the body, or the patient has been in contact with infectious agents.
- After complete healing, the drug leaves a cicatricial scar in the child. It serves as proof of the introduction of this vaccination.
Important! Everyone is familiar with the Mantoux reaction - the nurse "draws a button" on her hand, which should not be scratched and wet before measuring the result. A pronounced reaction to Mantoux is a contraindication to BCG vaccination.
BCG vaccine reactions
True Negative consequences associated with vaccination against tuberculosis can occur in three cases:
- the introduction of a vaccine in the presence of one or more contraindications in a child;
- severe immunodeficiency in a child;
- ingestion of the drug under the skin, incorrect injection technique.
In this case, the true consequences of BCG vaccination are understood as:
- inflammation of the bones (bone tuberculosis);
- keloid scars formed after pathological healing of vaccination in a child;
- the development of BCG infection in children (spread from the components of the vaccine of mycobacteria in the child's body).
If a child has any of the above consequences of vaccination, then revaccination of this vaccination will not be carried out; at the same time, constant observation of such children by a phthisiatrician and the prescribed anti-tuberculosis treatment is required.
Common consequences of BCG vaccination
Vaccination against tuberculosis in the overwhelming majority of cases is tolerated without any consequences, there are no complaints about the introduction, the wound gradually heals, the redness subsides and a scar forms. It is absolutely normal if the baby does not have an active reaction to this vaccine. Normally, after the injection, the body temperature does not rise, the injection site does not bother. But sometimes wound healing in children is atypical, which causes anxiety among parents. Consider the most common complaints about drug reactions that occur 6-12 days after administration.
The wound is festering from BCG
Mothers describe it this way: at first the vaccine looked like a red and dense "button", but then it became covered with a crust, from under which pus comes out. Apex suppuration is a normal reaction of the body to this vaccine... The redness of the injection site can also accompany the entire wound healing period. This forms a characteristic dense scar. The only thing that can be alarming in this situation is the spread of redness beyond the vaccine.
Note! During the healing period, the wound from vaccination is open for various infections... Try not to leave the injection site open, dress your child in clean clothes with sleeves. In rare cases, the healing process is delayed, but if the wound festers not for several weeks, but for several months, then a phthisiatrician consultation is necessary.
The vaccine is swollen / swollen
If immediately after the administration of the drug, the vaccination site has a somewhat swollen appearance, then there is no reason for excitement. The swelling on the child's arm will subside in the first three to four days after the injection. Then the vaccination reaction occurs, the wound heals, a crust appears, possibly a slight suppuration with the formation of a scar. If the vaccination in children has severe swelling and there is no visible decrease in its size, you should show the cause of your concern to the attending physician.
Lymph nodes enlarged after the vaccine was administered
Allowable enlargement of lymph nodes - up to 1 cm in size as an answer immune system organism on live vaccine... But if the increase reaches large sizes may need surgery due to the possible ingestion of mycobacteria of the drug into the lymph nodes, which is fraught with complications.
Cicatrix is slowly forming
The wound after the injection is healed and scarred within 2-4 months. This long-term process does not depend on external reasons, so all that remains is to wait and observe the purity of the baby's body. Do not rub the injection site diligently with a washcloth / soap / rub with a towel, just avoid this area when bathing your baby.
On a note! The vaccination does not need to be treated with anything, there is no need to glue it before bathing, smear it with wound-healing creams, and even more so cauterize it with alcohol-containing substances. The healing process does not require parental intervention or manipulation.
What is BCG: decoding, history of the term and purpose of vaccination
BCG M - vaccination for the prevention of the development of tuberculosis
BCG vaccine composition: everything about the production and components of the drug
BCG (short for BCG bacillus Calmette-Guerin) is a tuberculosis vaccine based on a strain of an attenuated live tubercle bacillus. Mycobacterium has practically lost the ability to infect human body because it was created in an artificial environment. It is an intradermal injection that has been in use since 1927.
