"Protecting vaccines with vaccines" BCG

Author: Song Shunshan Zhongshan People's Hospital

Reviewer: Yang Xiufang, Chief Physician, Zhongshan People's Hospital

In the growth process of babies, vaccination is one of the important means to prevent diseases and protect health. Today, let’s talk about a vaccine that is very important for babies - BCG.

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1. Small vaccine, big effect

BCG is a vaccine included in the national standardized immunization program. It is a live attenuated vaccine that can effectively prevent miliary tuberculosis and tuberculous meningitis in children.

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2. Vaccination Method

BCG only requires one injection at birth, which is given intradermally into the deltoid muscle of the upper arm.

3. Delayed Vaccination

1. Babies with gestational age less than 31 weeks and low birth weight must wait for medical evaluation to confirm that their condition is stable before vaccination.

2. Vaccination should also be delayed for critically ill newborns whose condition is deemed unstable by medical assessment.

IV. Contraindications to vaccination

1. Infants with immunodeficiency diseases should not be vaccinated.

2. Neonates who are known to be allergic to the vaccine or any of its components should not be vaccinated.

5. Principles of replanting

1. Infants under 3 months of age (with no contraindications and no deferral conditions) can be vaccinated directly.

2. Children between 3 months and 3 years old need to undergo a tuberculin purified protein derivative or BCG protein derivative skin test, and only those with a negative result can be vaccinated.

3. Children aged 4 years and above will no longer receive booster shots.

4. Children who have been vaccinated with BCG do not need to be boostered with the vaccine, even if no scar has formed at the vaccination site.

VI. Adverse reactions and treatment

1. Fever reaction

If a mild fever (body temperature below 38°C) occurs after vaccination and the baby is in good condition, no special treatment is required and the baby will generally recover on its own within 1 to 2 days; if a moderate fever (body temperature above 38.5°C) occurs and lasts for more than 48 hours and the baby is in poor condition, seek medical attention promptly.

2. Allergic reaction

The most common: urticaria, which generally does not require special treatment. If the area is too large, the itching is severe, or there is a secondary infection, you should seek medical attention promptly.

The most serious: anaphylactic shock, manifested by cold and wet skin, pale complexion, slow reaction, and even cardiac and respiratory arrest. You should stay for observation for 30 minutes after vaccination as required.

3. Adverse reactions at the injection site

The intradermal papules disappeared about 30 minutes after inoculation.

In the later stage, redness, swelling, nodules, abscesses, ulcers, and scabs may appear.

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In the above cases, no special treatment or disinfection is required, just keep it clean. Do not squeeze out pus or remove scabs by yourself to prevent infection.

VII. Post-vaccination care

1. Clean the vaccination site: After returning home, keep the vaccination site clean and avoid using disinfectants or irritants.

2. Avoid friction: During the healing process of the vaccination site, avoid rubbing or pressing the area to prevent the baby from scratching and causing infection.

3. Wear loose clothing: To reduce friction and irritation, dress your baby in loose clothing and make sure the clothing does not stick to the vaccination site.

4. Avoid hydrotherapy: Before the vaccination site heals, avoid exposing the baby to hydrotherapy or soaking in water for a long time to prevent infection.

8. Conclusion

As a key vaccine for preventing tuberculosis, BCG is of great significance to the healthy growth of babies. As mothers, we should fully understand the relevant knowledge of BCG, actively vaccinate our babies, and protect their health. At the same time, we should pay close attention to the physical condition of the baby, promptly detect and properly handle abnormal reactions, and ensure that the baby grows up healthily and happily.

References:

[1] Chinese Medical Association Tuberculosis Branch. Guidelines for clinical management of adverse reactions to BCG. Chinese Journal of Anti-Tuberculosis, 2021, 43(6): 533-538.