What to expect and what to fear from the reaction to BCG? What is the BCG vaccination for? After BCG

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One of the mandatory and important is the vaccination of a newborn. It is included in the list of the main ones, they do it in the hospital. In rare cases, the vaccine may be unusable, or the injection technique itself is violated, due to insufficient qualifications of the medical staff. All this leads to the ineffectiveness of vaccination or to the occurrence of complications. Sometimes a similar outcome is observed with improper care of the injection site. Let's consider all these points in detail.

Is it necessary to do?

Vaccination against tuberculosis is needed, as this disease is currently flourishing in Russia. This is the only way to keep your baby safe. They started doing it from the 21st year, and it does not lead to any deviations. If there are contraindications, then this is another matter, here the doctor will recommend to refrain from vaccination. A healthy child usually tolerates BCG well.

If a mother believes that her child is not in danger, since there are no patients nearby, then this is not true. Communication in the future with the environment cannot be avoided - attending cultural events, traveling by public transport, hospitals, etc. Everywhere there may be a carrier of a tuberculosis bacillus. In contact with this person, infection is inevitable if there is no immunity. Vaccination contributes to its development of this. Tuberculosis can be present in anyone.

The composition of the vaccine

Sometimes it is the composition of the vaccine that scares. It should be noted that since the 21st year it has not changed. It contains several subtypes of Bovis microbacteria. There are several vaccine developments. Basically, they use the one in which such strains:

172 Tokyo;
"Glaxo";
1173 R2 Pasteur French;
1331 Danish.

Each one has a different number of bacteria. To obtain any subtype, experts use the technique of sowing bacilli on a nutrient medium. Growth goes on for a week, then there is an allocation, filtration and concentration. After doing the transformation, until a homogeneous mass is obtained, it is diluted with water at the end. The result is live and dead bacteria.

Remember! The introduced vaccine does not serve as a 100% guarantee that a person will not get sick in the future. Now there is a constant mutation of cells. If infection has occurred, then the course of the pathology will not be so severe. Vaccinated people do not develop:

tuberculous meningitis;
disseminated respiratory disease.

Such forms of the disease unequivocally end in death. Others are treatable.

Contraindications

weak immunity;
low birth weight (less than 2500 g);
a newborn from an HIV-infected woman;
children who were infected in utero;
moderate and severe hemolytic disease;
birth trauma in which the brain was damaged;
ulcers on the skin;
the presence of tuberculosis patients in the family of a newborn;
the presence of Down's disease or other genetic pathology;
complications after vaccination in a sister, brother, father or mother.

Babies who were underweight may receive a half dose or be vaccinated a week later when body weight reaches 3 kg.

If for some reason vaccination was not carried out in the maternity hospital, BCG can be done in a regular clinic in a manipulation room. Before the introduction of the Calmette-Guerin bacillus, the hospital must first do a Mantoux test. This is a diagnostic procedure that will show whether the baby had contact with the patient. If so, then there is no longer any expediency in BCG.

The clinic does not vaccinate with:

oncology;
radiation exposure;
exacerbated chronic diseases.

If there are no absolute contraindications, it is recommended to be vaccinated immediately.

How is the BCG vaccine given to newborns?

To protect the baby from an insidious disease, BCG vaccination is carried out even in the maternity hospital, before discharge. The doctor must first make sure that there are no contraindications. Any mistake can lead to serious consequences, up to death.
What day after birth?

The TB vaccine for newborns is not given at the same time as other vaccinations. BCG is carried out from the 3rd to the 5th days of life, after birth, if the body weight is more than 2.5 kg. If there are any relative contraindications, then they are already vaccinated at the clinic at the place of residence. The extract indicates that the newborn was not vaccinated.

To what place?

Where is the BCG vaccine given to newborns? The nurse injects the vaccine into the left shoulder area, from the outside. If we talk specifically about the injection site, then this is the middle and upper third of the shoulder. They will inject into this zone in subsequent times - meaning 7 and 14 years.

injection technique

The technique of setting BCG is the same everywhere. Knowing it, each parent will be able to be sure whether the child was manipulated correctly or not.

The nurse who will be vaccinated should not have any injuries to the skin and long nails. She is dressed in a clean medical gown and cap. Before starting the procedure, the table is disinfected without fail, the hands of the manipulation nurse are washed and disposable gloves are put on.

The drug is removed from the refrigerator immediately before administration. The ampoule is opened in the presence of the vaccinated. The mother has the right to check the expiration date of the vaccine used, view its composition and name. The ampoule should not contain cracks, chips.

