Today, many parents write refusals of vaccinations for their children. Everyone has their own explanation for this. Whether this is right or wrong is difficult to answer unequivocally. Tuberculosis is a very dangerous disease that, if left untreated, can cause many health complications.
In our country, the fight against it is approached at the state level. According to the order of the Ministry of Health No. 109 of 2003, every child over the age of 1 year is required to undergo a Mantoux test. It is completely safe for children and has no contraindications or side effects. However, its importance cannot be underestimated, since this test makes it possible to detect tuberculosis at the earliest stages.
But there are a number of other dangerous pathologies that require prevention, some of which can even lead to death. Therefore, many parents have a question about what vaccinations after Mantoux should be done and after what period of time. Let's look at this issue in more detail, let's understand the main aspects related to vaccination of children.
What is tuberculosis?
Before we find out how long after Mantoux a child is vaccinated to immunize a child and what vaccines are used, let’s first understand the basic concepts.
Many people do not know what tuberculosis is and why it is dangerous. This is a very serious disease of infectious etiology, which is not always treatable. Its main insidiousness is that in the early stages of development it is asymptomatic, so it is not always possible to diagnose and begin treatment in time. In its advanced form, consumption, as tuberculosis is also called, causes complications, and in acute cases there is a high probability of death.
Possible consequences
If left untreated for a long time, tuberculosis can lead to the development of many serious complications. Among the most common are the following:
- destruction of the blood vessels of the lungs, accompanied by internal bleeding;
- atelectasis;
- inflammatory lesion of the pleura;
- spontaneous pneumothorax;
- fistula;
- amyloid dystrophy;
- decompensated myocardial dysfunction;
- renal failure.
All of these complications are very dangerous; they pose a great threat to the health and life of the baby. Therefore, it is very important to diagnose tuberculosis as early as possible and begin treatment. But there are a number of other serious diseases that need prevention. To develop immunity to them, children are vaccinated after Mantoux. But there are a number of nuances that every parent should take into account. They will be discussed in detail later in this article.
Pirquet reaction
The Mantoux test (when you can get vaccinated after this test to immunize a child will be discussed in the following sections) is a test that allows you to detect antibodies to the causative agent of tuberculosis in the blood. Its essence lies in the fact that during the procedure, a drug containing Koch's bacillus is injected under the skin. Within 72 hours the body must respond to it. A papule forms on the child’s body, the size of which is of interest to doctors. If there are no problems, then it will not go beyond certain boundaries. The absence of any external manifestations indicates that the child is at increased risk of contracting tuberculosis. The final diagnosis is made based on the diameter of the “button”:
- negative - 0-1 mm;
- doubtful - 2-4 mm;
- positive - more than 5 mm.
The last immune response is also classified according to the following types of intensity depending on the diameter of the papule:
- weak - 5-9 mm;
- average - 10-14 mm;
- high - 15-17 mm.
If everything is in order, then there is no particular cause for concern. However, many parents continue to worry about the question of what vaccinations can be done after Mantoux. And this is not surprising, because any infectious diseases are very difficult for children to tolerate, and they can also cause serious complications.
Contraindications
Only a doctor can decide whether the drug “Tuberculin” is suitable for testing for tuberculosis.
“Tuberculin” is contraindicated for persons with allergic and autoimmune diseases!
The use of Tuberculin is also contraindicated in the following cases:
- common skin diseases
- epilepsy
- acute, chronic infectious and somatic diseases during exacerbation; allergic conditions (rheumatism in acute and subacute phases, bronchial asthma, idiosyncrasies with pronounced skin manifestations during exacerbation).
It is not allowed to carry out the Mantoux test in those children's groups where there is a quarantine for childhood infections. The Mantoux test is performed 1 month after all clinical symptoms disappear or immediately after quarantine is lifted.
Why is research needed?
The Pirquet test is an allergic diagnostic method that allows you to determine whether the body produces antibodies to tuberculosis. It is necessary to develop the ability of the immune system to independently fight the pathogen.
