Sunday, January 26, 2020

Bureaucracy Update: Tuberculosis Tangent

Last month I had my meltdown over the kids' medicals. Maybe it's good that I didn't know another month would go by without getting them done!

We were sick until early January, then everything in the country was closed until January 9th. As soon as offices opened back up, we were at the clinic with the kids.

We went to the kids' section of a fancy private clinic down the street (not the same one that failed to diagnose my appendicitis in a timely fashion). We consulted with a pediatrician first ($$$) per the rules, then got the kids their Mantoux skin test which rules out tuberculosis. That's what is required by immigration authorities, and it has to be entered into a vaccine booklet, which we didn't have yet.

Speaking of tuberculosis, one of Andrei's students got sick with TB this year, and he (Andrei) had to go to the infectious diseases hospital and get all the tests done to prove he wasn't infected! The student likely had had a latent form anyway, though.

Since we got the skin probe, we were thinking about going ahead and getting the kids a TB vaccine (BCG). It's given at birth or shortly thereafter in Russia and some other countries. Our kids were born in the U.S. and we hadn't gotten around to getting them one. The BCG is not given to adults because 1) it hasn't been shown to be effective beyond a certain age and 2) it doesn't prevent the form of TB that affects the lungs. (some new research is currently coming out, though!)

There are some pros and cons to getting the BCG vaccine...

Pros: immunity, easier acceptance into work/school with the vaccine record
Cons: exposure to live virus, lifetime positive TB test, no guarantee of effectiveness

It turns out that you have to get the vaccine within 2 weeks of having the skin test, to ensure you haven't been exposed in the meantime. Double exposure is not recommended.

While we needed to continue with our other paperwork, we had to stop and try to find out where to get the BCG done, since there was a time limit on that. We called around to lots of private and government-owned clinics, but it seemed that no one had a supply of the vaccine. Since it's a live vaccine, they only do it one day a week during limited hours, and the private clinic we tried first did it on a day when we weren't available. Other clinics didn't have any of the vaccine in stock, even maternity wards where babies are supposedly given one immediately. Meanwhile, the government clinic near us wouldn't give the vaccine as a paid service.

This begs the question: If TB is such a concern in Russia that they give it to newborns, why don't they make the vaccine more readily available to foreigners or kids that haven't gotten it yet? Surely prevention is a priority?

Spoiler alert: we didn't get the vaccine. If the kids do gain access to free government medical care, we'll check again.

The good news is that the private clinic was happy to transfer the kids' vaccine records into an official Russian immunization booklet. A nice nurse sat down with me and we puzzled over the American print-out together, and then she entered it all into the medical card with all the necessary stamps. So now we can just consult with that whenever we need to recall the kids' vaccine info for Russian purposes.

And when we go to get the kids' bloodwork done, we'll just show the vaccine booklet with proof of a negative Mantoux result (good for 3 months). Easy peasy.

Yeah, we still haven't done the bloodwork and it's already the end of January.

Whenever we're doing paperwork, I hint to God that it would be nice if we got a break just once and got things done faster than usual, with no unexpected obstacles. But God has other plans for us, again. So, we're hanging out in limbo at the moment and have decided to take our trip to Finland instead, get the new border/registration stamp, and go from there.

To be continued...


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  2. All of my Russian kids were vaccinated with that live virus vaccine, and it has caused us a world of problems.... but, they never really got TB, I gather. :)

    1. I'm glad we had time to think about it because I'm not sure we will go ahead with that particular vaccine...


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