BCG immunizations: schedule, benefits, and side effects

Immunization in children is very important so that IDAI determines the immunization schedule grouped according to age. The type of immunization that is given once in a lifetime is BCG. WHO also requires the provision of the BCG vaccine, especially in countries with high rates of tuberculosis (TB) sufferers, such as Indonesia. The following is an explanation of BCG immunization, starting from how it works, schedule, to side effects.

What is BCG immunization?

Quoting from the official website of the Indonesian Pediatrician Association (IDAI) immunization bacille Calmette-Guerin (BCG) is a vaccine that contains germs Mycobacterium bovis or M. bovis that's been weakened.

The BCG vaccine has been used in various countries to protect infants from severe tuberculosis (TB) and inflammation of the brain due to TB.

Until now, the benefits of BCG immunization have been felt, namely being an effective deterrent in dealing with the occurrence of tuberculosis (TB or TBC).

The BCG immunization is given just under the skin or intradermally and is usually injected into the upper left arm.

Quoting from the Vaccine Knowledge Project from the University of Oxford, the BCG vaccine provides protection against TB infection by 70-80 percent.

The BCG vaccine has become mandatory for children since 1953 in England. Initially this vaccine was offered to school-age children, 14 years, because TB is generally contagious at that age.

How does the BCG immunization work?

Before being given the BCG vaccine, your little one can be given a tuberculin skin test or a Mantoux test. This is to check whether your baby has had TB or not.

If there is a red, mosquito-like bite in the area that was injected, this is a positive result. This means that the baby's immune system recognizes tuberculosis (TB) because it has been exposed to it before being given the BCG vaccine.

Can you give BCG immunization if you are positive? Not. According to the University of Oxford's Vaccine Knowledge Project, babies who are already exposed to TB have immunity to the BCG vaccine and can cause bad side effects.

However, if the results of the Mantoux test do not show a lump reaction, the sign is that he is negative for TB and it is safe to get BCG immunization.

Based on the immunization schedule recommended by the Indonesian Pediatrician Association (IDAI), the BCG vaccine is given once to infants aged 0-2 months. Unlike MMR immunization or hepatitis B immunization that is given repeatedly.

Who needs BCG immunization?

The Center for Disease Control and Prevention (CDC) explains that there are two groups that need to get the BCG vaccine, namely:

Babies and children

Quoted from the Vaccine Knowledge Project from the University of Oxford, giving a baby BCG immunization is once when he is two months old, especially for babies exposed to TB from adults. For example, parents or grandparents who have TB.

Infants and children under 16 years of age who are included in the TB risk group must be given the BCG vaccine.

Tuberculosis (TB) is a disease that is still experienced by many Indonesians and is an infectious disease. In infants, TB can be transmitted from adults but not from baby to baby.

Health workers

The BCG vaccine does not work optimally when given to adults. However, doctors, nurses and health workers with a maximum age of 35 years who often come into contact with tuberculosis (TB) patients must receive the BCG vaccine.

The reason is, there is a risk of transmission of tuberculosis bacteria in hospital patients.

The CDC explains that there are TB patients infected with tuberculosis bacteria that are resistant to drugs, such as isoniazid and rifampin.

They will be asked to have a skin test before being given the vaccine. The test is to check whether health workers already have antibodies against TB or not.

Conditions that make a person need to be aware of the BCG vaccine

BCG immunization is indeed useful for preventing tuberculosis (TB), but are there any conditions that make someone need to be aware of this vaccine?

Quoting from the Center for Disease Control and Prevention (CDC), there are two groups that should not get the BCG vaccine, namely:

Immunosuppression

This is a condition in which a person has very weak immunity, for example, a person who has HIV. Not only that, the BCG vaccine is not recommended for someone who is a candidate for organ transplant.

Pregnant mother

The CDC recommends not to give BCG immunization to pregnant women during pregnancy. Although there have been no studies on the dangers of vaccines in fetal conditions, further studies are needed for their safety.

The BCG vaccine needs to be postponed if your little one is experiencing these things:

• Baby weighs less than 2.5 kg
• Babies born to HIV positive mothers
• The baby has a fever and a slight illness (cough and cold)

Consult a doctor for more information.

What are the side effects of BCG immunization?

After being given, the BCG vaccine will produce scars in the form of ulcers or festering wounds. But parents don't need to worry, because this is a natural response of the child's immune system to the vaccine given.

So it is hoped that parents will not be surprised if babies who have been immunized will experience wounds or ulcers on their upper right arm.

Reaction to the appearance of boils or scar can vary, ranging from 2 to 12 weeks after immunization. However, generally, it is between four and six weeks. The size also varies, starting from seven millimeters (mm).

Children do not need to be brought to the doctor if boils appear after BCG immunization because boils can heal on their own. You can compress with an antiseptic solution at the injection area.

However, you do need to take your little one to the doctor if there is severe swelling, a high fever, or excessive pus appears from the boils from the injection. These things can indicate infection after immunization.

What if there are no scars after immunization?

This question is often asked, when there are no ulcers or lumps after being vaccinated against BCG, did vaccination fail? The answer is no.

Written on the official website of the Indonesian Pediatrician Association (IDAI), a boil or lump that does not appear does not mean that the child's immunization has failed because the body's reaction is different for each baby.

Immunization does not see the presence or absence of wounds or ulcers, but has been injected or not, so that the BCG vaccine does not need to be repeated.

Why so? This is because every child's immune system is different. Boils are a common response, but they cannot be used as a measure of the success of immunization.

When to see a doctor

The most common side effect of this immunization is the injection marks on the arm which leave scar tissue. However, there are some conditions that are very rare and need special handling, namely:

• High fever
• New injection marks are visible for 2-6 weeks
• Swelling in the armpit by 1 cm
• Inflammation
• Abscess at injection site

It should be noted that this condition is very rare and only occurs in 1 in 1000 BCG immunizations. If you see your little one experiencing the above, immediately contact your doctor for further treatment.

Babies who are not immunized or immunized late are very susceptible to disease so it is advisable to follow the predetermined vaccine schedule.

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