The main objective of the method is to identify children who are sick for the first time, those who have been sick for more than 12 months, as well as diagnosing tuberculosis in the early stages.
Doctors need this information to assess the patient’s condition and create the most effective treatment program.
Does the Pirquet reaction affect the child's immunity?
Any vaccination in the year after Mantoux must be taken very seriously, since although this test is safe for the health of children, it nevertheless has some consequences. It is important to take into account that the opinions of qualified specialists regarding the effect of this test on the state of immunity differ. Some believe that it does not create any burden on the body's protective functions, while others take the opposite point of view, arguing that the vaccine is toxic.
However, the safety of the Pirquet reaction has long been scientifically proven, so there is no particular cause for concern. It does not have any negative effects on the body and does not undermine health. Thus, you can safely do other mandatory vaccinations after Mantoux. You can find out which ones and when exactly further.
Time interval
When to vaccinate after Mantoux? This question haunts every young parent. There is a popular belief that after it, it takes at least one month for the immune system to fully restore. But this is a mistake. The Pirquet reaction is not a vaccination, since the drug is administered subcutaneously and not intravenously, so immunization can be carried out after three days, provided that the result is negative.
It is worth noting that tuberculosis diagnostics does not apply to reactogenic research methods that provoke an immunological reaction. Therefore, the question of how long after Mantoux is vaccinated disappears in itself. But if the result is positive, the doctor may prescribe an additional examination to confirm it and prevent the development of undesirable consequences.
Vaccine against tuberculosis
BCG is one of the most common vaccinations given to prevent the development of a dangerous disease. As a rule, it is prescribed to children already in the first days after birth. This vaccine protects babies from tuberculosis. It is valid for one year, after which a Pirquet test is prescribed, which checks whether the body produces antibodies to the pathogen or not.
If for some reason BZD was not done, then a Mantoux test is performed 3 days before the intended immunization. If the result is negative, then vaccination is prescribed. In addition, the child’s blood and urine are first taken for a general analysis.
Indications for the Mantoux test
The Mantoux test is performed to diagnose tuberculosis.
Children vaccinated against tuberculosis:
The Mantoux test (Intradermal allergy test with tuberculin) is performed once a year, regardless of the results of previous tests, from the age of 12 months.
For children not vaccinated against tuberculosis (children who have not been vaccinated with BCG), the Mantoux test is performed 2 times a year starting at the age of 6 months
Children not vaccinated against tuberculosis:
The Mantoux test is performed - 2 times a year, starting from the age of 6 months, the Mantoux test is performed.
DTP, KKP and others
What vaccination is given after Mantoux? The vaccination schedule is designed in such a way that after the test, immunization is carried out against such dangerous infectious diseases as diphtheria, tetanus and whooping cough. If the test shows that the body produces antibodies to Koch’s bacillus, and the diameter of the “tablet” does not exceed four millimeters, then vaccination is carried out.
In addition, at the age of 12 months, children are vaccinated against measles, mumps and rubella. In this case, both mono and combined drugs can be used. The latter are more preferable because they are highly effective and provide reliable protection, and their administration is carried out only once.
"MANTU" - test for diagnosing tuberculosis
The drug Tuberculin - Allergen-tuberculoprotein for performing the Mantoux test
Manufacturer: Pharmstandard-Biolek, Ukraine; Pharmstandard-UfaVita, Russia; Lecco, Russia.
Applicable to: children aged 12 months to 18 years
Advantages of the Tuberculin vaccine:
- A preparation purified from protein impurities of the nutrient medium
- Non-toxic
- Safe
- Economical and affordable
Other vaccines
The tuberculin test is not included in the vaccination calendar, so it does not have exact dates. It was described above what vaccinations children are given after Mantoux. However, to ensure that they do not in any way affect the accuracy of the test results, you must adhere to the following rules:
- any live immunobiological drugs are administered one and a half months before the prescribed Pirquet reaction;
- in no case should the test and vaccination be carried out on the same day;
- After the Mantoux test, vaccinations are allowed on the third day.
