The main vaccines

The BCG or the vaccine that counters tuberculosis

Tuberculosis is always present in France.

The BCG is obligatory for the children as of their entry at the school before 6 years. It can be practised as of the first months of life if the child lives in community or in a medium where it is likely to contract this disease.

It is of habit to practise a cutaneous reaction to tuberculin (R.C.T.) before vaccination by the BCG, in order to detect a tuberculosis already in progress.

In the young child, the BCG is carried out using a plastic applicator provided with impregnated points of a homogeneous suspension of BCG. A bandage is then applied and must be kept 24 hours during which you will avoid bathing the child. Three weeks after vaccination, you will observe red papules at the points of impact which will persist two to three months. Apply any pomade nor no disinfectant to the local reaction. The B.C.G. causes neither fever, nor deterioration of the general state. It can be practised in all seasons.

Cutaneous tests with tuberculin

Tuberculin is a concentrated extract of cultures of killed and crushed bacilli of Koch. A child who never was in contact, neither with the B.C.G., nor with tuberculosis, has tuberculinic cutaneous reactions (R.C.T.) negative.

If they are positive, it is that the child is sensitive to tuberculin thus that the B.C.G. "took" if it were vaccinated or that the child contracted tuberculosis if it were never vaccinated. After the B.C.G., the positivity of the R.C.T. lasts a few years. The pediatrist checks them every year in order to revacciner by the B.C.G. when they are négativent.

The test is composed of an applicator for plastic multipuncture provided with impregnated concentrated purified tuberculin points. The pediatrist cleans with alcohol the former face of the front armlever. He applies then the tiny points to the drop of product test which he makes penetrate. The gesture is painless.

The place of the pressure is surrounded by a feature of pen in order to facilitate the later location. The reading of the reaction is done to the 3 ^2nd  day with palpating. A palpable induration of 2mm at least corresponds to a positive reaction.

If the R.C.T. are negative after three attempts at B.C.G., the practice is not to repeat the vaccine. On the other hand, the progressive extinction of the R.C.T. (checked remotely viral disease which can the négativer transitorily) justifies the revaccination.

Positive R.C.T. testify to a protection with respect to the disease tubercular patient but not to an absolute immunity: the frequency of tuberculosis is simply reduced by 80%.

In the event of need, the BCG can be associated the other vaccines.

Diphteria, Tetanus and the Poliomyelitis

Immunity is acquired by 3 injections with 3 to 6 weeks of interval, with recall one year later and injection of maintenance every 5 years during all the life.

The subcutaneous or intramuscular injection is carried out in the shoulder (know-thorny pit), the buttock, the thigh or the external face of the arm.

The calendar of vaccination in progress in France recommends to practise these vaccines as from 2 months at a rate of 3 injections separated by one month. 

A feverish reaction is frequent after the vaccine. You can manage with the child antithermic approximately three hours after vaccination. In the event of significant feverish reaction, the usual drugs against the fever and cooling are necessary and sufficient. 

Perhaps you will note instead of injection of the vaccine a nodule under cutaneous. This red and painful ball, without gravity, is frequent with the "adsorbed" vaccines that the injection is intramuscular or subcutaneous and whatever its place (buttock, thigh, shoulder etc). Indeed, adsorbing it (alumina hydrate, phosphates calcium) improves the effectiveness of the vaccine but behaves as a true foreign body against which the organization defends itself by a local reaction. Thus do not accuse the doctor who badly would have mixed the suspension or badly practised the injection. The pharmacist is not more responsible by the sale for so-called "a bad batch"… In the event of painful local reaction, your pediatrist will advise you a product to be applied. 

Allergic reactions are possible. The fear of an allergic reaction should not prevent vaccination counters such serious diseases. Your doctor however will take significant precautions for the recalls.

These three vaccines are in general associated those against the whooping-cough and the hæmophilus B.

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