Preventive vaccination against tuberculosis is the very first vaccination given to a child in a maternity hospital. The route of administration of the BCG vaccine is simple. but medical professional you need to be careful and collected. The procedure is allowed only medical staff middle level, specially trained.
Vaccine composition
BCG contains different subtypes of mycobacteria. Modern composition the vaccine is no different from the composition of the drug since its first use in 1927. WHO maintains data on all types of mycobacteria used in the production of BCG.
To obtain the desired culture of mycobacteria, which are necessary for the creation of vaccine preparations, the method of sowing bacilli in a specially created nutrient medium is used. Cell culture grows in conditions nutrient medium in seven days. After this, the bacilli go through several processing processes:
- allocation;
- filtration;
- concentration;
- bringing the mass to a homogeneous consistency;
- dilution with purified water.
As a result, the finished vaccine contains dead and live bacteria at the exit. The number of bacteria in a single dose of the drug may differ. It depends on the subtype of bacteria and the specific production of the vaccine. There are many types of BCG vaccine available today. However, 90% of all preparations contain one of the strains of mycobacteria:
- Tokyo 172.
- Danish 1331.
- French 1173 P2.
- Glasco 1077.
The effectiveness of the strains used in all preparations is similar.
Contraindications for BCG
The introduction of the BCG vaccine is contraindicated in newborns if:
- prematurity (birth weight less than 2.5 kg);
- diseases in acute form;
- prenatal infection;
- purulent diseases;
- anemia (as a result of blood incompatibility);
- malfunctions nervous system with neurological symptoms;
- infections skin;
- weakened immunity;
- oncological diseases;
- radiation treatment;
- family members tuberculosis;
- maternal HIV infection.
Algorithm for the introduction of BCG
Equipment for the procedure:
- The table is sterile, cotton swabs, napkins, tweezers.
- Medical latex gloves.
- BCG vaccine, solvent.
- A glass for an ampoule with a drug.
- Black cone for protection from light.
- Two syringes - 2 ml and tuberculin.
- Container for used syringes.
- Capacity with disinfectant solution for waste material.
- Ethyl alcohol 70%.
The sequence of actions of a medical professional
- Prepare the necessary materials.
- Wash hands, dry, wear gloves, mask.
- Remove the ampoules with the drug and solvent from the box, treat the ampoules with a cotton swab dipped in alcohol, and file.
- Cover with a sterile napkin and break.
- Dispose of used materials in a prepared container with a disinfectant solution.
- Place open ampoules in a beaker.
- Open the package of a 2 ml syringe. Put on the needle and fix. Remove the cap.
- From the ampoule with the solvent, draw the liquid into a 2 ml syringe.
- Inject the solution into the ampoule with the vaccine carefully along the wall.
- The vaccine is mixed. The pre-washed syringe is discharged into a container with a disinfectant liquid.
- Open the package of the tuberculin syringe, put on the needle and fix it.
- From the ampoule with the dissolved vaccine, draw 0.2 ml of the finished solution into the syringe.
- The ampoule with the remnants of the finished product is placed in a glass, closed with a sterile napkin and a light-shielding cone.
- A sterile napkin is taken with tweezers. Air from the syringe is released into it. The napkin is thrown into a container with a disinfectant solution.
- The drug should remain in the syringe in a volume of 0.1 ml. The syringe is removed inside the sterile table.
Note: Newborns receive 0.1 ml of solution, the rate of administration is 0.05 ml. The introduction of BCG is carried out after instructing the child's mother about the rules for caring for the injection site.
Vaccine injection site
On the recommendation of the World Health Organization, BCG vaccine is put in left shoulder, along the approximate line of separation of the upper and middle parts. This method is used in Russia. The drug is administered strictly intradermally. Intramuscular or subcutaneous is prohibited. If the vaccine cannot be given to the shoulder for some reason, it is injected into the thigh.
Where is vaccination carried out
In the maternity hospital, after birth, all babies are done. If the child has not received the vaccine during his stay in the hospital, immunization is carried out in the clinic where the newborn is observed.