The BCG vaccine should be injected into the upper arm into the skin. Subcutaneous or intramuscular administration is fraught with complications. All rules must be strictly followed.

The nurse who will administer the vaccine must:

Treat hands and table with disinfectant.
Open the packaging containing the sterile gloves and put them on.
Take an ampoule and solvent. Wipe the neck of the ampoule with cotton wool, which has been pre-treated in alcohol. Cut it with a nail file and open it.
Remove the used cotton wool and the upper part of the ampoule in a special container.
Take a disposable 2 ml syringe and open it.
Collect the solvent and inject it into the ampoule where the vaccine is located.
Remove the syringe into a container.
The resulting solution stands for 5 minutes. After in the light, check if everything has dissolved.
Take a syringe with a shortened needle with an oblique cut (tuberclinic) and draw the finished vaccine into it.
Then release the air and excess solution. For newborns, 0.05 ml remains.
Moisten cotton wool with alcohol and treat the shoulder area where the vaccine will be injected.
Use the index finger and thumb to stretch the skin and insert the needle intradermally. The angle must be 100 degrees.
After insertion, remove the needle, close it with a cap and throw it into the container along with the syringe and gloves.

Correct staging

After vaccination, a white bump (papule) will appear on the baby’s shoulder. After a certain period of time, everything will disappear. In the place where the injection was given, redness or even suppuration may be present - this is the norm. It usually goes away after 5-7 days.

How does a normal reaction proceed?

What does a normal BCG vaccine look like? The reaction to BCG in newborns can be different, in most cases there are no negative consequences. Rarely there is an increase in body temperature up to 37.2 degrees.

There is no point in saying anything at once. After 40-80 days, a seal, abscess, crust, brown or blue spot appears on the shoulder. Thus, the child's body reacts to the vaccine and this is absolutely normal.

The photo shows what a child's shoulder looks like 2 months after vaccination.

Crusts from this zone can separate on their own. They cannot be torn down. In no case should the wound be treated with any drugs. All this will lead to the ineffectiveness of the vaccination or to the occurrence of complications.

Six months later, the injection area heals. In its place, there is a trace of BCG - a scar. Doctors are guided by it in the future. First, it is a sign of vaccination. Secondly, its size indicates the effectiveness of the vaccination itself.

No response to BCG

The reaction to the BCG vaccination in a child can be different. After vaccination, the mother is warned about what will happen and how the post-vaccination period proceeds. If neither after 1 month, nor after 2-3 months, an abscess, crusts and other manifestations appeared at the injection site, which would indicate the formation of immunity, then something went wrong.

Is it normal or not?

When there is no reaction to BCG, this is not the norm. This suggests that the vaccine did not work or the baby has already developed immunity.

The reasons

Several factors can influence this:

low-quality vaccine;
incorrect injection technique;
the baby has innate immunity against tuberculosis;
non-compliance with the recommendations of the doctor in the post-vaccination period.

What to do in this case?

To find out the exact reason why there was no reaction after BCG, you need to do a Mantoux test. If the result is positive, then the baby has innate immunity or the child had contact with a sick person. If the result is negative, revaccination is done. The TB vaccine is being re-introduced. Whether to do BCG again is up to the parents. There is an option to wait until the age of 7 and get a routine vaccination, but there is no guarantee that the child will not become infected during this period. After weighing all the pros and cons, a decision is made.

Complications

BCG vaccination in newborns may not give very good results. This rarely happens, but there have been cases.

Cold abscess. There is a lot of pus in the injection area. This happens when the nurse made the injection not intradermally, but subcutaneously. In this case, you need to resort to surgical intervention.
The inoculation on the shoulder of the baby and the lymph node were inflamed. This reaction occurs in weak children whose immunity is unable to cope with the vaccine.
The appearance of a keloid scar. At the injection site, the skin swells and turns red. Such a pathology requires urgent treatment, otherwise the keloid will grow.
The occurrence of an ulcer. It develops in newborns who have an allergic reaction to the vaccine. Subsequent vaccination at 7 years of age is not performed.
Children who are immunocompromised may develop a generalized BCG infection. To avoid this, you must first exclude all possible contraindications.
Osteitis. It appears rarely and in children who have immune disorders.

Conclusion

Before refusing to vaccinate, find out what the BCG vaccine is for. An increase in the incidence of tuberculosis is an indication for vaccination in the first place. To protect and save the life of the child, listen to the doctor's opinion and do not refuse vaccination. Find out why the vaccine is given, its composition, contraindications to make sure it is appropriate.

According to the World Health Organization, 10 million people in the world become ill with tuberculosis every year. Tuberculosis is a deadly infectious disease caused by Koch's bacillus, a mycobacterium that is transmitted by airborne droplets, mainly affecting the lungs, but can settle in any organ and system of the body.

