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Tuberculosis is generally recognized throughout the world as a difficult to treat disease, which is quite widespread in modern conditions. The causative agent – Koch’s wand – is able to resist the drugs used, developing specific resistance.
Young children are vaccinated against tuberculosis in the very first days after birth, because, due to weak immunity, their body is most susceptible to the causative agent of this disease. When the microorganisms that cause tuberculosis enter the human body, they begin to intensively kill the defense system. In this case, the disease can proceed in a latent latent form and become more active only when the body is weakened by other infections.
When to get vaccinated against tuberculosis
On the third or fifth day of a newborn’s life, he is given a vaccine against tuberculosis. Such emergency vaccination is due to the fact that in many countries tuberculosis epidemics are permanent and about 30% of all people living on the planet are carriers of this infection.
About 3 million people die from tuberculosis every year in the world. In addition, when mycobacteria are transmitted by airborne droplets, there is a risk of infection even through indirect contact – this microorganism is stable in the external environment, that is, outside the human body. It is very problematic to cure tuberculosis, since the pathogen has already developed resistance to specific anti-tuberculosis drugs, and even if the disease recedes under the influence of treatment, the possibility of its relapse is not ruled out.
Immunization cannot provide complete safety in contact with infected people, but it reduces the severity of the disease and the likelihood of severe complications of tuberculosis.
Thus, vaccination for 3-5 days after the birth of a child is essential to protect him. If there are any medical contraindications at this stage, vaccination should be postponed until the patient has fully recovered.
The use of the first vaccine in the maternity hospital will help protect against tuberculosis for 6-7 years of life. Further, in order to avoid a weakening of immunity to the disease, revaccination is required at 7 and 14 years.
Vaccination at the age of seven is considered especially important – the age when the child goes to school, where the children’s team can act as a source of various infections. Since fluorography is not done for children, it becomes almost impossible to anticipate the onset of an epidemic of tuberculosis.
Revaccination at the age of seven will help protect the child’s body for up to 10 years.
However, the greatest surge of tuberculosis is noted by specialists at the age of 13-14 years, therefore it is at this stage that it is recommended to carry out the next revaccination, without waiting for the weakening of the previously created immunity.
3 days before vaccination, children are given Mantoux – a test for the presence of microorganisms in the body that lead to the development of tuberculosis. With a negative Mantoux indicator, vaccination can be performed.
Main indications and contraindications for vaccination
The main indications for vaccination against this disease, doctors include:
- being in the same territory with an identified carrier of the disease;
- moving to places of increased concentration of tuberculosis patients;
- work in medical institutions where patients suffering from tuberculosis are permanently located.
All people who may in one way or another come into contact with patients with tuberculosis are subject to monitoring, regular examination and, if necessary, additional vaccination.
After 14 years, the vaccine protects a person from tuberculosis microorganisms for a long time – up to 20 years.
However, from the age of 18, all people need to undergo fluorography annually in order to timely detect the onset of the disease. Sometimes vaccinations are also carried out after 30 years, at the request of the person himself to protect himself or if he has not previously been immunized.
As with any other disease, in the case of vaccination against tuberculosis, there may be absolute and temporary contraindications. Absolute contraindications to vaccination are the presence of neoplasms in the body and immunodeficiency. Relative or temporary contraindications for vaccination against tuberculosis in the maternity hospital include:
- low body weight of the baby (up to 2 kilograms), prematurity;
- identified intrauterine infections of the fetus;
- birth trauma affecting the nervous system of the baby;
- severe stages of skin diseases;
- all kinds of infectious processes;
- all kinds of purulent-septic diseases;
- hemolytic disease.
Also, in the future, it is impossible to revaccinate against tuberculosis if very severe reactions were previously observed to the introduction of such vaccines. Only after the complete cure of all the above conditions, doctors consider the possibility of immunization for such a child.
Vaccination
On the eve of vaccination against tuberculosis in the maternity hospital, the newborn is examined by a doctor. If the examination is positive, a specially trained nurse injects the vaccine intradermally into the upper arm. Before giving an injection, the injection site is treated with disinfectants, but after vaccination, the injection site cannot be touched – it is not treated in any way and tourniquets are not applied so that the injected drug can be fully absorbed by the body.
It should be remembered that the vaccine is administered to a person immediately after opening the ampoule, which should be monitored by parents of newborns. It is also important to remember that in the maternity hospital or 2 months after birth, vaccination against tuberculosis is carried out without a preliminary Mantoux test. In all other cases, the test is desirable.
It must be understood that vaccination against tuberculosis can have many consequences in the form of various reactions and side effects. All complications occur in the body not after the introduction of the vaccine, but a few weeks after that. However, after vaccination, a full-fledged disease does not develop.
Neonates may develop an infiltrate of 5 to 10 millimeters as a reaction to TB vaccination 4 or 6 weeks after immunization. This is a kind of nodule with liquid inside at the injection site. It resolves on its own a couple of days after the onset, does not require any medical intervention, and often leaves a scar on the arm.
Of the most common complications of tuberculosis immunization, experts note the occurrence of lymphadenitis. At the same time, the lymph nodes closest to the injection site increase in the child – in the armpits, in the collarbone area. Sometimes such a complication goes away by itself, sometimes it needs to be observed and opened in the future. This circumstance must be controlled by a doctor.
It is not uncommon for children to develop a cold abscess if the injection is incorrectly administered during immunization.
It can form even 8 months after immunization. As a rule, the abscess passes on its own, and in its place a fistula first appears, and then a scar. Ulcers can also develop on the surface of the skin. So that they do not bring complications and heal normally, ulcers must be treated with anti-tuberculosis medications in the form of tablets and ointments.
Often, after vaccination against tuberculosis, a keloid scar can occur at the injection site. With its relatively small size (up to 1 cm in diameter), the scar does not require treatment. With increasing sizes, the use of hormonal ointments is required. Such scars cannot be removed surgically, since they always return to their place, but already in an enlarged size.
To avoid possible complications of vaccination in the maternity hospital, it is worth limiting the contact of the newborn and mother with strangers. The ward must be ventilated frequently so that the pathogens of any infections do not stagnate in the air of the room. And after discharge from the maternity hospital with a newborn, you need to walk in the fresh air in places where there are no large crowds of people.
If an infiltrate occurs after vaccination, and in the future – a scar – do not panic. These are natural reactions to the introduced vaccine and they must be present in the post-vaccination period. The rest of the side effects cannot be avoided if the child’s immune system aggressively accepted the drug.
Existing vaccines
The tuberculosis vaccine is called BCG (short for Bacillus Calmette-Guerin). In world practice, a vaccine based on live bovine bacteria of this disease is used, which are not dangerous to humans. The ampoule contains 20 doses of dry matter for dissolution and injection. The agent is diluted immediately before vaccination of each patient. The vaccine is also stored in a special way separately from other drugs in a special refrigerator so that the bacteria do not die and can develop immunity in the patient.
There is another drug for immunization against tuberculosis – the BCG-M vaccine. It is a weakened version of the first vaccine and is used for immunization of preterm infants, as well as in other cases when immunization with a standard vaccination is contraindicated for a patient.
Vaccination against tuberculosis will not always help to avoid the disease, but it will protect a person from severe complications and a long course of the underlying disease. The most severe forms of tuberculosis are difficult to treat, so it is important to vaccinate in a timely manner and try to follow all the instructions of specialists to prevent contact with infected people.