The tuberculosis vaccine is created from a strain of weakened live bovine tuberculosis bacilli that have lost their virulence for the human body. Into the body of healthy newborns it administered on days 3-5 of life.

Revaccination with BCG is carried out at the age of seven. Most people develop a specific scar. But there are times when the scar does not remain.

Characteristics of BCG in a child

Vaccination is necessary to prevent severe forms of tuberculosis. BCG does not reduce the prevalence of the disease; it is intended to prevent the development of those types of tuberculosis that are highly lethal.

The decision to carry out universal vaccination is due to the unfavorable epidemiological situation.

For newborn children, the vaccine is administered intradermally into the left shoulder in the area where the deltoid muscle attaches. This area is located between the central and upper third of the shoulder. Depending on the condition of the newborn, he may be given BCG or BCG-m (a weakened version intended for premature, low-birth-weight babies).

If administered correctly, a papule will form immediately after injection. Its diameter does not exceed 10 mm. Within half an hour it dissolves. This is the main sign of a correctly administered vaccination.

Reference! Improper administration of the vaccine leads to complications. With subcutaneous injection, some people develop an abscess that ulcerates. The condition can be normalized by long-term use of antibiotics.

The reaction to BCG does not appear immediately. It should be delayed. As a rule, after 4-6 weeks An abscess forms at the injection site. Over time, it becomes crusty and gradually heals.

In the absence of complications, the healing process continues up to 4.5 months. Initially, the injection site turns red or turns purple, blue, or black. Parents should not be afraid - this is a variant of the norm. At the site of darkening and redness, an abscess appears, in the center of which there is a scab. But some people develop a reddish blister filled with liquid. Sometimes the ulcers burst and their contents spill out.

Attention! There is no need to treat the wound with antiseptics, sprinkle it with powdered antibacterial agents, or make an iodine mesh. It is also not recommended to squeeze pus out of the wound.

A successful BCG vaccination and the formation of an immune response is indicated by the resulting scar. A scar is formed with a length of 2 to 10 mm. If it is absent, figure out why this situation arose. The larger the scar size, the stronger the developed immunity:

• 2-4 mm: protection lasts for 3-4 years;
• 5-8 mm: the vaccine will last for 4-7 years;
• from 8 mm: immunity from tuberculosis has been formed for a period of more than 7 years.

Photo 1. The size of the BCG scar in a child is about 5-8 mm, so the vaccine will last for 4-7 years.

The correct reaction to a vaccine is as follows.

1. A white papule appears at the injection site, which disappears after 10-30 minutes.
2. After 4-6 weeks, the vaccine injection site turns red, an abscess or blister with liquid contents appears, and a scab forms on the surface. For some, pus may leak. In this case, it is recommended to cover the area with a sterile wipe and change it as needed.
3. After 3-4 months, the injection site heals completely and a scar forms.

This is a normal reaction of the body to BCG.

Why is there no trace of the vaccine?

In some vaccinated babies, the scar after the injection is not visible. This situation occurs frequently: in 5-10% of children There are no traces left from the first vaccination. The main reasons for this include:

• violation of vaccination technology;
• use of spoiled or expired vaccine;
• the presence of innate powerful anti-tuberculosis immunity.

Innate resistance to mycobacterial lesions is observed in 2% of the population. In these people, the mark will not appear even after repeated injections of BCG. They do not suffer from tuberculosis, and the Mantoux reaction is always negative. Infection is possible only with a strong decrease in immunity, for example, against the background HIV infection.

But figuring out whether the absence of a scar is due to innate immune defenses or whether it is missing due to the use of a low-quality vaccine is difficult. The condition can be monitored by regular testing using the Mantoux reaction. If it is negative, then revaccination is done.

People with innate anti-tuberculosis immunity will not develop a scar. If the immune response has not been formed due to the use of low-quality raw materials or its incorrect administration, then the person is at risk. When infected, the risk of the disease becoming open and causing death increases. Vaccinated people are much less likely to develop meningitis and other disseminated types of tuberculosis that lead to death.

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There was no trace left after revaccination

Re-administration of the vaccine is necessary even for children who have vaccine marks. It is carried out to increase the body's immunity to the effects of mycobacteria.

As a rule, general revaccination is carried out in regions where tuberculosis is widespread. It is mandatory for children whose family includes people with this disease.

In some babies, a scar at the site of vaccine administration does not form at all, in others it disappears over time. This indicates the absence of post-vaccination immunity. Children with a missing BCG scar are considered equal to those who did not vaccinate. Situations where the scar resolves are rare. Doctors say that this indicates a lack of immunity. In such a situation, revaccination is recommended to be carried out as soon as possible.

In cases where there is no scar left from BCG, repeated administration of the drug is mandatory. This is necessary for the formation of immunity. Otherwise, the risks of developing severe forms of the disease leading to death remain high.

But first do a Mantoux test. BCG vaccination is carried out only on the condition that there is no local reaction on the forearm from the tuberculin test: visualization of the injection mark is acceptable. The vaccine is administered immediately after confirmation of a negative reaction to the administered tuberculin. The maximum permissible time interval between Mantoux and BCG placement is 2 weeks.

If there is no trace and Mantoux is negative, it is recommended to re-administer the live vaccine outside the standard time frame ( at 7 or 14 years old), and through 2 years. If the first tuberculin test was negative, and a year later a change is observed (a positive reaction appears), then a consultation with a phthisiatrician is required.

It is impossible to do BCG with a positive or questionable Mantoux. This situation is included in the list of contraindications for revaccination.

Reference! If T-lymphocytes have previously been in contact with Koch's bacillus, then specific inflammation will occur at the site of tuberculin injection. If the immune system is not familiar with the causative agent of tuberculosis infection, then the papule will be absent.

It is strictly prohibited to administer BCG to children whose immune system has reacted to tuberculin.

Instructions for parents: what to do if the BCG vaccination is not visible

If a baby is given BCG or BCG-m, then after a few months he will have a characteristic scar on shoulder. If it is not available, consult a pediatrician and, if necessary, a phthisiatrician.

The trace of the BCG vaccination does not always remain. Its appearance is considered normal after the introduction of weakened tubercle bacilli that have lost their virulence. The spot parameters (size, color) are different. However, sometimes there are no scars on the skin in the area where the vaccine was administered. To find out if this is normal, you need to study the probable causes of this phenomenon.

What should the trail be like?

The norm is the presence of a post-vaccination sign at the site where the vaccine is administered. This means that the body has developed immunity to tuberculosis bacteria. The mark from the BCG vaccination does not appear immediately after the injection. It takes several months for a papule to form and transform into a scar on the shoulder.

At the point of injection of the substance during vaccination, after 6 weeks, a papular formation develops. Subsequently, the lump transforms and goes through different stages: it turns purple, turns blue. These changes are considered normal. Immunity is developed 4.5 months after the vaccine is administered. By this time, the child’s BCG scar remains.

At the stage of formation of immunity to tuberculosis bacteria, other changes in the papules are observed. A purulent process develops in the tissues in this area of ​​the skin. The integrity of the neoplasm is disrupted when pus breaks out. After this, crusts may remain. The BCG scar in newborns and older children appears when the wound dries out and heals.

Why does BCG vaccination leave a scar?

A papule immediately forms at the point of vaccine administration. It dissolves quickly. This indicates the beginning of the process of developing immunity to tuberculosis. Subsequently, the body responds to the penetration of conditionally pathogenic particles, although they are weakened, but do not pose a danger to human health: a pustule is formed, which is accompanied by the release of pus.

This is a local manifestation of cutaneous tuberculosis.