In any children's clinic there is a specially equipped vaccination room where the vaccination procedure is carried out. Simultaneous vaccination, blood sampling, injections drugs unacceptable. In the case of two treatment rooms one is used for daily routine procedures, the other is used only for vaccinations. In the event that there is only one room, a specific day of the week is assigned to vaccinate children with BCG. The cabinet is used exclusively for this procedure.
In addition to the polyclinic, the BCG vaccine can be delivered at a tuberculosis dispensary. Child having high risk development of an active reaction, vaccinated exclusively in stationary conditions.
The legislation of the Russian Federation allows immunization at home. The departure of a specialized team with the necessary equipment and materials is carried out at paid basis... This service is not included in the list mandatory activities for health insurance and is paid by the customer of the service.
BCG vaccination can be done in specialized center vaccination. The center must have a certificate valid at the time of the procedure.
Variety of vaccine
The vaccine has been developed in two versions: BCG and BCG-M. The BCG-M preparation contains half the bacteria and is a sparing vaccination option. The drug is applied to those children who, for whatever reason, cannot enter the solution intended healthy child... As a rule, these are premature babies weighing less than 2.5 kg.
When is the vaccination done?
The first vaccination is carried out in the hospital 3-7 days after birth. Only if no contraindications are found. The first revaccination is carried out at the age of 7.
Before immunization, a test is required - the Mantoux test. In case of a negative reaction, vaccination is carried out no earlier than three days after the test, no later than two weeks. If the body's reaction to the sample is positive, immunization is not performed.
The second revaccination is carried out at the age of 14 according to the same rules. First, the Mantoux test is performed, then, based on the results, the doctor prescribes vaccination or is not necessary.
Adults are vaccinated only once after age 30.
How BCG is vaccinated
The technique of administering the BCG vaccine implies compliance with some mandatory rules. Vaccination is carried out strictly intradermally immediately after the solution is drawn into the syringe. The area of the skin of the left shoulder is treated with 70% ethyl alcohol.
The needle is inserted with the cut edge up into the surface layer of the skin. For ease of introduction, it is slightly pulled. You must first make sure that the needle is inserted exactly intradermally. For this, a small amount of the vaccine is administered. Then the drug is injected completely. As a result of a correctly performed vaccination, a whitish papule is formed. Its diameter is 7-9 mm. Usually, the primary papule disappears within 20 minutes after drug administration.
Preparation for the BCG vaccination is not required.
Complications after vaccination
A local reaction develops at the injection site. It has several external varieties:
- papule;
- infiltrate;
- pustule;
- ulcer.
In newborns or those who are initially vaccinated, the vaccine reaction develops at 4-6 weeks. During the revaccination procedure, the reaction appears after 1-2 weeks.
Complications appear mainly locally:
- the appearance of abscesses;
- inflammation of the lymph nodes;
- the appearance of a keloid scar.
What does the reaction to BCG look like?
BCG vaccine causes allergic reaction... T-lymphocytes begin to accumulate under the skin, which actively fight against the causative agent of tuberculosis. The corresponding reaction of the skin develops.
During the first days after vaccination, no visible changes in the skin are observed. There may be slight redness at the injection site. The lack of visible reaction can last for several days. After this, the injection site should not differ from the surrounding skin.
Within a month after vaccination, a small papule begins to form. Outwardly, it is a small bubble of liquid. This is the development of a normal reaction and we can talk about a successful vaccination. Sometimes the appearance of a papule is accompanied by itching. It is strictly forbidden to comb it in order to avoid subcutaneous infection.
After three months, the papule crusts and heals. A small whitish scar forms at the site of the healed wound. The size of the scar varies from 7 to 10 mm. A scar of less than 4 mm indicates that the vaccination goal has not been achieved. Anti-tuberculosis immunity has not been developed.
