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BCG Vaccine Uses, Dosage and Side Effects

Fri, 21 Apr 2023 07:41:51 GMT

Mycobacterium bovis Bacille Calmette–Guérin (BCG) is the only vaccine which can currently counter tuberculosis, existed for over 80 years and is one of the most widely used vaccines in current days.

BCG is an M. bovis attenuated strain that was developed, culminating to 13 years of continuous in vitro research, BCG vaccine is given to prevent TB (tuberculosis). The World Health Organisation (WHO) endorses the immunisation of infants soon after birth as possible in all countries with a high risk of tuberculosis infection.

Tuberculosis and its Reach

No country in the world today, rich or poor, can claim to be free of tuberculosis.

Tuberculosis is a major health concern globally that claims almost 20 lakhs of lives annually, with developing countries bearing the major brunt of the disease. In March 1993, the WHO declared tuberculosis a "global public health emergency". The situation has deteriorated to great extent due to the emergence of multidrug-resistant tuberculosis and human immunodeficiency virus infection. A fourth of the global population gets latently infected with tuberculosis, and 5 -10% of this latently infected group develops active disease during their lifetime.

The burden of tuberculosis morbidity and mortality in the world as a whole impinges most heavily on developing countries and disproportionately on the poor and other disadvantaged subpopulations of better-resourced countries.

The only available tuberculosis therapy is Directly Observed Treatment Short - course (DOTS), which is very lengthy and possesses various side effects, including the dampening of immune responses resulting in the vulnerability to TB reactivation and reinfection.

At present, the evolving medical research actively seeks an answer in the field of immunology and vaccinology for a permanent or near-permanent solution to curb the growth of the ailment.

BCG vaccine and its Evolution

After years of intensive research, the BCG vaccine, which was innovated in 1921, still in remains the most widely used vaccine until today despite its limitations and highly variable efficacy.

BCG vaccine full form - Bacille Calmette-Guerin vaccine

The BCG vaccine discovered by Léon Charles Albert Calmette and Jean-Marie Camille Guérin of the first vaccine against tuberculosis disease. The BCG vaccine, named after its discoverers - Calmette and Guerin, at the Institut Pasteur (Pasteur Institute) in Paris, France. Léon Charles Albert Calmette was a French physician, bacteriologist and immunologist and Jean-Marie Camille Guérin was a French veterinarian, bacteriologist and immunologist.

BCG Vaccine was developed from a live-attenuated strain of Mycobacterium bovis , a subspecies of M. tuberculosis . They discovered that the addition of beef bile reduces the clumping in M. bovis and decreases the virulence of the strain.

Clinical immunisation with the BCG vaccine started in Europe as early as 1921. By the 1940s, several studies established the protective role of the BCG vaccine in tuberculosis among children. As the tuberculosis rates increased after World War II, several international health organisations recommended BCG vaccination among the population. In 1948 BCG vaccine was introduced in India, which spread to schools in almost all states of India by 1949. A 2022 study demonstrated that the BCG vaccine also provided protective efficacy against a likely symptomatic COVID-19 infection.

BCG Vaccine Uses / Indication

There are a lot of benefits of BCG vaccine for newborns and infants when compared with adults. BCG Vaccine can be given to the following populations:

Infants and neonates under five years are at high-risk to active tuberculosis.
It could be done in children aged 7-14 if they weren’t previously vaccinated.
BCG vaccination is considered by healthcare individuals who work among regions or wards with high tuberculosis transmission.
While the BCG vaccine is used for preventing tuberculosis, it also demonstrated therapeutic efficacy in treating non-invasive forms of bladder cancer.

BCG Vaccine Dose

For children over one year of age and adults, 0.1 ml of vaccine can be given. A single dose is enough to provide lifetime immunity from TB (tuberculosis)

BCG Vaccine Route

The BCG vaccine can be administered intradermally.

BCG Vaccine for newborn

BCG vaccine standard dose at birth is 0.1 mg in 0.1 ml. Few studies show half the dose for newborns. BCG vaccination should be given at birth. Some studies demonstrate increased tuberculin conversion after 1-3 months.

BCG Vaccine Scar

The BCG vaccine scar can range from 2-8 mm in size. Its measurement has no relation to induced immunity and is usually related to wheal size.