Despite the fact that tuberculosis diagnosis does not pose any threat to children, it is still better not to rush with vaccination. This is especially true for situations where the result is positive. In this case, the child will have to undergo additional testing to make an accurate diagnosis.
Indications for the use of Tuberculin for the Mantoux test
Tuberculin is used for tuberculin diagnostics (carrying out an intradermal Mantoux tuberculin test), which is an indicative diagnostic test for the purpose of:
identifying the need for a patient to be vaccinated against tuberculosis with BCG
peptic ulcer, blood disease, systemic diseases, children receiving hormonal therapy, HIV-infected, frequently ill, suffering from chronic kidney and respiratory diseases)
The active substance of the drug (allergen-tuberculoprotein) causes, when performing an intradermal tuberculin test in people infected or vaccinated with BCG/BCG-M, a specific delayed-type hypersensitivity reaction in the form of a local reaction - hyperemia (redness) and infiltrate (papule formation).
When can the Pirquet test be performed after immunization?
This article has already discussed which vaccination is given after Mantoux. As a rule, the test is done before vaccination, but in medical practice there are cases when this is not possible. Immunization of children involves the introduction of medications into the body that activate protective functions and stimulate the production of antibodies. This negatively affects the accuracy of the tuberculin test results. The “tablet” may be too large in diameter for no apparent reason. As a result, the baby will have to undergo additional tests. To prevent this, the test is delayed by one month, or by 6 weeks when using live vaccines. When the state of the immune system stabilizes, correct results can be obtained.
How long after DPT can you do Mantoux?
The complex DTP vaccine can undermine the child’s immune system. After the injection, some experience an increase in temperature up to 39 degrees. After vaccination, the body is weakened, as it loses the strength to fight the introduced microorganisms.
In this case, it is impossible to immediately carry out diagnostics to identify tuberculosis bacilli, since the result for the most part will be false.
The recommended period for performing Mantoux after DTP is after a month.
When is the Pirquet reaction performed after an illness?
The previous section described in detail how long after Mantoux vaccinations can be prescribed for children. They are done in accordance with a predetermined schedule. However, it may move if the child was ill shortly before the scheduled vaccination. This is due to the fact that any disease weakens the immune system, so doctors cannot predict how the Pirquet reaction will go. It is impossible to give exact dates, since everything here depends on the characteristics of the specific pathology:
- ARVI. It is easily tolerated by children, and complete recovery occurs after 14 days.
- Pneumonia is a very serious disease that affects everyone differently. The decision to discharge a patient is made by the attending physician based on his clinical picture. The Mantoux test can be performed no earlier than 30 days after recovery.
- Mononucleosis. This pathology is infectious in nature, but, unlike others, it affects the cells that ensure the normal functioning of the immune system. As a result, the protective functions are reduced, and the body's susceptibility to various diseases increases. With this diagnosis, vaccinations after Mantoux are prescribed one year after complete recovery.
- Chickenpox. It takes 20-25 days for a child’s body to recover from it. There is no point in testing the baby for the Pirquet reaction before, since the results will be unreliable.
If the test was carried out shortly before infection, then there is a high probability of developing side effects. According to qualified specialists, the most common are:
- increased body temperature;
- sleep disorder;
- decreased or complete lack of appetite;
- skin rash;
- itching;
- allergic reactions;
- nettle fever;
- anaphylactic shock.
Parents should be prepared for the problems listed above. If they occur, you must immediately go to the hospital to receive qualified medical care.
Possible side effects
- For most, the test process is asymptomatic.
- Headaches may rarely occur
- General weakness, sleep disturbances, and increased body temperature rarely develop.
- Individuals with altered reactivity experience allergic reactions.
- Considering the possibility of developing immediate allergic reactions (anaphylactic shock, Quincke's edema, urticaria) in particularly sensitive individuals, vaccinated persons must be provided with medical supervision for 30 minutes.