After the scab falls off, a scar remains. The reason for this is that pathogenic particles penetrate deep into the skin. The more intense the response the body gives, the stronger the reaction to the injected drug will be. When deep layers of skin are affected, tissue damage is significant. This leads to the fact that a scar remains after BCG.

When does a scar appear?

The scar appears during the process of long-term transformation of the papule (the tissue undergoes changes). Normal reaction to the vaccine:

• formation of a flattened neoplasm at the point of drug administration;
• signs of the body's response appeared: hyperemia in the area where the injection was made, the development of purulent processes, the formation of a vesicle;
• release of exudate, release of pus from the neoplasm.

The appearance of a scar is due to the development of these processes. However, it occurs at the final stage of developing immunity - several months after the administration of the drug during vaccination. The crust that periodically forms as a result of suppuration of the pustule should not be mistaken for a scar. At first it disappears, soon after this the BCG scar appears.

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In order for the process of developing immunity to develop properly, children should not pick off the scabs. They should peel off on their own. If you put effort into this, the scar is formed with deviations. The above signs indicate that vaccination was performed correctly. The formation of a scar is not affected by the intensity of pus discharge. If this process develops more clearly, it is enough to cover the pustule with a sterile gauze cloth. This will remove excess pus.

The size of the scar determines the effectiveness of the vaccination. Possible options:

• 4 mm;
• up to 8 mm;
• up to 10 mm.

The best option is a scar of 8 mm and above. This indicates that immunity has been developed for a long period (up to 7 years). If the scar size is 5-8 mm, it is believed that the effect of immunity will not be long enough - up to 3 years. A small scar remaining after the end of the suppuration process (up to 4 mm in size) is considered a consequence of ineffective vaccination. Among the consequences of this is a keloid scar. It looks like a burn mark.

Why is there no trace

The main reason for the absence of a scar after BCG is undeveloped immunity. This means that additional manipulations are required. So, if the child does not have a trace of BCG, it is recommended to test with tuberculin. After this, you can vaccinate again. However, it is important that the Mantoux reaction is negative.

Re-vaccination is not always carried out in the near future. It is permissible to vaccinate at the age of 7 according to the schedule. If there is no trace left after the vaccine is administered, there may be two reasons:

• innate immunity (this occurs in 2% of the world's population);
• violation of vaccination rules.

If there is innate immunity against Koch's bacillus, you can check whether this is the case by performing a tuberculin test. In this case, not only is there no trace after the BCG vaccination, but also after Mantoux there are no signs of tuberculin administration.

BCG (vaccine against tuberculosis) was obtained by French scientists A. Calmette and C. Guerin in 1919. Later (1921), the vaccine was first administered to a newborn child, and a couple of years later it was approved by the League of Nations and began to be widely used throughout the world.

Today, a baby is given BCG upon discharge from the maternity hospital, but with the condition that there are no contraindications. The BCG vaccination is a vaccine aimed at producing immunity against tuberculosis.

In the production of the drug against tuberculosis, Bacillus Calmette-Guerin, or an attenuated strain of Mycobacterium bovis, is used.

What should a BCG vaccination look like?

What does the BCG vaccination look like, or rather, the place of its administration on the human body? After the injection, the formation of a papule is observed on the skin, the diameter of which does not exceed one centimeter. These manifestations indicate that vaccination was successful. After a quarter of an hour, the papule disappears and resolves.

How many days/months does it take for the initial reaction to appear? The reaction to BCG does not appear earlier than after a month. The duration of the vaccination reaction is 4.5 months. A mark appears at the injection site - a pustule with slight suppuration. There is no need to be afraid of this manifestation.

Then, on the skin at the injection site, the formation of a compaction (diameter 0.5-1 cm) is observed, which over time turns into a bubble filled with liquid. After 2-3 months, the blister bursts, and in its place a wound appears, covered with a crust.

Important point! The resulting crust cannot be removed. When performing water procedures, you should also not get it wet. The injection site does not need to be lubricated with antiseptics.

After some time, a BCG scar with a diameter of 0.3-1 cm forms at the site of the wound. The scar is characterized by a reddish tint. A year later, the mark from the BCG vaccination is completely healed, which indicates that the vaccination was carried out correctly/successfully.

What should be the reaction after BCG? First of all, it should be noted that if the drug was administered correctly, taking into account contraindications, the vaccination period will proceed without any particular cause for concern.

So, with proper vaccination we observe:

• the appearance of a papule after an injection;
• after 1.5 months the injection site turns red;
• the appearance of an abscess or bubble with fluid;
• leakage of pus and its re-formation;
• the appearance of a scar, the diameter of which is in the range of 3-10 mm.

BCG is done three days after the birth of the baby, and then at seven years, but only if there are no contraindications.

A vaccination given to a child when he or she has prohibiting factors often causes complications that can be determined visually.

Vaccination is not carried out if:

• neoplasms were detected in the baby;
• the mother is diagnosed with HIV;
• One of your close relatives is observed to have a generalized BCG infection.

Vaccination is also not given if:

• development of acute diseases, as well as exacerbation of chronic pathologies;
• detection of immunodeficiency;
• undergoing a course of radiation therapy;
• severe diseases of the nervous system.

Also, the vaccine is not given if the baby weighs less than 2.5 kg. If there are contraindications, vaccination is not carried out or is postponed for some time until the child’s condition returns to normal.

Reaction to the vaccine

Many parents mistakenly believe that the manifestation of various kinds of reactions (for example, itching, redness, fever) refers to negative consequences. This is not true at all. Such phenomena are considered normal. Let's look at the reactions to BCG that are most often observed:

Lack of scar and other abnormalities

No scar, is that bad or not? If there is no trace of the injection, it means there is no immunity or the drug was administered incorrectly. If there is no trace of the vaccine, Mantoux testing is performed. If there is no positive result, re-vaccination is carried out. Sometimes, when there is no trace of BCG, the drug is reintroduced when the child turns seven years old.

If there is no trace of BCG vaccination, this may be due to the patient having innate immunity against tuberculosis. In this case, a scar will not form.

How do you know that the absence of a trace of tuberculosis is normal? After Mantoux testing, only a trace of BCG remains on the arm - this indicates the presence of innate immunity to tuberculosis.

Sometimes a scar forms under the skin. During examination, you may not see it, but an experienced doctor will easily identify the scar located under the skin.

It is usually determined by a change in the color of the skin at the site of vaccination - the skin turns red/pink. This means that local changes occur within the tissues. If there was a scar and then disappeared, this indicates that the vaccine has stopped working.

Sometimes BCG vaccination can be accompanied by complications, which are visually detected as follows:

• cold abscess (if the drug is administered subcutaneously rather than intradermally);
• ulcer with a diameter of more than one centimeter;
• inflammation of the lymph nodes (if bacteria enter the lymph nodes from the skin);
• osteitis/bone tuberculosis (begins to develop after vaccination six months, or even a couple of years);
• BCG infection (develops in the presence of severe immune disorders) is manifested by an inflammatory process outside the site of vaccine administration;
• keloid scar.

If the drug was administered incorrectly, keloid scars may appear after a year (they look like knots formed after a burn). They may be growing or not growing.

The growing species has the following characteristics:

• reddish and sometimes brown tint;
• a developed network of capillaries inside the formation;
• wrong shape.

A growing scar resembles a tumor, which has a dense structure and a smooth surface. Supposed causes of keloid formation:

• the inflamed lesion does not heal for a long time;
• genetic failure of connective tissue;
• incorrect administration of the vaccine.

With the help of intensive therapy, it is possible to slow down/stop the process of keloid growth. After revaccination, it will not be possible to remove the scar.

Collapse

Tuberculosis is a dangerous infection, immunity to which is artificially formed from the first days of a baby’s life. By administering a vaccine, which contains a certain amount of dead and live mycobacteria, the child develops antibodies that are persistently resistant to Koch's bacillus.

