Revacinação BCG em escolares: evolução da lesão vacinal entre 48 horas e 10 semanas / BCG revaccination in school children: evolution of the lesion at the vaccination site between 48 hours and 10 weeks

Objetivo: a reação cutânea na revacinação BCG tem sidomotivo de questionamentos dado à sua magnitude. Seria ela intensa o suficiente para desencorajar seu uso na idade escolar? O objetivo deste estudo é descrever o aspecto evolutivo da lesão vacinal entre 48 horas e a décima semana pós-revacinação.Métodos: estudo de coorte descritivo em que foram revacinadas 484 crianças entre seis e 11 anos de idade, com O,lml da vacina BCG Moreau, e aferidos eritema, enduração, pústula, úlcera, crosta ecicatriz em 48h, 72h e, semanalmente, até a décima semana de evolução, acompanhadas no período de julho a dezembro de 1997. Os dados foram informatizados em programa Epi-Info 6.0, avaliando-se freqüências, médias, medianas e desvios-padrões.Resultados: enduração estava presente em 99,1por cento, e eritema em 91,6por cento das 438 crianças avaliadas com 48h. Pústulas foram observadas na primeira semana em 26,1por cento de 479 crianças. Na segundasemana, já apareceram as primeiras úlceras. Na décima semana, 69,8por cento das 463 crianças presentes exibiam crostas, mas apenas...

[BCG revaccination in school children: evolution of the lesion at the vaccination site between 48 hours and 10 weeks]. / Revacinação BCG em escolares: evolução da lesão vacinal entre 48 horas e 10 semanas.

OBJECTIVE: Cutaneous reaction after BCG revaccination has been cause of concerns due its magnitude. Would it be intense enough to discourage its use in school-age children? The objective of this study is to describe the evolution of BCG vaccination site between 48 hours and 10 weeks post-revaccination. METHODS: A descriptive cohort study was carried out involving 484 children between six and 11 years. The subjects were vaccinated with 0.1 mL of BCG-Moreau. Erythema, induration, pustule, ulcer, crust and final scar were measured within 48 h, 72 h and weekly until the tenth week, evaluated between July and December 1987. Epi Info 6.0 software was utilized to analyze frequencies, means, median and standard deviations. RESULTS: Induration was present in 99.1% and erythema in 91.6% of 438 children evaluated within 48 h. Pustules were observed in the first week in 26.1% of 479 children. The first ulcers were seen during the second week. In the tenth week, 69.8% of 463 children showed crusts but only 29.2% completed the healing process. CONCLUSIONS: BCG revaccination in school-age children causes intense and early reaction that can be related to Koch phenomenon, even though it does not present the expected reduction in the healing period. The magnitude of the reaction is not enough to discourage its recommendation for school-age children. On the other hand, it is possible that the rapid inflammatory response is an indication of active immune response from the first vaccination.