About vaccinations for newborns in the maternity hospital in questions and answers

Why is BCG vaccination necessary?

Back in the middle of the last century, treatment for tuberculosis was developed.
The problem is that the causative agent of the infection, Mycobacterium tuberculosis, has a special, complex structure. This makes it very resistant to environmental influences and practically insensitive to disinfection. And the pathogen quickly develops resistance to specific antibiotics created for treatment. Today, the proportion of resistant (treatment-resistant) tuberculosis reaches 50%. Tuberculosis does not develop immediately after infection. The disease can occur years later and be long-lasting and asymptomatic. In this case, an infected person releases the microbe into the environment, infecting others. Hence the importance of timely diagnosis of infection (Mantoux test, fluorography, diaskintect). All of the above leads scientists to the conclusion that the BCG vaccine is still relevant.

What is included in the BCG vaccine?

The vaccine contains mycobacterium bovis (bovine) and a solvent – ​​monosodium glutamate. Bovis was chosen because it is similar in structure to Mycobacterium tuberculosis, but is safer. This microbe is grown on a special nutrient medium and is attenuated (weakened) through repeated division outside the body. This causes the bacterium to lose its ability to cause disease. The strain of bacteria included in the vaccine does not multiply uncontrollably. Its properties (the ability to provoke disease and the ability to create immunity) are constantly monitored during production. The strain used for the vaccine in Russia is considered one of the safest in the world. Somewhat later, the BCG-M vaccine, containing a smaller number of mycobacterial strains, was developed to vaccinate weakened children.

Vaccine

The most common vaccine

Vaccination against HBV is included in the National Vaccination Calendar. Immunization is provided free of charge to all children in the maternity hospital after the written consent of the mother. Currently, there are only preventative vaccines; if infection has already occurred, they will not help cure.

The first drugs for the prevention of hepatitis were invented and began to be introduced in the 80s of the 20th century. The drugs are made based on the envelope protein of the virus (surface antigen). The following types of vaccines are currently used in Russia:

1. Recombinant yeast vaccine against hepatitis B. Manufactured in Tomsk.
2. Vaccine H-B-VAX II made in the USA.
3. Engerix-V.
4. Eberbiovak.

Russian-made drugs are used for immunization free of charge. If desired, the patient can purchase an imported vaccine at his own expense and get vaccinated at a local clinic or paid medical center.

What happens after the BCG vaccination?

After administration of the BCG vaccine, a number of changes occur at the injection site. About a month after vaccination, redness and thickening appear at the injection site. Then an abscess. It becomes covered with a crust, which then falls off, leaving behind a scar. This happens around six months. Sometimes the inflammation is so active that pus can be released from the wound. All these changes are normal and indicate that the baby is developing immunity. There is no need to do any manipulation with the wound during inflammation. It will live on its own when the time comes.

What complications can occur after BCG vaccination?

The most common are cold abscess, lymphadenitis, and BCG osteitis. Such complications occur when the vaccine administration technique is violated - the vaccine is administered subcutaneously rather than intradermally. The most dangerous and rarest of the complications (4 cases per 100,000 vaccinated children) is BCG osteitis. It requires long and complex treatment.

General complications are not typical for the BCG vaccine. Their occurrence indicates that the child has an immunodeficiency.

As with other vaccinations, acute allergic reactions and/or local allergic manifestations are possible after BCG.

Information leaflet on vaccinations for newborns at the State Budgetary Institution of Higher Education "OPTs"

Dear moms!

We present to your attention an information leaflet on vaccinations for newborns.

at the State Budgetary Institution of Higher Education "Regional Perinatal Center".

In our institution, children are vaccinated only after the “Informed Voluntary Consent to Vaccinations” has been completed by the child’s legal representative. Most often it is the mother.

Vaccinations for children: why are they needed?

Babies receive two vaccines. On the first day after birth, children are vaccinated against viral hepatitis B. Our OPC uses a domestically produced vaccine. Vaccine against viral hepatitis B "Combiotech". The vaccine is administered intramuscularly, 0.5 ml, into the anterior outer part of the thigh.

Babies are given anti-tuberculosis BCG on days 3-5. The vaccine is used to produce immune bodies against tuberculosis BCG “M” GENTLE. BCG - intradermally to a place on the border of the upper and middle third of the left shoulder.

Why is hepatitis B vaccinated?

Hepatitis B is viral in nature. The “object of interest” of the pathogen is the liver, which performs a huge number of functions in the body. The disease often has a long, asymptomatic course. Hepatitis B is especially dangerous due to its consequences. It often develops into irreversible, life-threatening conditions such as cirrhosis or liver cancer. And children of the first year of life are one of the most vulnerable categories.

30% of virus carriers do not know about their illness. A mother can transmit hepatitis B to her child, even if she was tested during pregnancy; a false negative result from this test cannot be completely ruled out. Therefore, it is very important to give your baby the hepatitis B vaccine within the first 24 hours after birth.