The consequence of a successful reaction to vaccination is a scar at the injection site. The formation of immunity is extremely important for the life and health of the baby, therefore the absence of a reaction to the introduction of the vaccine should alert medical personnel and parents.

Why might a scar not form after BCG?

1. The vaccination technique was broken. BCG must be injected intradermally into the left shoulder, less often into the thigh area.
2. When using a low-quality vaccine. Storage and dilution rules must be strictly observed to avoid side and adverse effects.
3. The child was born with innate immunity against tuberculosis.
4. Sometimes the scar is not visually visible, but it forms under the skin. Only a qualified TB specialist is able to recognize the hidden mark after vaccination.

Incorrectly placed BCG

If there is no trace (scar) from the BCG vaccination, it is necessary to establish the exact cause. A common cause of unformed immunity is violations during the administration, dilution or storage of the vaccine.

To achieve the required result, BCG-M is administered strictly intradermally; administering the vaccine by other means is strictly prohibited. After dilution, the solution with mycobacteria should not be stored in the light for more than 1 hour, after which the diluted vaccine is destroyed in an autoclave at a temperature of 125 degrees.

What to do if there is no trace of BCG? The Mantoux test will help determine the presence of a formed immune defense. After tuberculin diagnostics, a specific reaction to tuberculin administration should be observed (formation of a pink papule of a certain size). A negative reaction indicates the body does not have an immune response to the vaccine.

This confirms violations during the procedure. In this case, re-vaccination is required. Sometimes the doctor decides to repeat BCG-M at the age of seven. In such children, the Mantoux test is performed once every six months to exclude infection with tuberculosis.

Innate immunity

Another reason for the absence of a vaccination mark may be the presence of natural immunity already at birth. 2% of the planet's inhabitants have congenital resistance to Koch's bacillus.

After the tuberculin test is carried out, only the injection mark remains on the child’s arm. In infants with innate immunity, there is no trace of the vaccine at the injection site. Such children do not require additional vaccination.

Despite this, phthisiatricians carefully monitor the results of the Mantoux test. Even with innate immune protection, there is a possibility of infection, since in most cases it is not strong enough.

If an unvaccinated child with innate immunity is in normal conditions, he will not get tuberculosis, but once children are exposed to infection or have a weakened immune system, the risk of disease is very high.

Conclusion

If there is no trace of vaccination in a child, it is important to regularly monitor the results after tuberculin administration. When a papule does not form at the injection site, and the result after the Mantoux test is consistently negative, such children should be constantly monitored by an experienced phthisiatrician to avoid tuberculosis.

What should a scar look like after a BCG vaccination? When does he appear? What should be the correct reaction of the body? What to do if there is no trace after the vaccine was delivered? These questions concern mothers, because the formation of immunity from the tuberculosis bacillus is important for the child.

Tuberculosis vaccination technique

BCG vaccination is given to newborns in the maternity hospital before discharge, if there are no contraindications. The purpose of this vaccination is to build immunity against tuberculosis. The drug is administered intradermally into the left shoulder, following the rules of injection technique. In exceptional cases, they vaccinate not in the shoulder area, but in the thigh.

If the child was not immunized in the maternity hospital, vaccination is carried out in the clinic under the supervision of the attending pediatrician. In other cases, BCG vaccinations can be given at home with appropriate payment for a medical team to travel.

After the vaccine is administered, the child develops a papule up to 10 mm in diameter - white and flat. This indicates the correct introduction of the drug into the dermis layer. After 18-20 minutes the papule resolves. After about a month and a half, a pustule with slight suppuration forms at the location of the graft.

Important! After three months, a crust forms in the form of a scab, and the wound gradually begins to heal. These phenomena are considered the norm, and tearing off the crust is strictly prohibited. It is also forbidden to treat the crust with brilliant green!

When the crust dries and peels off, a scar characteristic of BCG forms in its place. The scar may have a reddish tint and may be 10 mm in diameter. If there is no scar at the injection site, it means that the vaccination was ineffective. Many parents get scared when they see a wound festering, however, this reaction of the body indicates the correct process of developing immunity after vaccination.

Normal reaction to a vaccine

What should be the correct reaction to a vaccine? We list the signs of a correct reaction to the BCG vaccine:

• formation of a flat white papule immediately after vaccination;
• redness of the injection site one and a half months after vaccination;
• formation of an abscess or red blister with a scab at the injection site;
• periodic leakage of pus from under the scab and the formation of a new abscess;
• formation of a red scar with a diameter of 3-10 mm at the injection site.

Important! Do not try to remove pus from the wound or sprinkle the suppuration with antibiotic powder!

The listed signs are evidence of a high-quality BCG vaccine. If a child experiences excessive leakage of pus from the wound, you can cover this area of ​​skin with a sterile napkin, periodically replacing it with a clean one.

Scar sizes

The scar can be of different sizes, which determine the quality of the vaccine and the formation of immunity:

1. small scar size: less than 4 mm;
2. average scar size: up to 8 mm;
3. large scar size: up to 10 mm.

If the size of the scar is less than 4 mm, the vaccination process was carried out ineffectively and the effect of immunity will not exceed three years. Scar sizes of 5 mm or more indicate effective BCG immunization. Size up to eight mm. will show a positive immunization result for up to seven years.

Lack of reaction to the vaccine

Why do some children have no trace after vaccination? This shows that anti-tuberculosis immunity has not been formed. What to do if there is no trace of a scar? In this case, Mantoux testing is necessary. If there is no positive reaction, repeated vaccination against tuberculosis should be performed. In some cases, if there is no trace of a scar, BCG vaccination is carried out at the age of seven.

Approximately 10% of vaccinated children do not respond correctly to BCG. What does the absence of a trace of BCG indicate? It could be:

• unformed immunity due to improper administration of the drug;
• innate immunity against tuberculosis.

Approximately 2% of people on earth have innate strong immunity to Koch's bacillus. Such people do not have a trace of a scar on their shoulder after vaccination: it does not form. How do you know that the absence of a trace is the norm and not the cause of a violation of the injection technique or a low-quality drug? A child with innate immunity to tuberculosis has no trace even after the Mantoux test: only a trace of the injection itself remains on the arm.

There are also cases of scar formation inside the skin. Upon visual examination, there are no scars, however, an experienced TB specialist will be able to detect a hidden scar at the injection site. Hidden scars can be identified in advance by changes in skin color from vaccination: it should be red or pink. This indicates local changes taking place inside the skin.

Why did the scar disappear? What does it mean if there are no marks at the injection site? The scar was there initially, but then it disappeared! This indicates the end of the vaccine's effect. The Mantoux test in this case will show either a questionable result or its absence (negative).

Keloid and hypertrophic scars

If the vaccine is administered incorrectly, keloid scars may form. What is it? Such formations begin to form a year after immunization. Keloid scars are similar to post-burn nodes. Among them we can distinguish growing and non-growing forms.

Growing scars have a characteristic reddish (sometimes brown) tint, irregular shape and a developed network of capillaries inside the formation. A keloid resembles a small tumor that rises above the skin, has a dense texture and a smooth surface. Growing scars do not develop in reverse, that is, they only tend to increase. The reaction to a keloid is pain when touched and periodic itching.

The causes of keloids are not yet fully understood. Supposed:

• hereditary failure of connective tissue;
• long-term non-healing inflammatory focus;
• quality of the vaccine and violation of injection technique.

Sometimes a keloid forms in response to repeated administration of the drug. A reaction to the initial administration of the drug with the formation of a keloid is extremely rare.

