What are the symptoms of adverse reactions to the BCG vaccine in the arm?

The BCG vaccine is injected into the human arm, but because the body resistance of patients who have just received the vaccine is very low, a small number of people will have adverse reactions. Usually, the arm after the vaccine may have some redness and swelling, or a lymphatic drainage reaction, and there may be mild eczema on the local arm, which requires waiting for the local scab to form. Rare adverse reactions include pustules, swelling and pain. Severe cases require going to the hospital for examination.

Adverse Reactions

1. Common adverse reactions

(l) About 2 weeks after vaccination, local redness, swelling and infiltration may occur. If this happens, purulent ulcers may form, which usually scab over after 8 to 12 weeks. Generally no treatment is required, but attention should be paid to local cleaning to prevent secondary infection.

(2) Those with pustules, superficial ulcers and secondary infections should go to the hospital for treatment by a doctor. For the former, apply 1% gentian violet and let it dry and form a scab. For the latter, sprinkle anti-inflammatory powder on the wound surface. Do not drain pus or remove the scab on your own.

(3) If the diameter of local abscesses and ulcers exceeds 10 mm or does not heal for a long time (more than 12 weeks), timely diagnosis and treatment should be given.

(4) Lymph node reaction: The axillary lymph nodes on the inoculated side (a few are supraclavicular or contralateral axillary lymph nodes) may be slightly swollen, generally not exceeding 10 mm, and disappear after 1 to 2 months. If local lymph nodes become swollen, softened and form pustules, timely diagnosis and treatment should be sought.

(5) A transient fever reaction may occur after vaccination. Most of them are mild fever reactions, which will resolve on their own after 1 to 2 days and generally do not require treatment. For moderate fever reactions or fever duration exceeding 48 hours, symptomatic treatment can be given.

2. Rare adverse reactions

(1) Severe lymph node reaction: clinically divided into caseous, abscess type, sinus type, etc. If there is a strong reaction in the lymph nodes near the vaccination site, such as in the armpits, above and below the clavicle, or in the neck, and the local lymph nodes swell and soften to form pustules, timely diagnosis and treatment should be given.

(2) Keloids are occasionally seen during re-implantation.

3. Extremely rare adverse reactions

(l) Osteomyelitis.

(2) Allergic rash and allergic purpura.

Precautions

1. Subcutaneous or intramuscular injection is strictly prohibited.

2. The syringe used for BCG vaccination should be dedicated and should not be used for other injections to prevent suppurative reactions.

3. When opening the vaccine bottle and injecting, do not allow disinfectant to come into contact with the vaccine.

4. Vaccine bottles with cracks, unclear or expired labels, or those that appear turbid after reconstitution should not be used.

5. The vaccine should be used immediately after opening. If it needs to be stored, it should be kept at 2℃~8℃ and used up within half an hour. Any remaining vaccine should be discarded.

6. Drugs such as epinephrine should be available for emergency use in case of severe allergic reactions. The recipient should be observed on site for at least 30 minutes after the injection.

7. Freezing is strictly prohibited.

8. Avoid light when using.