Contraindications of BCG Vaccine

BCG Vaccinations cannot be administered to any immunocompromised patients as BCG is a live vaccination. Reduction of immunity can be due to various reasons, such as:

HIV infection
Malignancy
Congenital immunodeficiency
Drug-induced immunosuppression, such as
Tumour necrosis factor-alpha blockers
Corticosteroids

Side effects of BCG Vaccine

Similar to every other vaccine, the BCG vaccine can also cause side effects, but usually they are mild and not commonly occurred. The side effects of BCG vaccine include:

Soreness or discharge at the injection site
Increase in temperature (fever)
Swollen glands under the armpit in the arm where the injection was given
A small sore may be developed at the injection site which may leave a small harmless scar upon healing.
In case of serious complications, such as abscesses (swelling with pus), bone inflammation contact the pulmonologist at once.

BCG Vaccine Complications

The most common complication of BCG vaccination is the Injection site reaction, which could include:

Granulomatous lesions
Lymphadenopathy of regional lymph nodes
Nodules or ulcers at the vaccination site, with or without draining sinus tracts or fistulae.
The other complications include
Osteomyelitis
Osteitis
Opportunistic infections that could occur in the setting of immunosuppression, including HIV infection.

Precaution Tips at the Injection Site

Maintain the site clean and dry.
After bathing the baby, care must be taken to pat the area dry thoroughly.
In case of oozing from the area, a wound dressing with gauze can be done.
To clean the area, a sterile alcohol swab must be utilised.

Frequently asked questions

For safe and effective vaccination, request an appointment.

Importance of Newborn, Baby, Child Vaccinations – Chart and Types

Mon, 10 Apr 2023 13:57:40 GMT

What is Newborn, Baby, Child vaccination?

Newborn, Baby or Infant, Toddler and Children are exposed to an open environment, and since their immune systems are not fully developed, they are prone to contracting a pathogen which may stir a disease in them. Unless completely treated, these diseases could prove fatal.

To void any such mishaps, the newborn, baby or infant, child can be vaccinated.

A vaccine is a dead or attenuated form of the pathogen (germ) responsible for any disease. When the child is provided with some form of vaccination, their immune system (the body's germ-fighting mechanism) can produce antibodies that protect them against catching the disease if and when exposed to the condition.

Types of vaccines

Various types of vaccines are designed to equip the immune system with the necessary means to defend the body against various germs and the fatal diseases they cause.

Inactivated vaccines – These vaccines utilise the killed version of the germs which cause diseases. They fail to provide immunity which is as strong as live vaccines.
Live-attenuated vaccines - These vaccines inject an attenuated form (a weakened form) of the microbe that causes a disease. They create a long-lasting immune response.
Messenger RNA vaccines —also called mRNA vaccines – These vaccines utilise mRNA to create proteins which can trigger an immune reaction.
Subunit, recombinant, polysaccharide, and conjugate vaccines – These vaccines utilise particular parts of the microbe, such as sugar or capsid, which provide a robust immune response.
Toxoid vaccines – Microbes create toxins (harmful products). These vaccines utilise toxins to create immunity instead of the whole germ.
Viral vector vaccines – A modified version of a different virus is used to deliver protection in these types of vaccines.

Why vaccination is necessary for baby, newborn or child?

Vaccinations not only keep newborn, baby or infant, children safe by eliminating or significantly reducing harmful diseases that are used to transmit from child to child, but they also protect from potentially fatal diseases such as and not limited to tetanus (lockjaw), diphtheria, hepatitis, measles, polio, tuberculosis etc.

India has the greatest number of deaths among children under the age of five years (early childhood) globally, the majority of which are due to vaccine-preventable diseases. Protection against communicable diseases requires timely vaccination to develop immunity and minimise susceptibility to infection.

Delays in vaccines beyond the recommended time frame (i.e., untimely vaccination) could expose the newborn, baby or infant, child to a prolonged risk of disease and contribute to the ongoing transmission of diseases. Therefore, vaccination timeliness is an important criterion for evaluating immunisation program performance, since coverage estimates alone may lead to incorrect assumptions about herd immunity and transmission risk.

List of vaccines for babies in India | Types of vaccination

The common vaccinations which are to be done in new-borns and babies and under 1 year are as follows.