In some cases, intensive therapy helps slow down the growth of the keloid, and sometimes it is possible to completely stop the growth of the changed tissue. Successful healing is possible only in newborns with primary vaccination. It is practically impossible to remove a keloid after revaccination. Therapy leads to even greater growth of the keloid, sometimes over the entire surface of the shoulder.

It is necessary to distinguish a keloid from hypertrophic nodes, which do not rise above the surface of the skin and never have a network of capillaries inside their structure. Hypertrophic nodes have a dull color and a rough surface, in contrast to glossy keloids. The hypertrophic node does not cause itching and after a certain period of time simply resolves on its own.

What vaccinations do children need at 7 years old? Description of ADSM, BCG and Mantoux.

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Graft BCG is one of the very first that a newborn baby receives in the maternity hospital. Vaccine BCG intended for the prevention and prevention of severe, deadly type of tuberculosis. In Russia, a decision has been made on universal vaccinations all newborns, since the prevalence of tuberculosis is very high, the epidemiological situation is unfavorable, and measures taken for treatment and early detection of cases of infection have not been able to reduce the incidence.

Tuberculosis is considered a social disease, since people are constantly in contact with its causative agent, mycobacterium. Moreover, at least a third of the population of the entire planet are carriers of mycobacteria, but tuberculosis, as a clinical disease, develops only in 5–10% of all infected people. The transition from asymptomatic carriage to the active form - tuberculosis - occurs under the influence of unfavorable factors, such as poor nutrition, bad habits, poor living conditions, unsatisfactory sanitary conditions, etc. The number of Mycobacterium tuberculosis carriers also has a huge impact, since these people are sources of infection.

It is important to understand that the BCG vaccine does not protect a person from infection with Mycobacterium tuberculosis, since under existing conditions this is simply impossible. However, it has proven to be effective in significantly reducing the severity of tuberculosis in children under 2 years of age. In this category of children, BCG vaccination eliminates the possibility of developing meningitis and disseminated forms of tuberculosis, which are almost always fatal.

Explanation of BCG vaccination

The abbreviation BCG, written in Russian letters, is a tracing paper of the Latin letters BCG as read according to the rules of the Romance languages ​​(Latin, Italian, Romanian, French, Spanish, Portuguese). The letters of the Latin alphabet BCG stand for bacillus Calmette–Guerin, that is, “Bacillus Calmette-Guérin.” In Russian, it is not the translation abbreviation BCG (Bacillus Calmette-Guerin) that is used, but the direct reading of the Latin abbreviation BCG, written in Russian letters - BCG.

Vaccine composition

The BCG vaccine consists of different subtypes Mycobacteria bovis. Today, the composition of the vaccine has remained unchanged since 1921. Over the course of 13 years, Calmette and Guerin isolated and repeatedly subcultured a cell culture consisting of various subtypes of Mycobacterium Bovis, ultimately isolating an isolate. The World Health Organization maintains all series of mycobacterial subtypes used to produce BCG.

To obtain a culture of mycobacteria intended for the production of vaccine preparations, a technique is used to inoculate bacilli on a nutrient medium. The cell culture grows on the medium for a week, after which it is isolated, filtered, concentrated, then turned into a homogeneous mass, which is diluted with clean water. As a result, the finished vaccine contains both dead and live bacteria. But the number of bacterial cells in one single dose is not the same; it is determined by the subtype of mycobacteria and the peculiarities of the production method of the vaccine preparation.

Today, a huge number of different types of BCG vaccine are produced in the world, but 90% of all drugs contain one of the following three strains of mycobacteria:

• French "Pasteur" 1173 P2;
• Danish 1331;
• Strain "Glaxo" 1077;
• Tokyo 172.

The effectiveness of all strains used in the BCG vaccine is the same.

Should I get the BCG vaccine?

Today in the world, tuberculosis takes the lives of a huge number of people under the age of 50. Moreover, mortality from tuberculosis is in first place, ahead of both cardiovascular diseases and oncological processes. In countries where tuberculosis is widespread, more women die from this severe infection than from complications of pregnancy and childbirth. Thus, tuberculosis is a very serious problem, causing high mortality in the population. In Russia, the problem of tuberculosis is also very acute, the prevalence of the disease is incredibly high, and the mortality rate from the infection is almost equal to that in the countries of Asia and Africa.

For children, the danger of tuberculosis lies in the rapid development of extremely severe forms, such as meningitis and the disseminated form. In the absence of intensive therapy for tuberculous meningitis and the disseminated form of infection, absolutely all patients die. The BCG vaccine allows you to create protection against tuberculous meningitis and the disseminated form for 85% of vaccinated children, who, even if infected, have a good chance of recovery without negative consequences and complications.

The World Health Organization recommends that children in countries with a high prevalence of tuberculosis be given the BCG vaccine as early as possible. That is why in Russia the BCG vaccination is the first one on the national calendar; it is given to all babies in the maternity hospital. Unfortunately, the BCG vaccination provides protection against tuberculosis and its severe forms (meningitis and disseminated) only for 15 to 20 years, after which the effect of the vaccine ceases. Repeated administration of the vaccine does not lead to increased protection against the disease, so revaccination is considered inappropriate.

Unfortunately, the BCG vaccine does not in any way reduce the spread of tuberculosis, but it effectively protects against the development of severe forms that are highly lethal. The development of severe forms of tuberculosis is especially dangerous in children, who, as a rule, do not survive. Due to these circumstances, the epidemiological situation in Russia and the mechanism of action of the vaccine, it seems that vaccination is still necessary to protect the newborn from the high risk of developing severe and almost always fatal forms of tuberculosis.

According to the findings and recommendations of the World Health Organization, the BCG vaccine is recommended for the following categories of people:
1. Children of the first year of life who are constantly in regions with an extremely high prevalence of tuberculosis.
2. Children of the first year of life and school-age children who have a high risk of infection with tuberculosis, provided they live in regions with a low prevalence of the disease.
3. People in contact with patients who have been diagnosed with a form of tuberculosis that is resistant to many drugs.

Vaccination of newborns in the maternity hospital

The BCG vaccine has existed and been used since 1921. To date, vaccination of all newborns is used only in countries where the tuberculosis situation is unfavorable. In developed countries, cases of tuberculosis are relatively rare and are detected mainly among risk groups - the poorest segments of the population, consisting mainly of migrants. Due to this state of affairs, developed countries use BCG only in infants at risk, and not in all newborns.

Since the situation with tuberculosis in Russia is unfavorable, BCG vaccination is given to all newborns on the 3rd - 4th day in the maternity hospital. This vaccine has been used for almost 100 years, so its effect has been studied very well. It is well tolerated by all newborns, so it is not only possible, but also should be given as early as possible after the birth of the child. Remember that BCG is given to protect the child from severe forms of tuberculosis, which almost always inevitably lead to death. Vaccination also helps prevent the transition of asymptomatic carriage to acute disease.

The opinion that a newborn has no place to “meet” Mycobacterium tuberculosis in order to get sick is wrong. In Russia, approximately 2/3 of the adult population of the country are carriers of this mycobacterium, but do not get sick. Why many people never get sick with tuberculosis, although they are carriers, is currently unknown, although the interaction of the microbe with the human body has been studied for many years.

Mycobacterium carriers are sources of microorganisms that enter the environment when coughing and sneezing. Since even with a small child it is necessary to walk on the street, where there are always a lot of people, the likelihood of the baby becoming infected with mycobacteria is very high. In Russia, 2/3 of children are already infected with Mycobacterium tuberculosis by the age of 7. If the child is not vaccinated with the BCG vaccine, then there is a high risk of developing tuberculous meningitis, a disseminated form of the disease, extrapulmonary tuberculosis and other very dangerous conditions, the mortality rate of children is very high.