Approximately 30% of people from all over the globe are carriers of mycobacteria, and in Russia this figure is about 75%, but only 3-9% of the total number of infected people develop tuberculosis.

Vaccination is the best way to protect against this terrible disease. Now all over the world, in our country in particular, two types of tuberculosis vaccines are used: BCG and BCG-M. Both vaccines are made from the same strain, bovine TB. Live attenuated mycobacteria are used, artificially grown by seeding them in a nutrient protein medium. Their concentration is low to provoke the development of the disease, but sufficient to form a stable anti-tuberculosis immunity.

BCG is an abbreviation from English: BCG, or Bacillus Calmette-Guerin. In Russian, it sounds like Bacillus Calmette-Guren. It is named after two French scientists who created it in 1920. All pharmaceutical companies adhere to the same standards, so the composition of their vaccines is identical. Pediatricians prefer to work with domestic drugs, believing that they are fresh, as it saves time for transportation and customs procedures.

There is only one difference between the modifications of vaccination preparations - the vaccination dose of BCG-M contains two times less mycobacteria. The concentration of active substances:

BCG - 0.05 mg;
BCG-M - 0.025 mg.

In standard situations, all newborns are vaccinated based on the BCG preparation. Total immunization is recommended due to the acute epidemiological situation in Russia. In countries where the situation is not so acute, vaccination is indicated for babies at risk. Parents or guardians have the right to refuse this procedure, it is voluntary by law. At the same time, they must be aware of the degree of risk to which they expose the little person for whose life they are responsible.

BCG-M vaccinations are given to premature babies or if there are contraindications for BCG. If, for some reason, immunization did not take place within the time limits set by the standard vaccination calendar, a drug with a reduced amount of active ingredient is used. In addition, an individual schedule is drawn up for such a patient.

The introduced vaccine does not give a 100% guarantee against infection with tuberculosis, but in 75% of cases it does not allow the latent course of the disease to go into an open form, and also protects against the development of severe complications and forms of the disease: tuberculosis of the bones, lungs, meningitis, disseminated form of infection. If at the beginning of the last century "consumption" meant inevitable death, then vaccination, even if it does not prevent infection, will exclude a lethal outcome. In our country, almost 75% of the inhabitants are carriers and, nevertheless, do not get sick.

According to the vaccination schedule, during the first week of life, all newborns are given BCG, and infants with contraindications - a little later. At the age of 7 years in Russia, according to the National Immunization Schedule, revaccination is performed. The final injection is performed at the age of 13-14 (according to indications).

There are contraindications for vaccination and revaccination:

prematurity (weight less than 2.5 kg);
hemolytic disease of the newborn (incompatibility of blood groups of mother and child);
any acute processes;
chronic diseases in the period of exacerbation;
sepsis;
neurological disorders;
dermatological diseases;
oncology;
taking immunosuppressive drugs;
tuberculosis;
positive Mantoux reaction. The test is done a few days before the scheduled date of revaccination;
previously identified BCG intolerance (for revaccination).

As a rule, the drug is injected intradermally into the shoulder, and if contraindicated, into the thigh. The reaction to BCG is described below.

The BCG vaccine is characterized by a delayed reaction. It takes time to form the scar that every adult has on their shoulder. Usually it begins to appear a month and a half after the injection and lasts up to 5 months.

BCG vaccination: what should be the reaction

Before getting vaccinated, the neonatologist is obliged to tell what the BCG vaccine is, about its side effects, and what should be the normal reaction.

Normal response to vaccination

After the introduction of BCG, typical reactions in children include the following symptoms:

if redness appears in the area where the BCG was vaccinated, this is the norm. It is associated with the introduction of foreign agents into the body and the onset of the inflammatory process. It is important that this redness be painless and located at the injection site;
an increase in body temperature in the first days after vaccination is possible, since an infection has entered the body, and it begins to fight it. This is where thermometry is a must. It is important to ensure that there is no body temperature above 38 ° C;
suppuration after a month is a normal reaction to a vaccination against tuberculosis. You can not squeeze out pus, treat with antibiotics or antiseptics. It must be removed with sterile gauze or bandage;
itching in a vaccinated baby also refers to an inflammatory reaction. In the event of such sensations, it is necessary to isolate the injection site with a gauze bandage.

After vaccination, the child's immune system is weakened, there is a risk of contracting other viral or bacterial infections. It is necessary to limit visits to public places (supermarkets, shops, children's and playgrounds).