BCG - Bacillus Calmette Guerin . This vaccine offers protection against tuberculosis.
OPV - Oral Polio Vaccine is given at birth, 6 weeks at 10 weeks, and 14 weeks old.
Hepatitis B - This vaccine protects against the viral Hepatitis B infection of the liver. It is administered at birth, at 6 weeks at 10 weeks old, and at 14 weeks old.
DTwP / DTaP - Diphtheria combined with tetanus and pertussis (whooping cough disease) vaccines. It is given to the baby at 6, 10 and 14 weeks of age.
Rotavirus - This vaccine protects the baby against severe diarrhoeal disease and is given when the newborn is 6, 10 and 14 weeks old.
PCV - This vaccine protects against pneumonia, meningitis, septicemia, sinusitis and otitis media, which is given at 6 and 14 weeks.
Influenz (IIV) -The Inactivated Influenza Vaccine, which is given at 6 & 7 months of age protects the baby from contracting influenza.
Typhoid Conjugate Vaccine – This vaccine protects the baby from typhoid disease.
MMR – The Measles, Mumps, and Rubella is given at 9th and 15th month and protects 3 diseases - measles, mumps, and rubella.
Hepatitis A – At 12th month Hepatitis A vaccine is given which protects the baby against Hepatitis A, a deadly viral infection which attacks the liver.

History of Vaccination in India

It was in May 1802 that the first vaccine arrived in India. It was issued to treat the smallpox epidemic, and on the 14th of June, 1802, Anna Dusthall, a three-year-old kid from the erstwhile Mumbai, became the first person in India to receive it.

From then till date, paediatric vaccinations have been conducted gradually across the length and breadth of India, delivering wholesomeness and healthy living. The immunisation drive was so much of a roaring success that the World Health Organisation (WHO) had declared the elimination of smallpox and polio from the face of the globe by 1980.

Herd immunity

It is more difficult for an infectious virus to spread in a community when a large number of individuals are immune to it. This is called herd immunity which can be typically achieved through vaccination. Prior to vaccination, natural attainment of herd immunity was only possible with direct infection, which posed a threat of fatality.

Through herd immunity, even the people who are not immune to a disease can be protected, such as those who:

never contracted the disease
can't get vaccinated
cannot become immune because due to a weak immune system

When about 70-80% of people are immune to an infection, the entire community is usually protected.

Financial and evolutionary advantages of vaccines

Baby vaccinations can save families time and money by preventing vaccine-preventable diseases that can result in prolonged disabilities and financial burdens. Vaccinations have also eliminated many diseases that were once common and deadly, protecting future generations from these illnesses.

By continuing to vaccinate now, parents can help ensure that some diseases of today will no longer exist to harm their children or future generations.

Tips on immunisations for babies and children

There are a few tips which the parents need to be aware of to understand vaccinations and their smooth reruns.

The parent must look out for any swelling at the injection site, pain, and fever, as they are common adverse effects of vaccines. These side effects must be discussed with the doctor and inquired about, which symptoms needed a visit.
Do not forget to bring your child's vaccination record to all office visits, and ensure that the doctor signs and dates each vaccination.
Healthcare centres often maintain an immunisation reminder or recall system. Know if the center you have been to have one of those, and if so, do register. This system reminds you not only about the due immunisations but also will warn you in case of any missed immunisation.

Vaccination chart for babies in INDIA | Download ��

PAP Smear Test after 30 years – Preparation, Procedure & Risk factors

Tue, 04 Apr 2023 16:20:19 GMT

What is pap smear test?

Pap smear test meaning

A pap smear test (also called as Pap test) is used to screen cervical cancer in a woman. The test generally involves the collection and examination of cells from the cervix region (lower and narrow end of the uterus) for the existence of abnormal cells leading to cancer.

Pap smear full form - The Papanicolaou test (Pap test)

Early pap smear screening for cervical cancer improves the likelihood of successful treatment. A cervical pap smear can also detect the presence of precancerous cells (abnormal cells) and is also the first step in preventing cervical cancer.

When should I go for screening?

As per the American College of Obstetricians and Gynaecologists (ACOG) recommendations, the screening should start at 21 years, irrespective of sexual status.