Newborns in the maternity hospital are vaccinated with the BCG or BCG-m vaccine, which is a gentle option because it contains exactly half the concentration of microorganisms. BCG-m is used for weakened children, for example, low birth weight or premature babies, who cannot be given a dose intended for ordinary babies.

BCG vaccinations for children

Usually, children are vaccinated with BCG in the maternity hospital 3–7 days after birth, if the child has no contraindications. Otherwise, the BCG vaccine is administered as soon as the child’s condition allows it. The drug is injected into the shoulder intradermally, at the border between its upper and middle third. The reaction to the vaccine is delayed and occurs 4 to 6 weeks after the injection. An abscess develops at the injection site, which becomes covered with a scab and heals. After the scab has healed and fallen off, a spot remains at the injection site, indicating that this vaccination has been given.

If the child does not have a medical card and vaccination certificate, and there is no way to obtain objective data on the presence of vaccinations, then the question of BCG placement is decided based on the presence or absence of a scar on the shoulder. If there is no scar, then the graft must be administered.

In our country, it is customary to carry out another BCG revaccination, in addition to the vaccination the child receives in the maternity hospital, at the age of 7 years. Revaccination at 7 years of age is carried out only if the tuberculin test is negative (Mantoux test). This strategy was adopted due to the extremely widespread prevalence of the disease and the high risk of infection. Vaccination is also carried out by injecting the drug intradermally into the shoulder.

Usually the entire dose is administered in one place, but some medical institutions have adopted the technique of multiple injections, when the drug is administered at several points located in close proximity to each other. Both methods are good, and the advantages of one over the other have not been proven - in other words, their effectiveness is the same.

Children are administered only certified and proven BCG vaccines, which are the same throughout the world. Therefore, there is no difference between domestic and imported drugs in relation to this vaccine.

Vaccination after BCG vaccination

No more vaccinations should be administered at the same time as BCG! Those. on the day of BCG placement, only this drug is administered, and no others are added. Since reactions to BCG develop only 4 to 6 weeks after the injection, no other vaccinations should be given during this entire period of time. After vaccination, at least 30–45 days must pass before any other vaccination.

In the maternity hospital, it is precisely because of these features that BCG is given after vaccination against hepatitis B. Since the hepatitis B vaccine gives reactions immediately, lasting within 3 to 5 days, it can be administered before BCG. That is why, on the first day after birth, the child is given the hepatitis B vaccine, and 3 to 4 days later, before discharge, he is given BCG. Then the child enters a period of immunological rest - that is, no vaccines are administered until the age of 3 months. At this point, immunity to tuberculosis has already been formed, and all vaccination reactions have passed.

BCG vaccination calendar

In Russia, it is customary to administer the BCG vaccine twice during life:
1. 3 – 7 days after birth.
2. 7 years old.

For children aged 7 years, revaccination with BCG is carried out only with a negative Mantoux test. This strategy allows you to increase immunity to tuberculosis and increase the percentage of the body’s resistance to the effects of mycobacteria. In those regions of the country where the prevalence of the disease is relatively low, revaccination at 7 years of age may not be necessary. And where the epidemiological situation is unfavorable, repeated administration of BCG is mandatory. The epidemiological situation is considered unfavorable if more than 80 cases per 100,000 people are detected in a region. This data can be obtained from the tuberculosis clinic or from epidemiologists in the region. Also, revaccination of children at 7 years of age is mandatory if among relatives there are patients with tuberculosis who are in contact with the child.

When is the BCG vaccination given?

If there are no contraindications, then the BCG vaccination is given according to the national calendar - that is, on the 3rd - 7th day after birth, then at 7 years. If there were contraindications and a medical exemption from BCG vaccination for some period of time, then the vaccine is given after the child’s condition has normalized. In this case, before immunization, you must first perform a Mantoux test. If the Mantoux test is negative, then BCG vaccination should be completed as soon as possible. In this case, the vaccine after a negative Mantoux test is given no earlier than three days later, but no later than two weeks. If the Mantoux test is positive (that is, the child has already had contact with mycobacteria), then the vaccination is useless - in this situation, immunization is not carried out.

Vaccine injection site

The World Health Organization recommends placing the BCG vaccine on the outer side of the left shoulder, on the border between its upper and middle third. In Russia, BCG is administered in exactly this way - into the shoulder. The vaccine preparation is administered strictly intradermally; subcutaneous or intramuscular injection is not allowed.

If there are any reasons why the vaccine cannot be injected into the shoulder, then another place with sufficiently thick skin is selected where the injection is placed. As a rule, if it is impossible to place BCG in the shoulder, it is injected into the thigh.

Where can I get the BCG vaccination?

Newborns are vaccinated with BCG in the maternity hospital. If the child did not receive the vaccine in the maternity hospital, then immunization is carried out in the clinic where the baby is being observed. The clinic has a special vaccination room, and sometimes two, where vaccinations are given. If there are two vaccination rooms, then in one of them they carry out BCG vaccination exclusively, and in the second they give all other vaccines. When there is only one vaccination room in the clinic, then, according to sanitary rules, a special day of the week is allocated for vaccinating children with BCG, on which only this manipulation is carried out. It is strictly forbidden to administer this vaccine in a treatment room where a nurse draws blood, performs intramuscular and intravenous injections, etc.

In addition to the local clinic, the BCG vaccine can be delivered at the tuberculosis dispensary. Children who are at high risk of developing a severe reaction to vaccination are vaccinated exclusively in a hospital setting. Russian legislation allows immunization to be carried out at home, when a specialized team arrives with all the necessary equipment and materials. The visit of a vaccination team to your home is paid separately, since this service is not included in the list of mandatory services provided under the compulsory health insurance policy.

In addition to the above options, BCG can be delivered in specialized vaccination centers that are certified to carry out this type of medical procedure.

What does the BCG vaccine look like?

Firstly, the BCG vaccine must be administered strictly with a disposable syringe, with a short-cut needle. It is very important to adhere to the correct injection technique to avoid possible complications. The correctness of the injection can be assessed by the appearance of the BCG vaccination.

So, before the needle is inserted, the skin area is stretched. A small amount of the drug is then injected to see if the needle goes in correctly. If the needle is intradermal, then the entire BCG vaccine is injected. After such correct administration of the vaccine, a flat papule measuring 5–10 mm in diameter, painted white, should form at the injection site. The papule lasts for 15 - 20 minutes, after which it disappears. Such a papule is called a specific reaction to the administration of the BCG vaccine, which is absolutely normal.

In newborn children, 1 - 1.5 months after BCG vaccination, a normal vaccination reaction develops, which lasts for 2 - 3 months. In children who are repeatedly injected with BCG (at 7 years of age), the vaccine reaction develops 1 to 2 weeks after the injection. The injection site with a vaccination reaction should be protected, and strong mechanical effects such as friction, scratching, etc. should be avoided. You should be especially careful when bathing your child; under no circumstances rub the site of the vaccination reaction with a washcloth.

The vaccination reaction is characterized by the formation of a papule, pustule or slight suppuration at the site of BCG injection. Then this formation undergoes reverse involution for 2 - 3 months, during which the wound becomes covered with scabs and gradually heals. After complete healing of the wound, the scab disappears, and in its place remains a small scar, up to 10 mm in diameter. The absence of a scar is evidence of improper administration of the vaccine, which means the complete ineffectiveness of the BCG vaccination.

Many parents are very scared when a child at 1 - 1.5 months develops an abscess at the injection site, which they mistake for a complication. However, this is a completely normal course of the vaccination reaction; you should not be afraid of a local abscess. Remember that the duration of its complete healing can reach up to 3 – 4 months. During this period, the child must maintain a normal routine of life. But you should not smear the abscess or scab with iodine or treat it with antiseptic solutions - the wound should heal on its own. Also, you should not tear off the scab until it falls off on its own.

