EVALUATION OF THE EFFECT OF VACCINATION TECHNIQUE ON BCG VACCINE REACTION

Yıl 2015, Cilt: 78 Sayı: 3, 72 - 75, 08.04.2015

Esra DEVECİOĞLU Bahar KURAL Meryem ÖREN Yasin YILMAZ Tijen EREN Gülbin GÖKÇAY

https://doi.org/10.18017/iuitfd.13056441.2015.78/3.72-75

Öz

Objective: To evaluate the effect of BCG vaccination technique to post BCG reactions and scarring.

Material and Methods: Eighty four children were enrolled in this descriptive, observational study. All of them received 0.05 ml of BCG of Serum Institute of India Ltd at 2 months of age, in the upper left deltoid region. A detailed questionnaire was completed. The vaccines were implemented by 9 different pediatricians who were trained for intradermal injection and working consecutively at the Unit between December 2011 and Mai 2012. The vaccination technique was monitored by direct observation of post-vaccination wheal and route of administration. One investigator evaluated the BCG reaction by measuring immediately the longest diameter of wheal after injection. The technique was classified as Technique 1(intradermal) if the diameter is 5-6 mm, Technique 2 if the diameter is less then 5 mm. BCG reaction was evaluated at 3 months of age and scar formation was evaluated at 12 months of age. A scar formation with a diameter more than 2 mm was accepted as present. During this follow-up period, the local reaction is noted as exaggerated if the longest diameter of the reaction was more than 6 mm.

Results: Technique 1 (Intradermal) was applied on 44 (52,4%) infants. . The white wheal was not formed in 10% of the infants. All infants had vaccination reaction during the follow-up but BCG reaction at 3 months of age was earlier in Technique 1 (intradermal) group. During the follow-up period we observed exaggerated local reaction in 22 (27.2 %) infants. Exaggerated local reactions were less in the intradermal technique. 0f the 81 infants assessed for scar formation only one patient had no scar at 12 months of age and his reaction was abortive.

Conclusions: This study showed that the vaccination technique had no impact on scar formation but exaggerated local reactions occur less with intradermal vaccination. Further randomized studies relating vaccination technique to vaccine effectiveness are needed.

Anahtar Kelimeler

BCG vaccine, vaccination technique, intradermal, scar

BCG AŞI TEKNİĞİNİN BCG AŞI REAKSİYONUNA OLAN ETKİSİNİN DEĞERLENDİRİLMESİ

Öz

Amaç: BCG aşısı yapılmış olan çocuklarda aşı tekniğinin skar oluşumuna etkisinin değerlendirilmesi amaçlanmaktadır.

Gereç ve Yöntem: Aralık 2011- Mayıs 2012 yılları arasında İstanbul Üniversitesi İstanbul Tıp Fakültesi Sosyal Pediatri Poliklinik’ne BCG aşısını olmak için başvurmuş 2 aylık bebeklere bu süreçte poliklinikte çalışan 9 tane farklı hekim tarafından sol üst deltoid bölgeye yapılan 0.05 ml BCG aşısının tekniği incelenmiş ve aşının nasıl yapıldığı bu dönemde kaydedilmiştir. Aynı araştırıcı tarafından yapılan aşı sonrası oluşan beyaz makül 5 mm ve daha büyük ise Teknik 1(intradermal), 5 mm’den küçük ise Teknik 2 olarak tanımlanmıştır. BCG reaksiyonu 3.ayda ve skar formasyonu 12. ayda değerlendirilmiştir. Skar oluşumu ≥ 2 mm ise pozitif olarak kabul edilmiştir. İzlem süresinde en uzun çapı 6 mm’den fazla olan reaksiyonlar abartılı reaksiyon olarak tanımlanmıştır.

Bulgular: Çalışmaya alınan 84 hastanın 52,3%’ü Teknik 1 ile aşılanırken, diğerleri Teknik 2 ile aşılanmıştır. Hastaların 10%’nunda aşı sonrası beyaz iz oluşmamıştır. 1 ay sonrasında BCG aşısına bağlı reaksiyon Teknik 1 grubunda Teknik 2 grubuna göre daha erken oluşmuştur. İzlem sırasında 22 hastada abartılı reaksiyon gelişmiş olup, teknik 2 ile aşılananlarda daha fazla görülmüştür. 12. ayda BCG skarı açısından değerlendirilen 81 hastanın bir tanesi hariç hepsinde BCG skarı oluşmuştur.

Sonuç: Çalışmamızda BCG aşı tekniğinin BCG skarı üzerine etkisi gösterilememiş olup abartılı reaksiyon Teknik 2’de daha fazla görülmüştür. BCG aşı tekniğini ve aşının koruyuculuğuna olan etkisini inceleyen daha fazla sayıda çalışmaya ihtiyaç vardır.

Anahtar Kelimeler

BCG aşısı, aşı tekniği, intradermal, skar

Kaynakça

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