Possible side effects within acceptable limits

Acceptable side effects include:

cold abscess. If, when performing BCG manipulation, the introduction of mycobacteria was performed subcutaneously, and not intradermally, then a cold abscess may develop. After 6-8 weeks, at the injection site, the skin turns blue, and under them there is a hard nut-like area of compaction;
the appearance of an ulcer indicates an increased sensitivity to the drug;
lymphadenitis - vaccination can cause inflammation and suppuration of nearby lymph nodes.

Abnormalities and complications

Cases of unforeseen consequences and severe complications in the post-vaccination period are extremely rare. Most often they are fixed in children who have reduced immunity, with a state of congenital immunodeficiency. Although these complications are rare, it is important to be aware of them.

A keloid scar is no different in appearance from a burn scar. It is formed a year later in a child after incorrect administration of a vaccination preparation. Indicates hypersensitivity. In the presence of such a scar, revaccination or BCG revaccination at 7 years is strictly contraindicated, since the reaction can be unforeseen and dangerous.
Tuberculous osteomyelitis is a formidable complication that can develop years after vaccination. The disease in the future leads to the destruction of the affected areas of bone tissue.
BCGitis is an infection characterized by damage to the lymphatic system, and subsequently to the liver and kidneys.

Individual intolerance: what is it and how to define it

Cases of individual intolerance are extremely rare. The reason lies in the components of the vaccine. The symptom complex of this phenomenon includes:

instant allergic reaction;
a sharp increase in temperature;
redness and severe swelling at the injection site;
drop in blood pressure and increased heart rate.

What to do in case of intolerance

After the injection, you should stay in a medical facility for 30 minutes so that the child can receive emergency medical care if the above symptoms develop.

If such symptoms are detected, it is necessary to carefully examine and examine the child, show the patient to the phthisiatrician, tell him about all the examination data and anamnesis.

How does the BCG vaccine heal?

After the injection, the injection site turns red. The variants of the norm also include purple, blue, black colors of the skin. Subsequently, the formation of the scar occurs as follows:

at the injection site, immediately after vaccination, a papule forms on the skin - a small hard seal, similar to a wasp sting. A few days later, she disappears without a trace;
after 4-8 weeks, a papule with purulent or colorless contents is formed again. Both cases belong to variants of the norm. These processes indicate the beginning of the formation of immunity in the child;
after that, an abscess is formed, which bursts in a maximum of a month and a half;
the last stage of the healing period of the post-vaccination wound is the formation of a crust at the site of the abscess. Within a month, it can then disappear, then appear again. In the end, a scar is formed in size from 5 to 10 mm.

Immunity after vaccination

Immunity develops 8-12 weeks after the manipulation. During this time, a child with a vaccine is just as at risk of contracting tuberculosis as it is without it. The formed immunity after vaccination will not be lifelong. It disappears about 7 years after the injection.

As a rule, BCG vaccination is given to newborns in the hospital to protect the child from tuberculosis. The expectant mother, even before giving birth, consults with a doctor, weighs all the pros and cons, and signs the documents.

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What is BCG

BCG is a drug made from several types of tuberculosis pathogens. The vaccine has been used in our country since 1921, it has been carefully studied. The serum comes in powder form. Before the procedure, it is diluted with saline.

Should I vaccinate a newborn with BCG?

To vaccinate a child against tuberculosis or not is the decision of the parents.

BCG vaccination protects the infant from tuberculous meningitis and disseminated lung disease. Despite the fact that the baby's immune system is ready to form a response to the pathogen, many parents think that their baby has nowhere to catch a dangerous disease. When making a decision, one must take into account the fact that the symptoms of tuberculosis do not appear immediately, and therefore it is impossible to immediately know whether the child is sick or not.

Contraindications for vaccination

BCG vaccination cannot be done:

infants weighing less than 2 kg at birth;
children whose mothers had HIV or had another immunodeficiency;
if the child has severe genetic diseases;
if there are manifestations of hemolytic disease;
in case of birth trauma with brain damage;
in case of skin diseases, especially extensive pustular lesions;
in case of identification of persons in the close environment of the child who are sick with tuberculosis;
if complications after BCG injection were recorded in the family history.

BCG vaccination in newborns is not done if:

have any acute illness;
oncology;
diseases requiring treatment with immunosuppressants.

Vaccination in newborns

BCG vaccination for newborns is performed 3-7 days after birth.

An injection of the vaccine is made in the left shoulder in a thick layer of skin. A sample is placed before the procedure. If the test is positive, then the baby has already met with the virus, so the vaccine is useless. If the result is negative, the BCG injection is given no earlier than 3 days later, but no later than two weeks.