How does the BCG vaccine heal?

The vaccination reaction to the BCG vaccine begins to develop 1 - 1.5 months after the injection, and can last up to 4.5 months. At the very beginning of the reaction, the vaccination site may turn red or dark (blue, purple, black, etc.), which is normal. Do not be afraid of this type of vaccination. Then, instead of redness, an abscess forms in this place, which protrudes above the surface of the skin. A scab forms in the center of the abscess. In other children, BCG heals without suppuration; only a red blister with liquid contents forms at the injection site, which becomes covered with a scab and tightens, forming a scar.

The abscess can burst with the flow of inflammatory contents - pus. However, after this, pus can still form for some time, flow freely from the wound, or form a new abscess. Both options represent a normal process of the vaccination reaction to the BCG vaccine, which does not need to be feared.

Remember that the healing process of this abscess can take up to 4.5 months. During this period, you should not lubricate the wound with any antiseptic solutions, apply an iodine net, or sprinkle it with antibiotic powders. If pus flows freely from the wound, then it should simply be covered with clean gauze, periodically changing the contaminated napkin. Pus should not be squeezed out of the wound.

After local suppuration ends, a small red pimple will form at the injection site, which after some time will take on the appearance of a characteristic scar on the shoulder. The diameter of the scar can vary, and normally ranges from 2 to 10 mm.

No trace of BCG injection

The absence of a vaccination reaction and a trace (scar) from the BCG vaccination is evidence that immunity to tuberculosis has not been formed and the vaccine turned out to be ineffective. However, there is no need to panic or take any immediate action. In this case, it is necessary to give BCG again if the Mantoux test is negative, or wait for revaccination at 7 years. In this case, in a child under 7 years of age, the Mantoux test should only represent an injection mark.

Lack of body response to the first BCG vaccination occurs in 5–10% of children. In addition, about 2% of people have congenital genetically determined resistance to mycobacteria, that is, in principle, they are not at risk of developing tuberculosis. In such people there will also be no trace of the BCG vaccination.

Reaction to the vaccine

The BCG vaccination is well tolerated by the child, and reactions to the vaccine are of the delayed type, that is, they develop some time after administration. Many adults consider these reactions to be negative consequences of BCG, which is incorrect, since these changes are normal. Let's look at the most common consequences of BCG vaccination.

BCG blushed. Redness and slight suppuration of the injection site is a normal vaccination reaction. Redness can persist even after suppuration; during this period, a scar forms on the skin. Redness of the injection site is normally observed only during the period of vaccination reactions. Redness should not spread to surrounding tissues.

Sometimes a keloid scar forms at the site of injection of the drug - then the skin becomes red and swells slightly. This is not a pathology - the skin reacted to BCG in this way.
BCG festers or breaks out. BCG suppuration during the development of the reaction is normal. The graft should look like a small pustule with a crust in the middle. Moreover, the surrounding tissues (skin around the abscess) should be absolutely normal, that is, there should be no redness or swelling around the festering BCG. If there is redness and swelling around the festering BCG, then you should consult a doctor, since the wound may become infected, which should be treated. In severe cases, when the graft wound suppurates several times, a diagnosis is made BCJit, and the treatment tactics are determined by the doctor. In such a situation, the child should be carefully examined, since other routine vaccinations may be contraindicated, until the baby’s condition normalizes.

BCG is swollen. Immediately after the vaccine is administered, the injection site may swell slightly. This swelling does not last long - a maximum of two to three days, after which it goes away on its own. After such an initial reaction, the site of BCG injection should be absolutely normal, indistinguishable from neighboring areas of the skin. Only after an average of 1.5 months does the development of a vaccination reaction begin, which is characterized by a pimple and suppuration with a crust, ending with the formation of a scar. During the period of the vaccination reaction, BCG should not normally swell or rise. The abscess and subsequent red pimple with a scab in its place should not be swollen. If there is swelling around the vaccination, you should consult a phthisiatrician who will determine further tactics.

BCG is inflamed. Normally, the site of BCG vaccination is characterized by a vaccine reaction, which appears after some time and looks like inflammation. If BCG looks like an abscess or a red pimple, or a vesicle with liquid, and the tissue around this place is normal, then there is no need to worry, there are simply different options for the course of the vaccine reaction. A cause for concern is the spread of swelling or inflammation beyond the BCG to the skin of the shoulder. In this case, you need to consult a doctor.

BCG itches. The site of BCG vaccination may itch, since the active process of healing and regeneration of skin structures is often accompanied by various similar sensations. In addition to scratching, it may seem that something is moving or tickling inside the abscess or under the scab, etc. Such sensations are normal; their development, as well as the degree of severity, depend on the individual properties and reactions of the human body. However, you should not scratch or rub the injection site - it is best to restrain the child by placing a gauze pad over the injection site or putting on gloves.

Temperature after BCG. After BCG vaccination, a slight fever may occur, but this is a rare occurrence. During the period of development of the vaccination reaction, when an abscess forms, temperature may well accompany this process. Usually in children in this case the temperature does not rise above 37.5 o C. In general, some jumps in the temperature curve are characteristic - from 36.4 to 38.0 o C, over a short period of time. If, after a BCG vaccination, a child’s temperature rises at 7 years old, then you should consult a doctor.

Complications of BCG vaccination

Complications of BCG include conditions in which a serious disorder of the child’s health develops, requiring serious treatment. A vaccination reaction to BCG in the form of an abscess followed by the formation of a scar on the skin is not a complication, but is the norm. Complications of the BCG vaccine are extremely rare, and the majority of such cases occur in children who have a persistent congenital decrease in immunity (for example, at birth from an HIV-infected mother). Complications in the form of local reactions, such as inflammation of the lymph nodes (lymphadenitis) or a large area of ​​suppuration, occur in less than 1 child per 1000 vaccinated people. Moreover, 90% of these complications occur in children with immunodeficiency. A complication such as osteomyelitis is associated exclusively with a low-quality vaccine. In principle, almost all complications of BCG are associated with failure to follow the technique of administering the drug.

Today, BCG vaccination can lead to the following complications:

• Cold abscess – develops when the drug is administered subcutaneously rather than intradermally. Such an abscess forms 1 - 1.5 months after immunization and requires surgical intervention.
• Extensive ulcer at the injection site more than 10 mm in diameter - in this case the child is highly sensitive to the components of the drug. For such ulcers, local treatment is carried out, and information about sensitivity is recorded in the medical record.
• Inflammation of the lymph node – develops when mycobacteria spread from the skin to the lymph nodes. Inflammation requires surgical treatment if the lymph node increases in size more than 1 cm in diameter.
• Keloid scar– skin reaction to the BCG vaccine. The scar appears as red and bulging skin around the injection site. In this case, BCG cannot be reintroduced at 7 years of age.
• Generalized BCG infection – is a serious complication that develops in the presence of severe immune disorders in a child. This complication occurs in 1 child per 1,000,000 vaccinated people.
• Osteitis– bone tuberculosis, which develops 0.5 – 2 years after immunization, and reflects serious disorders in the child’s immune system. The complication occurs in 1 child per 200,000 vaccinated people.