Women aged between 21-30 years should have a pap test every other year; if more than 30 and has three normal PAP tests in a row, then the frequency can be changed to every three years.
Women with weak immune systems, a history of abnormal cervical cells and the presence of high-risk factors for cervical cancer should be having more screening tests.
Women between the ages of 65 and 70 with three normal pap tests in a row, sexually inactive, and who never had an abnormal pap test may no longer need to be screened for cervical cancer.
If the woman had a total hysterectomy (removal of the uterus and cervix), there is no need to have a screening test unless she has a history of prior surgery for cervical cancer or pre-cancer.

Why pap smear test is done?

The gynecologist advises having a pap smear to detect the presence of the following conditions in the cervical area:

Abnormal or precancerous cells
Cervical inflammations
Infections

Human papillomavirus (HPV) testing may be performed simultaneously with a pap smear by the gynaecologist. For women over the age of 30, HPV infection is the greatest risk factor for developing cervical cancer.

Who all are at risk for a Pap smear screening?

Women with the following risk factors are recommended for more-frequent screening tests.

Presence of human immunodeficiency virus infection
History of exposure to diethylstilbestrol (DES)
Weak immune system
Detection of precancerous cells on a pap smear test

How to prepare for pap smear test?

The gynaecologist will go through the entire pap smear procedure, including the potential risks, and answers any patient questions.

The gynaecologist would like to know if the patient is sensitive or allergic to medicines, latex, or tape and using medications that include herbals, birth control or hormone therapy, and other over-the-counter pills.
The gynaecologist would also like to know the patient's last period, pregnancy status and if the patient has a history of bleeding disorders or using any blood-thinning medicines.
The gynaecologist advises not to use any douche, lubricants, spermicidal foams, jellies, or creams in the vaginal area for at least 2 to 3 days before the test and to abstain from sexual activity for 24 hours prior to the test.
The gynaecologist would advise emptying the bladder before the procedure starts.
A sanitary pad may be advised to counter any spotting that may occur after the test.

How is pap smear test done?

Pap smear test procedure steps

The Pap smear test procedure includes the following:

The patient will be requested to wear a medical gown.
The patient will have their feet resting in stirrups on an examination table.
A speculum is a device used by the gynaecologist to get into the vagina. The cervix can then be viewed through the opening created in the vagina by spreading its walls apart.
The gynaecologist will use a small brush, swab, or spatula to scrape cells smoothly from the cervix and back of the vagina. The collected cells will be placed in a liquid-filled vial or smeared onto a glass microscope slide.
The gynaecologist will collect sample cells for HPV tests if needed.
In case of symptoms of vaginal infection, the vaginal cells will be collected.
The gynaecologist performs a pelvic exam, and the collected cells will be sent for laboratory analysis.

What happens after a Pap test?

After the procedure, the patient needs to take rest before heading home. The patient might have bleeding from the cervix due to scraping.

In addition to bleeding, the patient might have the following

Increase in body temperature
Foul smell vaginal discharge
Severe pain in the abdomen

Pap smear test result

The cervical pap smear test result could take longer than 20 to 21 days to arrive. If the test findings are normal, the woman might have a very low probability of developing cervical cancer. If the test results indicate positive, the patient needs to visit the gynaecologist for further follow-up.

Frequently asked questions

Advantages of Breastfeeding - Benefits of Breastfeeding for Mother & Child

Sat, 01 Apr 2023 16:33:48 GMT

What is Breastfeeding?

Breastfeeding, also known as nursing, is the process of feeding a baby with the mother's milk, either directly from the mother's breast or by pumping out milk and feeding it to the baby from a bottle.

Breastfeeding is one of the proven ways to make sure your infant's health. Breast milk is a complete food for babies, and it is safe, pure, and contains antibodies that help protect against many typical children's ailments. Breast milk fulfills the total energy and nutrients a baby needs during the first month of life, and continues to provide up to half or more of the nutrients a baby requires during the rest of the growing years.

It has been seen that infants who have been breastfed are more associated with the benefits of breast milk and are likely to perform better on intelligence tests, are less liable to suffer from overweight or obesity, and are less prone to develop diabetes in a later stage of their lives. As advantages of breastfeeding, lactating women have a lower risk of developing breast and ovarian cancer.