What is the future schedule for hepatitis B vaccination?

Usually it is carried out according to the scheme 0-1 month - 6 months, but other vaccination schemes are possible depending on the drug.

How long does the vaccine protect against hepatitis B?

Previously, it was believed that protection lasted no longer than 5-7 years, but later it turned out that even 25 years after completion of vaccination, protection still persists. Thus, vaccination in infancy also protects against infection as a result of risky sexual behavior in adolescents and young adults.

What are the contraindications for hepatitis B vaccination?

Hepatitis B vaccinations are contraindicated in newborns in the following cases:

• The child's mother has a severe allergy to bread yeast.
• The child is premature or weighs less than 2 kg.
• The child has severe primary immunodeficiency.

What complications can occur after hepatitis B vaccination?

• The temperature of a baby after vaccination against hepatitis B most often does not exceed 37.5 degrees. The rise is recorded 6–7 hours after vaccination, which is a normal immune response to foreign bodies.
• The average degree of post-vaccination reaction is characterized by a rise in temperature to 38.5 degrees and requires the use of antipyretics.
• In severe cases, the temperature rises above 38.5 degrees.
• The injection site swells, turns red, hardens, and pain appears when lightly pressed; The reaction is considered normal if swelling and induration do not exceed 6–7 cm, and redness does not exceed 8 cm. It is not recommended to apply compresses or use ointments. It goes away on its own.
• Severe allergic reactions such as hives, severe rash all over the body;

Why is BCG vaccination performed?

WHO recommends mass vaccination of newborns against tuberculosis in all countries where the disease is common. Russia is one of these countries, therefore, 3-5 days after birth, while still in the maternity hospital, all newborns are vaccinated with BCG-M.

What does the BCG-M vaccine protect against?

BCG-M quite reliably protects the child from the development of tuberculous meningitis and generalized forms of tuberculosis.

BCG-M “gentle” - what kind of vaccine is it?

BCG-M is “gentle” - a live vaccine, that is, it is prepared from a strain of weakened tuberculosis bacillus. This is one of the oldest vaccines, but there are no analogues to it in the whole world yet.

What complications are possible with BCG-M vaccination?

• Cold abscess - as a rule, when the insertion technique is violated.
• Lymphadenitis (frequency 0.35 cases per 1 million vaccinations).
• Generalized BCG infection (BCGit) - usually in children with congenital immunodeficiencies.

Why does BCG-M need to be vaccinated in the institution where the birth took place?

• Firstly, to protect the child from the very first days of life.
• Secondly, the effectiveness of BCG-M decreases over time; it must be administered up to a year.
• Thirdly, the younger the child, the lower the likelihood of complications - inflammation of the lymph nodes or cold abscess.

Are there any contraindications to BCG-M vaccination?

Yes. This:

• Prematurity of the newborn
• intrauterine malnutrition of III-IV degree. If the weight is less than 2000 grams, the newborn should not be vaccinated until he reaches the desired weight.
• Acute course of the disease. In this case, vaccination is postponed until recovery or stabilization of the condition.
• If the mother is HIV-infected, vaccination of the child is delayed until 18 months (until the child’s status is finally clarified).
• Primary immunodeficiency
• malignant neoplasms in a child.

What reactions of the body of newborns are acceptable to vaccinations against hepatitis B and BCG?

• Babies tolerate both vaccines well.
• After administration of the Combiotech vaccine, a short-term local reaction is possible in the form of redness of the injection site and slight thickening.
• Reaction to the BCG vaccine M.
• Soon a lump will form at the injection site. This can happen within a few days, and sometimes much later, after a month or a month and a half. The size of such a compaction is up to 1 cm. Subsequently, it undergoes changes, transforming into a bubble with transparent and then cloudy contents. Next, a scar is formed from 3 mm to 1 cm. This scar indicates the presence of specific anti-tuberculosis protection. If it has not formed or, conversely, the infiltrate is larger than 1 cm, consultation with a specialist is necessary.

Information leaflet on vaccinations for newborns at the State Budgetary Institution of Higher Education "OPTs"

When should you not be vaccinated against tuberculosis?

1. If the child was born premature (with a body weight less than 2500 g), vaccination is postponed.
2. In case of immunodeficiency in a child.
3. if the child is HIV-infected or was born from a mother with HIV.
4. In the presence of tumor lesions.
5. If the child has an acute infection or an exacerbation of a chronic one (then the medical diversion is temporary).
6. Why is the vaccine given so early?

The fact is that the vaccine does not protect against infection with the tuberculosis bacillus. It only helps prevent the disease and its severe forms from developing. This means that many people are carriers of the infection. If we add here the high resistance of the microbe to physical and chemical factors, it turns out that the risk of infection of an infant is not so low. Newborn children are many times more likely to suffer from generalized forms of tuberculosis, which are much more difficult to treat and lead to serious consequences.