BCG vaccination: reactions and complications - video

Contraindications to BCG vaccination

Today, the list of contraindications to BCG vaccination in Russia is much wider than that recommended by the World Health Organization, and includes the following conditions:
1. The weight of the newborn is less than 2500 g.
2. Acute pathology or exacerbation of chronic diseases (for example, in the presence of intrauterine infection, hemolytic disease of the newborn, neurological disorders, systemic skin pathologies). In the presence of these conditions, BCG vaccination is postponed until the child’s condition normalizes.
3. Immunodeficiency.
4. Generalized BCG infection, which was present in other close relatives.
5. Presence of HIV in the mother.
6. The presence of neoplasms of any localization.
7. Positive or questionable Mantoux test.
8. The presence of a keloid scar or lymphadenitis in response to previous administration of the BCG vaccine.

BCG-m vaccine

This vaccine differs from regular BCG only in that it contains a half dose of mycobacteria. BCG-m is used to vaccinate premature babies or those who are vaccinated not in the maternity hospital, but a little later. Before use, you should consult a specialist.

BCG is a vaccination against tuberculosis, a dangerous infectious disease, even today leading to death without correct treatment. Today, vaccination is the only effective method of preventing tuberculosis. The vaccine is administered intradermally into the baby's left shoulder on days 3-7 of life while still in the maternity hospital. If for some reason the vaccine was not given, the procedure is carried out later, in the vaccination office at the child’s place of residence after consulting a doctor. After injection of the drug, a papule forms at the injection site, which then scars. The mark from the vaccination is a scar, otherwise called a post-vaccination sign. Scarring is considered a normal reaction of the body to BCG. In some cases, no trace of the BCG vaccination remains. Or there was a post-vaccination sign, but it resolved very quickly and disappeared.

In 10 percent of cases, adults have no trace after BCG vaccination. You need to know how to distinguish a normal variant from an ineffective vaccination.

BCG vaccination is carried out only after a thorough examination and examination of the newborn child. If there are no contraindications to immunization, the baby is healthy and his weight is not less than 2500 g, the vaccination is given in the maternity hospital on the third day after birth. Immediately at the injection site, a papule swells - a small pad no more than 1 cm in diameter. After half an hour, the papule resolves on its own. This is a natural reaction to the injected tuberculin. She speaks of a correctly administered vaccination, and also that the formation of immunity has begun.

What indicates the emergence of immunity to tuberculosis?

Over time, at the injection site, the injection mark turns into an abscess. This happens a month and a half after the BCG was done. Some parents are very embarrassed and frightened when the papule takes on a bluish, purple, or burgundy hue. Such changes are completely natural and confirm that the process of developing immunity is proceeding normally.

Immunity to tuberculosis will be fully formed within 4-4.5 months from the date of vaccination. During this period, the papule may fill with purulent contents, break through, and become covered with a crust. That's how it should be. In order for the pustule to heal correctly, without complications, caring for the pustule during the process of healing and the formation of immunity is also important. The following rules must be followed:

• do not open the pustule or squeeze out the pus;
• do not smear the pustule with alcohol solutions, brilliant green, iodine;
• do not sprinkle with talc, zinc and other antiseptic powders;
• do not cover the vaccination site with a band-aid;
• It is forbidden to peel off the crusts.

Gradually the pustule heals and leaves the same BCG scar. The BCG trace in newborns and its condition is an indicator of how the body develops anti-tuberculosis immunity. A child's BCG scar is used to evaluate how well and effectively the vaccination against tuberculosis was carried out. Therefore, if there are no traces left after vaccination, this is always a reason to consult a doctor and find out the reason why there is no trace of BCG.

Normal post-vaccination sign

So, a positive reaction to an anti-tuberculosis vaccination can manifest itself as the formation of a purulent pustule, a change in the color of the skin, or a slight increase in body temperature during the formation of the abscess. A doctor's help is not required for such symptoms. You should contact a specialist only when symptoms appear that indicate the presence of infection and complications - if the skin all over the shoulder turns red and swells, the baby is very restless, a rash appears, and a high body temperature. In other cases, the child is shown to the pediatrician when the abscess is completely healed.

The level of acquired immunity to tuberculosis and the duration of its action are assessed as follows:

1. Low – the size of the scar is less than 4 mm. This immunity will last for about 3 years.
2. Medium - the size of the scar varies from 4 to 8 mm, it is believed that immunity will last up to 6-7 years. At this age, BCG revaccination is carried out.
3. High - if the size of the scar exceeds 8 mm, it is believed that such immunity will last for 7 years or more. In this case, revaccination is still carried out first at the age of 7, and then the last time at the age of 14.

Sometimes the baby does not have a scar at all after vaccination, or it resolves very quickly.

Why is there sometimes no trace after a BCG vaccination?

The absence of a trace after BCG can occur in two cases:

1. The child has strong congenital resistance to tuberculosis - this phenomenon is observed in approximately 2% of the population. In this case, natural immunity kills the rod even before it has time to penetrate the cells and give an inflammatory reaction.
2. The vaccination was not carried out correctly and did not give the expected results: the child did not develop immunity against tuberculosis. The reason is most often a vaccine of poor quality, expired or improperly stored. Or in the inexperience of the medical worker who performed the procedure: the vaccine must get strictly intradermally, and not under the skin.

The latter situation is especially dangerous. After all, this means that the baby is at increased risk. And in case of tuberculosis, he will endure the disease with difficulty, with unpredictable consequences and complications. In this case, repeated administration of the vaccine is necessary.

What does it mean if there was no trace after BCG at all?

If there is no trace of BCG, and there was not, then this most likely indicates that the vaccination was carried out incorrectly. In this case, doctors recommend revaccination earlier than the dates specified in the national vaccination calendar. That is, not at 7 years old, but two years after the first unsuccessful immunization. During this period of time, the child is constantly given a Mantoux or Diaskintest test in order to identify the infection as early as possible in the event of tuberculosis infection.

If the Mantoux test is always negative, after 2 years the vaccination is repeated no later than 2 weeks after the last tuberculin test. If the BCG revaccination did not give any reaction, this means that your child has a rare case of innate immunity against tuberculosis. If the reaction is positive or questionable, BCG vaccination is strictly prohibited.

Why was there a trace, but disappeared?

In children, the scar resolves and disappears, usually due to the expiration of immunity. This happens if the parents did not show the baby to the doctor in a timely manner after vaccination, if the vaccination was carried out incorrectly or if a low-quality drug was used. The scar resolves as the child grows older and the instilled immunity decreases. If the scar resolves on its own ahead of schedule, this means that revaccination is required. But, again, Mantoux’s reaction should be negative.

When to see a doctor

So, you should definitely consult a doctor in the following cases:

• no papule formed immediately after vaccination;
• after a month and a half there are no pustules or changes in skin color;
• a pustule has formed, but the skin around it has become inflamed and red;
• the child has a high fever, rash, general deterioration of condition;
• the pustule healed, but there was no scar left behind, or there was one, but it quickly resolved.

It is imperative to consult a phthisiatrician if the Mantoux reaction before re-vaccination was positive or false positive.

If a child does not have a reaction to BCG, this is not a reason to panic and get everyone on their feet. Your baby is not infected, but for some reason the vaccine did not work in his body. For what reasons only a doctor can find out. After the examination and additional tests, he will tell you what to do.

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Tuberculosis is a common disease with a high mortality rate. Thus, a dangerous disease is diagnosed in almost 9 million people. Moreover, up to 4 million people die annually from an infection caused by Koch's bacillus. To prevent the development of the disease, BCG is given to each person 3-5 days after birth and at 7 years of age. An indicator that the vaccine was administered correctly is a trace of BCG.

But some children don't have a scar after the vaccine. To understand whether this is considered normal, you need to learn more about BCG and read reviews from doctors.

What is BCG

is an anti-tuberculosis vaccine made from a live but weakened Mycobacterium bovis bacterium grown under artificial conditions.

BCG is used to prevent the development of tuberculosis in children 3-5 days after birth. Revaccination is carried out at the age of seven.

