Vaccination against tuberculosis and its complications in children of the Orenburg region

Introduction. The bacille Calmette-Guérin (BCG) vaccine, developed by French scientists Albert Calmette and Camille Guérin in 1921, remains an effective method for the specific prevention of tuberculosis. However, post-vaccination complications are possible when using the BCG/BCG-M vaccines, which is one of the reasons of parental vaccination refusal. The number of such refusals increases annually, creating a pressing medical problem. Furthermore, non-BCG vaccinated children are at increased risk of tuberculosis. Aim. Analysis of cases of complications following anti-tuberculosis vaccination in 2008–2022 among children of the Orenburg region and demonstration of possible clinical manifestations of complications of BCG vaccination in children using two case reports as an example. Materials and methods. A clinical and epidemiological analysis of all cases of complications following anti-tuberculosis vaccination in children in the Orenburg region from 2008 to 2022 was performed. Data from the personal register at the Orenburg Regional Clinical Anti-Tuberculosis Dispensary were used. Data from the follow-up of children and medical records (primary diagnostics and verification of diagnosis) were analyzed. Two clinical cases of complications were examined: BCG lymphadenitis and BCG osteitis. Results. The complication rate per 100 000 of vaccinated ranged from 21,6 in 2008 to 19,6 in 2022, showing a fluctuating trend with a downward trajectory. The most common complications following BCG vaccination (51,3% of cases) were inflammation in the regional lymph nodes (lymphadenitis), cold abscesses (31,3% of cases), and specific osteoarticular inflammation (BCG osteitis) – 12,5% of cases. Conclusion. Post-BCG/BCG-M vaccination reactions and complications are possible, and it is essential to spread the actual information regarding the extremely low risk of post-BCG complications in children. The reason for the population’s refusal of BCG vaccination is the lack of active anti-tuberculosis campaigns among pregnant women and new mothers, who need to be educated about the necessity of BCG vaccination and introduced to the features of vaccination in newborns. The increase in BCG vaccination refusals in the region is not related to possible post-vaccination complications. The case reports presented may be useful for primary pediatric care specialists (primary care pediatricians and pediatric surgeons).