Types of Breast Milk and Benefits of Breast Milk

There are three stages of breast milk, depending upon the duration of its production. All three types of breast milk are essential for infant nutrition, and the consistency of the milk gets thinner with the progression of the days. The stages of breastfeeding are as follows:

Colostrum milk
Transitional milk
Mature milk

Colostrum: It is the first milk produced by the breast after pregnancy. It is thick in consistency and looks yellowish. Colostrum is highly concentrated with minerals, vitamins, protein, and immunoglobulins- antibodies which help in the development of the baby's immune system. It is low in fat and sugar, which makes it easily digestible for the baby.
Transitional milk: This is the stage when Colostrum turns into mature milk just after the four days of birth and lasts for a week. During this period, the breasts will get tender, dense, and fuller, indicating that milk production has increased to meet the hunger of the growing infant.
Mature Milk: After 10–15 days, the Colostrum completely turns into mature milk with a thinner consistency, still with the adequate nutrients needed for the infant's growth.

Benefits of Breastfeeding for Baby

Breast milk is considered complete food for the infant, it contains all the nutrition baby need to grow. Breast milk contains an ideal combination of vitamins, protein, and fat in digestible form, which supports babies growth effectively. It also carries antibodies which helps fight infectious diseases caused by the bacteria and viruses.

Some of the prominent advantages of breastfeeding is it helps in fighting various disease to lower the risk of getting affected by it.

It helps in lowering the risk for Asthma and Allergies
Infant breastfeed for 6 months are less likely to be affected by ear infections (Acute Otitis media), respiratory ailment, and gastrointestinal infections (diarrhea/vomiting)
It lowers the risk of obesity, as breastfed promotes proper growth of baby rather uneven increase in weight.
Polyunsaturated fatty acid (Docosahexaenoic Acid -DHA), found in breast milk, supports efficient brain development.
It helps lower the risk of developing type-1 diabetes in future
It helps in the prevention of sudden infant death syndrome (SIDS)
It lowers the risk of Necrotizing Enterocolitis (NEC) for preterm infants
It reduces the frequent visit to doctor and chances of hospitalization

Benefits of Breastfeeding for Mother

The process of breastfeeding not only proves to be an immunity booster for the babies but also brings advantages to the breastfeeding mothers, as it involves physical activity and helps burn extra calories, which aid in faster pregnancy weight loss.

During breastfeeding, a hormone called Oxytocin is released, which helps in managing the uterus to regain its pre-pregnancy size and also lowers the uterine bleeding after birth.

Apart from the above-mentioned health benefits, breastfeeding helps in lowering the risk of getting various cancerous and non-cancerous diseases, which are as follows:

It lowers the risk of osteoporosis
It lowers the risk of developing breast and ovarian cancer
Helps in the management of postpartum depression
Develops deep mother child closeness
Breastfeeding aid in delay menstruation (ovulation)

pace-dandle

BCG Vaccine Uses, Dosage and Side Effects

Tuberculosis and its Reach

BCG vaccine and its Evolution

BCG Vaccine Uses / Indication

BCG Vaccine Dose

BCG Vaccine Route

BCG Vaccine for newborn

BCG Vaccine Scar

Contraindications of BCG Vaccine

Side effects of BCG Vaccine

BCG Vaccine Complications

Precaution Tips at the Injection Site

Frequently asked questions

For safe and effective vaccination, request an appointment.

Importance of Newborn, Baby, Child Vaccinations – Chart and Types

What is Newborn, Baby, Child vaccination?

Types of vaccines

Why vaccination is necessary for baby, newborn or child?

List of vaccines for babies in India | Types of vaccination

History of Vaccination in India

Herd immunity

Financial and evolutionary advantages of vaccines

Tips on immunisations for babies and children

Vaccination chart for babies in INDIA | Download ��

PAP Smear Test after 30 years – Preparation, Procedure & Risk factors

What is pap smear test?

When should I go for screening?

Why pap smear test is done?

Who all are at risk for a Pap smear screening?

How to prepare for pap smear test?

How is pap smear test done?

What happens after a Pap test?

Pap smear test result

Frequently asked questions

Advantages of Breastfeeding - Benefits of Breastfeeding for Mother & Child

What is Breastfeeding?

Types of Breast Milk and Benefits of Breast Milk

Benefits of Breastfeeding for Baby

Benefits of Breastfeeding for Mother

Frequently asked questions

To know more and how to breastfeed effectively, consult our super-specialist.