If the baby was not vaccinated with BCG at the time set by the calendar, after two months he is given a Mantoux test to check the reaction to tuberculin.

Infants born weighing 2 to 2.5 kg are given the BCG-M vaccine, which contains part of the vaccine.

More about the vaccine in the video from the channel Health saving channel.

Care after vaccination

After the injection, a reaction to BCG develops in the child's body, so it is impossible to complicate the work with additional vaccinations. Other vaccinations after BCG can be done only after 35-45 days at least.

After vaccination, you can not leave the clinic for another 10-20 minutes to observe the child's body. Suddenly, the baby will have a sudden allergic reaction to the drug or other complication.

Do not experiment with the diet of the baby and the nursing mother. You can wet the vaccine and bathe the baby if he feels well, the main thing is not to rub the injection site with a washcloth.

How does it heal

A month and a half after the injection, a reaction to BCG begins to develop, and this lasts up to 4–5 months. During development, the wound may turn red or turn blue. In some children, an abscess and a scab form at the injection site, which eventually drags into a scar. In other children, the reaction to the vaccine manifests itself without suppuration, and a vial with liquid inside forms at the injection site. Over time, it disappears, leaving a scar.

Injection mark

If the child does not have a reaction to the vaccine, and there is no characteristic scar on the shoulder, this indicates that immunity to the disease has not been formed. In this case, you need to do a Mantoux test and, if it is negative, repeat the BCG vaccination again.

Reaction to the vaccine

The reaction to the vaccine can be normal and pathological. In the first case, parents should not worry, and in the second, it is better to contact a phthisiatrician without delay.

All reactions to the vaccine are recorded in the medical record of the newborn, so that with future BCG revaccination, doctors are aware of the contraindications.

Normal

Possible reaction:

. It begins to actively develop immunity - a response to an injection. Do not try to bring down if it does not exceed 38.5C. If the temperature is higher and stays at the same level for a long time, you can give an antipyretic, but in no case Aspirin.
Small pustules, seals at the injection site. The healed crust may fall off. Do not treat the wound with antiseptic agents, you need to wait until the crust begins to form again.
The appearance of pus at the injection site. You can't push it out on your own. You can only carefully remove the discharge with a sterile cloth.

Pathological

It is necessary to visit a phthisiatrician in these cases:

if swelling and suppuration have spread from the BCG injection site to neighboring tissues;
if, after revaccination at the age of 7, the child's temperature jumped sharply;
if redness has affected areas of the skin of the shoulder outside the vaccination site.

Photo gallery "Reaction to the vaccine"

Negative reaction to the vaccine Negative effect of BCG

Possible complications and their causes

Causes of complications after vaccination:

incorrect technique of the procedure;
vaccination without taking into account the personal characteristics of the child and contraindications

When giving BCG vaccination to a child, parents should be prepared for complications:

Abscess. If a mistake was made during the procedure, and the drug got under the skin, a cold abscess will occur. The infiltrate can open without surgery, but not always.
Lymphadenitis. The reason for the complication is the excess of the permissible value of the content of pathogenic bacteria. The reaction is caused by an overdose of the vaccine or its increased potency. Inflammation originates in the left axillary zone - it is closest to the vaccination site.
Keloid scar. This complication manifests itself a year after the injection. The scar can be growing and not growing. In the first case, there is a seal in the tissues, an increase in the scar and a purple color. There is pain and unbearable itching.
Generalized BCG infection. The complication occurs in congenital immunodeficiency. The body is not able to protect itself, and is prone to various infections. If you do not take action in time, the complication will end in death.
post-vaccination syndrome. It is characterized by skin rashes and refers to late reactions.
Osteomyelitis is another of the most severe complications. Signs of the disease often appear after a year. The lesion begins with tubular and spongy bones, clavicles and ribs. The lower extremities are most affected.

A newborn from the first days of life gets acquainted with vaccination.

One of the first vaccines administered to an infant is BCG, a special culture of active and inactive microorganisms that contribute to the development of their own immunity against tuberculosis.

Vaccine administration does not give a 100% guarantee protection against tuberculosis, but significantly reduces the risk of mortality when infected with severe forms - tuberculous meningitis and disseminated tuberculosis.

Why is BCG prescribed for newborns?

Why are newborns vaccinated? The main goal of BCG is prevention dangerous forms tuberculosis, preventing the transition of the disease into an active form. Tuberculosis affects children at any age, the course of the disease in a child is severe, even fatal. A vaccinated child with the disappearance of the pathogen - Koch sticks- will transfer the disease more easily, in uncomplicated forms.

Photo 1. Newborns are vaccinated so that the body develops antibodies to the disease.