Parents need to know that the vaccine does not protect a person from contracting tuberculosis. It is able to prevent the development of severe forms of tuberculosis diseases that can lead to death. It is imperative to protect the child in the first days of his life. When the child comes out in the world where 2/3 of the population is carriers of the infection, it may be too late.
The best way to protect against ailment today is BCG vaccination (translated from Latin - bacillus Calmette-Guerin). Once in the human body, the tubercle bacillus remains in it forever, so the disease is considered one of the most difficult for treatment.
The drug used in this case, consists of dead and live bacteria-pathogens of the disease, and promotes the rapid development of anti-tuberculosis immunity.
The cells for the manufacture of the vaccine are obtained from the tubercle bacillus of a cow, weakened to such a state that it is not capable of causing harm to the body. Accordingly, the vaccine is absolutely safe for health, and cannot provoke the development of the disease.
Photo 1. The injection is placed in the child's thigh: this happens if there are contraindications that do not allow the injection, as usual, in the forearm.
The drug is introduced into upper part shoulder, and in the presence of contraindications - in the thigh. The procedure, as a rule, is carried out in the maternity hospital, at 3-7 day after the birth of the child.
Attention! BCG vaccine does not protect a person from contracting tuberculosis, but prevents serious complications and transition latent disease v open shape.
What should be the body's reaction to BCG
The BCG drug provokes an allergic reaction in the body: T-lymphocytes accumulate under the skin, which begin to fight the causative agents of tuberculosis, due to which a corresponding reaction from the skin develops. The vaccine is injected strictly into the inner layers of the skin (in no case subcutaneously), after which a white flat papule with a diameter of about 10 mm which dissolves through 18-20 minutes- this means that the drug was administered correctly.
V first days any changes in the skin at the injection site are invisible, but sometimes slight redness, thickening or inflammation of the skin may form - this is considered a normal option. It is important to note that such reactions can continue throughout 2-3 days, after which the injection site (before the formation of a papule and scar) in its own way appearance should not differ from the surrounding tissues.
When appears
About a month after the injection (depending on the individual reaction), a small papule which looks like a bubble with little suppuration.
This is a normal reaction and indicates that the vaccination was successful, the body "gets acquainted" with the causative agents of the disease and develops immunity.
In some cases, the formation of a papule and its healing is accompanied by severe itching, but combing it is strictly forbidden so as not to bring an infection under the skin. Sometimes a person may have a slight fever, but if the numbers on the thermometer do not rise above 37-38 , do not worry.
Three months after vaccination, the papule becomes crusted and heals, and an even scar appears in its place white, sometimes with a pink or reddish tinge. The size of the scar can be different, and depends on the individual characteristics of the organism and the quality of the formed immunity. The best option- scar from 7 to 10 mm in diameter. Scar formation less than 4 mm indicates that vaccination has not reached its goal and there is no anti-tuberculosis immunity.
Important! There are certain rules for caring for the site of administration of the BCG vaccine - the resulting papule it is forbidden grease antiseptics, squeeze out of it pus, delete crust or wrap tightly bandage.
Deviations from the norm: photo
The most common abnormality after BCG vaccination is the absence of any reaction. Absence papules and scars at the injection site indicate that the vaccine was expired or the body did not respond to its introduction by forming anti-tuberculosis immunity. In this case, it is necessary to conduct a tuberculin test (Mantoux) and re-administration of the vaccine.
Photo 2. Usually, after an injection, a papule is formed - a vesicle with suppuration. This is normal, deviation from the norm is the absence of any reaction at all.
In some cases, a scar forms after vaccination, but then suddenly disappears - this indicates the disappearance of anti-tuberculosis immunity, and requires revaccination person. At about 2% people on the planet have innate immunity against tuberculosis, so they also do not form a scar - the presence of such immunity can also be determined using the Mantoux test.
Photo 3. The vaccination site may turn red. If this is not too pronounced, there is no reason to worry.
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Photo 4. Not too much heat in a child after BCG - a normal phenomenon, you do not need to call a doctor.