Vaccination schedule up to 1 year

Before vaccination, the baby must be examined by a pediatrician - the condition of the mucous membranes of the oropharynx, body temperature, cleanliness of the skin, and the presence or absence of obvious signs of illness are assessed.

The generally accepted calendar determines what vaccinations a child is given per month and at what period of life revaccination is needed.

An individual vaccination calendar differs from the usual one in that the child receives vaccines not at the prescribed time, but in accordance with the characteristics of the health condition. According to such a calendar, for example, they determine which vaccination is given to a child at 2 months, and which one is better “postponed” to the age of about 1 year. Its advantages are that the doctor finds the optimal time when the child is the healthiest and will best tolerate the next vaccination. But there are also disadvantages - the “window” between revaccinations increases, which significantly reduces the level of protection against diseases.

Hepatitis B vaccine

Hepatitis B is a viral infection that is characterized by damage to liver cells followed by death. As well as a long course with frequent chronicity and resistance to treatment.

Hepatitis vaccination was introduced into the calendar relatively recently, approximately in the 80s of the last century. This late introduction of the vaccine into the national calendar is due to the peculiar structure of the virus and the frequent absence of a characteristic clinical picture in patients.

Why is it necessary to get vaccinated against hepatitis B?

Most adults recover on their own after contracting hepatitis. For some, the virus remains in the body and does not manifest itself in any way. Such asymptomatic carriage does not require treatment. Although the person remains infectious.

However, approximately 20% of infected adults and 80% of children develop the disease, causing inflammation and death of liver cells. After an acute process, fibrosis forms at the site of hepatocyte death. Cirrhosis of the liver may then develop with the possibility of tumor formation. The existing treatment takes a long time. The drugs have a pronounced toxic effect and are unable to completely remove the virus from the body, only to convert the disease into an inactive form.

When is the hepatitis B vaccine given?

According to the national calendar, the vaccine is given in the first 12 hours of life, then at 1 month and at 6 months. Children from risk groups are vaccinated four times. In the maternity hospital, then at 1,2 and 12 months. Children at risk include:

- born from mothers who are carriers of HBsAg (one of the components of the hepatitis B virus),

- from mothers of patients with viral hepatitis B,

- from mothers who do not have test results for hepatitis B markers,

- from mothers who use narcotic drugs or psychotropic substances,

- from families in which there is a carrier of HBsAg, or a patient with acute viral hepatitis B, as well as chronic viral hepatitis.

Previously unvaccinated children and adults not belonging to risk groups are vaccinated according to the same schedule - 0-1-6 months.

What is included in the hepatitis B vaccine?

The vaccine is a subunit vaccine. The main component is part of the virus shell. In addition, the vaccine contains an adjuvant (a substance that improves the production of immunity) - aluminum hydroxide, and a preservative thiomersal.

What happens after hepatitis B vaccination?

After completing the vaccination course (at 6 months for children not at risk), stable lifelong immunity is developed. The vaccine is almost 100% effective.

What complications can occur after hepatitis B vaccination?

This vaccine is one of the least reactogenic. Local reactions may be observed: redness, hardening at the injection site, swelling. General reactions: weakness, muscle pain, increased body temperature, high-pitched crying. All reactions resolve on their own and do not require treatment.

When should you not get vaccinated against hepatitis B?

1. If a severe reaction has developed to the previous injection - an increase in body temperature above 40*C, swelling and redness at the injection site more than 8 cm in diameter.
2. In children with severe immunodeficiencies due to HIV infection.
3. In children with acute diseases, as well as in cases of exacerbation of chronic diseases, temporary medical diversion is indicated.
4. In women during pregnancy and breastfeeding.

What else awaits the baby?

The first two vaccinations are just the beginning of following the National Preventive Vaccination Calendar. Here are some other vaccines your baby will be given before her first birthday:

• second vaccination against hepatitis B at 1 month;
• vaccination against polio and DTP (whooping cough, diphtheria, tetanus) after the baby reaches three months;
• at four and five months - the second vaccination against polio and DPT;
• third vaccination against polio, hepatitis B and DPT – every six months;
• at 12 months – first vaccination against measles, rubella and mumps + Mantoux test.

Vaccination after 1 year:

• re-vaccination against polio and DTP is carried out at one and a half years;
• at 1 year and 8 months - second revaccination against polio;
• at six years of age - repeated vaccination against measles, rubella and mumps;
• at seven years old - vaccination against diphtheria and tetanus + vaccination against tuberculosis;
• at 13 years old - vaccination against hepatitis B and rubella;
• at 14 years old - revaccination against diphtheria, tetanus and polio, revaccination against tuberculosis.

After each vaccination, experts strongly recommend providing the child with physical and emotional rest and, if possible, reducing the time spent walking in the fresh air and swimming.