Goals of vaccination BCG among newborns:

prevention development of open forms of tuberculosis and complications;
control morbidity among infants and older children;
preventing outbreaks of epidemics of tuberculosis (this function of vaccination is not always achievable due to fashionable tendencies to refuse vaccinations, belief in their negative impact on the child's body).

When is the vaccine given and how does it proceed?

Many parents do not understand why BCG put the fledgling baby. The meaning of vaccination in the first days of life is to instill in the body weakened microorganisms before encountering an active pathogen.

Important. The introduction of the BCG vaccine to newborns has reduced the incidence of tuberculosis in children to a minimum.

When is the vaccine given? BCG is placed in the hospital for newborns 3-4 days of life in the absence of contraindications. The vaccine is easily tolerated in the vast majority of cases. Reactions to BCG in newborns delayed and develop some time after vaccination.

The reaction in newborns is the norm

To normal reactions to vaccination include local skin manifestations and fever.

BCG redness- normal post-vaccination reaction; the place of injection of the vaccine not only turns red, often mild suppuration appears.
Area of redness is normal small does not apply to surrounding tissues. The appearance of redness is due to the local reaction of the skin to the introduction of a serum foreign to the body.
Occasionally appears at the injection site keloid scar- bulging red lesion. A small keloid scar is not considered a deviation.
Swelling at the injection site - a local reaction, normally the swelling lasts no longer than 3 days, after which it subsides on its own. After the injection site does not differ from neighboring areas of the skin, does not rise and does not swell.
The process of suppuration and the formation of an abscess at the site of BCG injection. The process of suppuration in the delayed period is a normal phenomenon. Inoculation, in the case of correct setting, looks like a small purulent formation (abscess), covered in the center with a thin crust.
Inflammation in place of BCG - a typical reaction that is within the normal range. A small inflammatory process occurs in the delayed period, when an abscess is formed.
Itchy skin at the injection site. In the post-vaccination period, mild to moderate itching is sometimes observed, associated with healing and skin regeneration. In addition to itchy sensations, discomfort may appear under the crust of the abscess. The main thing - avoid scratching injection site, it is fraught with infection.
Temperature rise after BCG is rare. Rise in temperature to subfebrile indicators ( 37-37.3°, less often up to 37.5°) often occurs not immediately after vaccination, but during the onset of vaccination reactions, after 4-5 weeks after injection. The temperature accompanies the process of suppuration of BCG. Some children develop a reaction in the form of temperature jumps - from 36.4° to 37.5° for a short time interval. This does not apply to pathology.

Attention! An important point that differs from the norm from the complication: the skin around the abscess should be normal, without redness, swelling.

Possible deviations: photo

Options for abnormal post-vaccination reactions:

Redness, covering not only the injection site, but also surrounding tissues; the skin has an intense red tint, the reddened area is hot to the touch.

Photo 2. The injection site itself and the skin around it turned very red. May be a sign of a negative reaction to a vaccine.

Suppuration and the formation of an abscess (pimple, infiltrate) in the early days after vaccination.
intense swelling, the injection site rises significantly above healthy skin; swelling does not subside after 3-4 days after BCG.

Photo 3. The injection site rises significantly above healthy skin, intense swelling.

Diffuse inflammation covering adjacent areas of the skin on the shoulder.
Temperature rise above 38.5° immediately after vaccination and in the delayed period; temperature keeps over 2-3 days contract.

Photo 4. A newborn baby is changing the temperature with an electronic thermometer. The norm at this age ranges from 36 to 37 degrees.

The appearance of post-vaccination reactions that deviate from the norm means that the BCG injection technique was wrong, sterility requirements are ignored.

Individual characteristics of the child's body, weakness and immaturity of the immune system of the newborn affect on the development of negative manifestations after BCG.

How BCG heals a day, a month, a year after vaccination

How the healing process of vaccination in newborns proceeds differs from the course of post-vaccination periods after other vaccinations. How BCG heals in newborns is distinguished into several stages in the healing of the injection site:

immediately after vaccination slight redness, puffiness, through 48-72 hours the injection site does not stand out among healthy skin;
later 21-42 days a spot forms at the injection site, then appears infiltrate- dense formation, increased in volume; allowable diameter no more than 1 cm;
appearance bubble filled with transparent contents, it becomes cloudy over time;
education on the surface of the abscess thin pink or reddish crusts;
education by 5-6 months scar diameter from 3 to 10 mm;
the scar takes its final form by 12 months, usually it is hardly noticeable due to the surface structure and color close to healthy skin.