Contraindications to vaccination:

• Purulent-septic processes
• Prematurity (up to 2500 g)
• Primary immunodeficiency
• Allergy
• Exacerbations of any disease
• Generalized skin diseases
• Radiotherapy
• Intrauterine infection
• NS defeats
• Tuberculosis
• Use of immunosuppressants, etc.

Vaccination can contribute to the appearance of a false positive reaction to the Pirquet test. If the reaction is strong, then tuberculosis is likely, but only in the absence of allergies.

Possible side effects of BCG include lymphadenitis, cold abscesses, and keloid scars. Allergic skin reactions may also develop after vaccination.

Is it normal if there is no BCG scar?

To distinguish a child’s normal reaction to a vaccine, you should know how the process of the response occurs. The scar after BCG appears gradually. So, after 30-45 days, an abscess appears in the injection area, which becomes crusty and heals in about 120-140 days.

Initially, the area where the vaccine was given turns purple or black, which indicates the child's normal reaction to the vaccine. The fact that the vaccine was administered correctly and an immune response has been formed is indicated by a characteristic scar, the length of which is 2-10 mm.

The size of the scar indicates the duration of the immune reaction:

1. 2-4 mm – protection lasts 3-4 years
2. 5-8 mm – immunity lasts from 4 to 7 years
3. From 8 mm – the reaction lasts for more than 7 years.

A trace from the BCG vaccination does not form in approximately 10% of children. If the vaccine was administered correctly, this can be considered normal, indicating that the child has innate immune protection against tuberculosis infection.

However, this phenomenon occurs only in 2% of children. The presence of immunity is confirmed if the child, after the Mantoux test, only has an injection mark on his arm.

In addition, occasionally scars appear under the skin, which makes them visually invisible. The presence of a scar is indicated by redness in the area where the vaccine was given.

If there was a trace, but disappeared, then BCG has stopped working. Therefore, Mantoux in this situation will be negative or doubtful.

What to do if there is no trace of BCG? Why not?

The leading factors due to which there is no trace of BCG in a child are the use of an expired or spoiled vaccine, the presence of innate immune anti-tuberculosis protection.

Also, if there is no BCG scar, this may indicate an incorrect vaccination technology. In the absence of a reaction caused by the use of a substandard drug, or in the event of incorrect administration of the drug, the child is in the risk category. This increases the likelihood of infection and subsequent death.

When all children have been vaccinated, but the child does not have a BCG scar, it is necessary to consult a physiatrist or pediatrician. If there is no scar, doctors recommend vaccination again after 2 years.

If there is no scar after BCG, then before revaccination you need to do a Mantoux test; its reaction should be negative. If the result is positive or doubtful, then the tuberculosis vaccine cannot be administered.

If the vaccine was given and there is no trace after the BCG vaccination, then parents are obliged to limit the child’s contact with the category of people who may be infected with tuberculosis. It is also necessary to regularly strengthen children's immunity through hardening, a balanced diet, exercise and timely treatment of any diseases.

BCG is the very first vaccination in a person’s life. It is given to a newborn right in the maternity hospital on the third to fifth day after birth. Today, according to current legislation, the mother is asked for written permission for vaccination. They bring the paper for signature, and more than half of the women have no idea what they are signing or what they are refusing. The famous pediatrician and authoritative favorite of millions of modern mothers, Evgeniy Komarovsky, often talks about the BCG vaccination in his articles and television programs.

What is it

BCG is a vaccine against tuberculosis, a disease that kills about 3 million people worldwide every year. Vaccination is mandatory in 19 countries. The vaccine contains a weakened bovine tuberculosis bacillus. The drug exists in two versions: BCG - for ordinary children and BCG-M - for babies born prematurely.

The first administration of the BCG vaccine is carried out in the maternity hospital (if the mother agrees, if the child has no contraindications), revaccination - at 7 years, 12 years, 16 years.

The first vaccination is done without a preliminary Mantoux test; for revaccination, a preliminary “button” is required. The fact is that it makes sense to get vaccinated only if infection has not yet occurred. If the child’s body has already encountered Koch’s bacillus, then there is no need to vaccinate. The Mantoux test just shows the advisability of revaccination.

The vaccine is administered subcutaneously into the shoulder. The injection site sometimes festers, although this is an individual reaction, but everyone, with a few exceptions, remains with a characteristic scar, confirming the fact of vaccination.

If there is no scar or it is too small, experts say that the child’s immunity to tuberculosis has not developed or is weak.

Komarovsky about BCG

When asked by mothers whether BCG should be done, Evgeniy Komarovsky answers unequivocally - it is necessary. After all, it will be much better for a child’s body if it encounters a small number of weakened pathogens of a serious illness than if the child receives an infectious dose of strong and aggressive microbes. But the reality in Russia is that getting sick is as easy as shelling pears - people with infectious tuberculosis move freely, travel in public transport, go to stores, sneeze and cough on the street. There is no shortage of aggressive sticks.

The video where Dr. Komarovsky will tell you everything about the BCG vaccination can be seen below.

This first vaccination is not done at the whim of Ministry of Health officials, but for a completely objective reason - the causative agent of tuberculosis is very likely to be the first pathogenic microbe that a newborn will encounter almost immediately after being discharged from the hospital.

Komarovsky especially emphasizes that the Mantoux test, which many mothers mistakenly also call vaccination, is a very informative way to find out whether a child is infected. The test must be done annually. If it suddenly turns out to be positive, this does not mean that the child will have a comfortable government bed in a tuberculosis dispensary. If an active live bacillus enters a child’s body, then usually the immune defense and the efforts of antibodies are sufficient to prevent tuberculosis from developing. In the absence of proper attention from doctors and parents, without special treatment, a serious illness develops in only 10-15% of children.

In general, the BCG vaccine protects quite effectively against fatal forms of tuberculosis, but, Evgeniy Komarovsky emphasizes, even a timely vaccination and subsequent timely revaccination do not provide an absolute guarantee that a child will not get tuberculosis, although they significantly reduce this risk.

Dr. Komarovsky will tell you why children need the Mantoux test in the next video.

To minimize the risk of infection with the tuberculosis bacillus, the doctor advises strengthening the child’s immunity from the very moment he is born. It is mandatory to get the BCG vaccine, but do not shift all responsibility only to doctors. Parents themselves must try. First of all, Komarovsky says, they must understand that the fight against vaccinations is a fight against future generations of the Earth’s inhabitants.

At the everyday level, mothers need to ventilate the premises more often, walk more and longer with the child, and provide the baby with adequate nutrition.

Preparation for BCG vaccination has no special features. Evgeniy Olegovich reminds that the child should go to the clinic on an empty stomach, with bowels emptied several hours before the visit. Two days before vaccination, mothers should not introduce new foods to the toddler’s diet; everything should be familiar to him. The less stress on the baby’s digestive system, the easier it will tolerate the vaccination, the doctor reminds.

Before administering the vaccine, the pediatrician is required to examine the child to identify contraindications. If you have viral infections, immunodeficiency, an allergic reaction to anything, elevated body temperature, or any disease in the acute stage, you cannot vaccinate a child. In this situation, vaccination is postponed to a later date until the little patient has fully recovered.

Some vaccinations cause complications, Dr. Komarovsky will talk about this in the next video.

After the BCG vaccination, Komarovsky advises giving the child more to drink, providing fresh air, and if the temperature rises, giving an antipyretic, preferably Paracetamol. In all other unclear situations, it is better to call a doctor. When asked by parents whether it is possible to bathe a child after BCG, Komarovsky answers in the affirmative. You can, but be careful; it is better not to rub the injection site with a washcloth or steam it. And if the injection mark festers, there is no need to treat it with antiseptics, because this is a natural process.