Other reactions from the skin and the whole body ( severe redness, seal, temperature) are due to characteristic features the human body or sensitivity to the drug, and, as a rule, do not require medical intervention... If they are too pronounced, specialist advice is necessary.
Reference! In some cases, a scar after the administration of the BCG vaccine is formed not on the surface of the skin, but in the deep layers. You can determine its presence by changing colors skin and small compaction.
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What symptoms should cause anxiety after vaccination
Serious complications after injection develop quite rarely - they are usually observed in people with reduced immune or positive HIV status... Most often these are abnormal reactions on the part of the skin, but in isolated cases pathologies may occur that threaten the health or even life of a person.
- Lymphadenitis... Individual body reaction to the introduction pathogenic microorganisms, which is characterized by an increase in lymph nodes, subclavian or supraclavicular. The patient needs consultation with an infectious disease specialist and specific therapy.
- Osteomyelitis. Dangerous disease developing through several months or years(on average one year) after injection. First, there is swelling of the tissues adjacent to the vaccine injection site, after which in pathological process the joints of the hands are involved, then - lower limbs, ribs and collarbone. Severe discomfort the patient does not feel - possibly slight increase temperature and stiffness in the joints.
- Keloid scars... Develop after wrong the introduction of the vaccine. Keloid scars begin to form a year after the vaccine is administered, and their appearance does not differ from burn scars. Growing scars are considered the most dangerous - they look like bright purple formations, often accompanied by itching and pain. Therapy is aimed at inhibiting or completely stopping the growth of the scar.
- BCG infection. Develops exclusively in people with reduced immunity, and is manifested by inflammation around the injection site.
Ulcer at the injection site... With individual sensitivity to the BCG vaccine, an ulcer may occur at the injection site, accompanied by severe itching.
If she has less than 1 cm in diameter, most likely there is nothing to worry about, but the patient is advised to consult an infectious disease specialist.
Cold abscess... The reason is a violation of the technique of administering the vaccine (the drug can be administered exclusively intradermally, and not subcutaneously). The complication develops in about 1-1.5 monthsafter vaccination and has the formtumorswith liquid contents inside.
He, as a rule, does not cause discomfort, but sometimes patients may have enlarged lymph nodes and ulcers on the skin. Most often, cold abscesses open on their own through 2-3 years but sometimes it is required surgical intervention(The abscess is opened and drained, after which the wound is sutured).
Most dangerous complications after BCG, there are osteomyelitis and BCG infection - they can lead to disability and even death, therefore, at the first symptoms of these diseases, you should consult a doctor as soon as possible. It should be noted that such complications arise in 1 case in 100 thousand therefore, anti-tuberculosis vaccination is considered a relatively safe procedure for health.
Attention! Any complication after BCG injection should be documented v medical card child and must be taken into account when revaccination .
How to distinguish a normal response from a pathology
The body's reaction to the introduction of the BCG vaccine is a sign that the body correctly "meets" the pathogens of tuberculosis and learns to fight them. But since any vaccine can cause side effects , after the introduction of the BCG drug, you should carefully monitor the person's condition, especially when it comes to infants.
The papule formed at the injection site should be small ( up to 1 cm in diameter) and the tissues around it look healthy, with no signs of inflammation or ulceration.
Skin color is normal white, pink or reddish- bright red or brown indicates the development of complications or side effects.
In addition, a specialist consultation is necessary in cases where the papule does not heal longer. 3-5 months.
Fever that may occur after injection continues no more than 3 days and is not accompanied by any additional symptoms(diarrhea, cough, pain) - otherwise, an increase in temperature indicates infectious disease.
To date, BCG vaccination is considered optimal and the most safe a way to protect the population from tuberculosis. In rare cases, the drug can cause adverse reactions organism, but strict monitoring of the state and proper care behind the injection site significantly reduces the risk of serious complications.
Useful video
Check out the video that tells you about the response to BCG, as it should be normal after vaccination.
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