The normal healing process from the moment the bubble appears to the appearance of the scar takes 3-4 months. The infiltrate sometimes breaks through with the expiration of purulent exudate - this normal course healing.

It is important not to treat the injection site with antiseptics - this interferes with the adequate action of the vaccine.

Prevent normal healing and scar formation negative factors: weakness of the body, the occurrence of allergic reactions, violation of the rules of vaccination (non-compliance with the technique of administration, incorrect selection of the needle, poor sterility), incorrect care for the infiltrate during the period of suppuration (mechanical damage, smearing with iodine).

Consequences and complications - why the vaccine fester

The likelihood of complications in newborns after vaccination is quite low. Complications after BCG in newborns include conditions associated with a serious deterioration in the health of the newborn and requiring qualified assistance.

Important. Negative consequences occur more often in children born with reduced immunity(for example, if the mother was a carrier of HIV infection).

According to the frequency of occurrence among BCG complications lead local (local) manifestations:

lymphadenitis- inflammatory process in the lymph nodes - develops in one newborn out of a thousand vaccinated;
cold abscess- pathological area at the injection site, filled with pus, without symptoms of an inflammatory reaction; a complication occurs when the BCG technique is violated (the vaccine is injected under the skin);
extensive ulcerative defect diameter over 1 cm- a bleeding wound that is difficult to heal at the injection site; ulcers as complications appear when the newborn is hypersensitive to the components of the vaccine and requires local treatment with antibacterial agents;
extensive rough(keloid) scar- response of the skin to foreign cells of the vaccine; the presence of a small scar ( up to 0.5 cm) does not apply to pathology; large rough scars over 1 cm) with protruding edges require control by a phthisiatrician and pediatrician;
osteitis- a dangerous complication of BCG, occurs extremely rarely - one baby for 200 thousand vaccinated; osteitis develops after 6-24 months after vaccination in the form of tuberculous lesions of the bones; at risk - children with congenital dysfunctions of the immune system;
generalized BCG infection- a serious condition that occurs in infants with severe immune disorders; frequency of occurrence - one vaccinated out of 100 thousand;
acute allergic reactions in the form of a sudden rash all over the body, severe itching develops in newborns with a tendency to allergies.

Useful video

It is important to know how the BCG vaccine works on the child's body, what vaccines exist and are being developed now, why put it at all.

When you can not do without a doctor - what to do

BCG is considered "lightweight" compared to other vaccines. Most newborns tolerate well both the vaccination itself and the process of infiltrate formation and healing. But there is list of reactions on BCG during administration and during healing, in which doctor's consultation is necessary:

acute skin manifestations(swelling, bloating, suppuration, abscess) with dimensions over 1 cm and soreness;
general sudden or prolonged (longer than 2-3 days) deterioration of the child, including refusal to eat, drowsiness, abrupt crying, change in stool;
temperature over 38-38.5°, difficult to correct with antipyretics;
swollen and sore lymph nodes.

Important. Newborns who have given an inadequate response to the introduction of BCG are subject to observation by a phthisiatrician. If the complications are severe, specific therapy will be required to restore the body. Subsequently, for such children, the issue of BCG revaccination is decided individually.

BCG is an important vaccine, the timely setting of which allows really to protect the child from deadly forms of tuberculosis. Many parents are afraid of the vaccine, believing that its action is not justified, and adverse reactions will seriously undermine the health of the baby. This opinion is erroneous with a responsible approach to vaccination, the risk of complications is reduced to zero.

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The best way to protect against the disease 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 that cause the disease, and contributes to the rapid development of anti-tuberculosis immunity.

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. An injection is placed in the child's thigh: this happens when there are contraindications that do not allow an injection, as usual, in the forearm.

The drug is injected into the upper part of the shoulder, and in the presence of contraindications - into the thigh. The procedure is usually carried out in the hospital, on 3-7 day after the birth of the child.

Attention! BCG vaccine does not protect person from contracting tuberculosis, but prevents serious complications and the transition of the latent disease to open form.

What should be the reaction of the body to BCG

The BCG drug provokes an allergic reaction in the body: T-lymphocytes accumulate under the skin, which begin to fight tuberculosis pathogens, which causes a corresponding reaction from the skin. 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 is absorbed through 18-20 minutes- this means that the drug was administered correctly.

AT first days any changes in the skin at the injection site are not noticeable, but sometimes a slight reddening, thickening or inflammation of the skin can form - this is considered a normal variant. It is important to note that such reactions can continue for 2-3 days, after which the injection site (before the formation of a papule and a scar) in its appearance should not differ from the surrounding tissues.

When it appears

Approximately within a month after the injection (depending on the individual reaction), a small papule, which looks like a bubble with a slight suppuration.

This is a normal reaction and indicates that the vaccination was successful, the body "gets acquainted" with the pathogens and develops immunity.

In some cases, the formation of a papule and its healing is accompanied by severe itching, but it is strictly forbidden to comb it so as not to introduce an infection under the skin. Sometimes a person may experience a slight fever, but if the numbers on the thermometer do not rise above 37-38 , no need to worry.

Three months after vaccination, the papule becomes covered with crusts and heals, and in its place an even scar of white color appears, sometimes with a pink or reddish tint. 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 is a scar from 7 to 10 mm in diameter. Scar formation less than 4 mm indicates that vaccination has not achieved its goal and there is no anti-tuberculosis immunity.

Important! There are certain rules for caring for the injection site of the BCG vaccine - the resulting papule it is forbidden lubricate antiseptics, squeeze out of it pus, delete crusts 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 a scar at the injection site indicate that the vaccine was expired or the body did not respond to its introduction with the formation of anti-tuberculosis immunity. In this case, it is necessary to conduct a tuberculin test (Mantoux) and re-administer the vaccine.

Photo 2. Usually, after an injection, a papule is formed - a vesicle with suppuration. This is normal, a 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. Approximately 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 become very red. If this is not expressed too strongly, there is no reason to worry.

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Photo 4. Not too high a temperature in a child after BCG is normal, you do not need to call a doctor.

Other reactions from the skin and the whole body (severe redness, induration, temperature) occur due to the characteristic features of the human body or sensitivity to the drug, and, as a rule, do not require medical intervention. If they are too strong, a specialist consultation is necessary.

Reference! In some cases, a scar after the introduction of the BCG vaccine is not formed on the surface of the skin, but in the deep layers. Its presence can be determined by changing colors skin and small compaction.

What symptoms should cause anxiety after vaccination

Serious complications after an injection develop quite rarely - they are usually observed in people with lowered immunity or positive HIV status. Most often, these are abnormal reactions from the skin, but in isolated cases, pathologies can occur that threaten the health or even life of a person.

Ulcer at 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, there is probably 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 for administering the vaccine (the drug can only be administered intradermally, not subcutaneously). The complication develops after about 1-1.5 monthsafter vaccination and looks liketumorswith liquid content inside.

As a rule, it does not cause discomfort, but sometimes lymph nodes may increase in patients and ulcers on the skin may appear. Most often, cold abscesses open on their own through 2-3 years, but sometimes surgery is required (the abscess is opened and drained, after which the wound is sutured).

Lymphadenitis. An individual reaction of the body to the introduction of pathogenic microorganisms, which is characterized by an increase in lymph nodes, subclavian or supraclavicular. The patient needs to consult an infectious disease specialist and specific therapy.
Osteomyelitis. A dangerous disease that develops through several months or years(average one year) after injection. First, there is swelling of the tissues adjacent to the injection site, after which the joints of the hands are involved in the pathological process, then the lower limbs, ribs and collarbones. The patient does not experience severe discomfort - a slight increase in temperature and stiffness in the joints are possible.
Keloid scars. Develop after wrong introduction of the vaccine. Keloid scars begin to form a year after the vaccine is administered, and in their appearance do 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 inhibition or complete cessation of scar growth.
BCG infection. Develops exclusively in people with lowered immunity, and is manifested by inflammation around the injection site.

The most dangerous complications after BCG 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 occur in 1 case out of 100,000 therefore, TB vaccination is considered a relatively safe health procedure.

Attention! Any complication after BCG injection should be documented in the child's medical record and must be taken into account when revaccinating .

How to distinguish a normal reaction from a pathology

The reaction of the body to the introduction of the BCG vaccine is a sign that the body correctly "meets" the causative agents of tuberculosis and learns to deal with them. But since any vaccine can cause side effects, after the introduction of the BCG drug, you should carefully monitor the condition of the person, 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.

Normal skin color white, pink or reddish- bright red or brown indicates the development of complications or side effects.

In addition, specialist advice is necessary in cases where the papule does not heal longer. 3-5 months.

Fever, which may occur after the injection, continues no more than 3 days and is not accompanied by any additional symptoms (diarrhea, cough, pain) - otherwise, an increase in temperature indicates an infectious disease.

To date, BCG vaccination is considered optimal and most safe way to protect the population from tuberculosis. In rare cases, the drug can cause adverse reactions in the body, but strict monitoring of the condition and proper care of the injection site significantly reduces the risk of serious complications.

Useful video

Check out the video, which tells about the reaction to BCG, which it should be normal after vaccination.