Materiały źródłowe

• #1 Bacillus Calmette Guerin – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538185/

  Bacillus Calmette-Guerin (BCG) is the live attenuated vaccine form of Mycobacterium bovis used to prevent tuberculosis and other mycobacterial infections. The vaccine was developed by Calmette and Guerin and was first administered to human beings in 1921. BCG is the only vaccine against tuberculosis. It is the most widely administered vaccine and usually a part of the routine newborn immunization schedule. BCG vaccine also offers protection against non-tuberculous mycobacterial infections like leprosy and Buruli ulcer. […] BCG vaccine is a fairly safe vaccine and it is not associated with severe complications. Prior to the mycobacterial infection, vaccine-induced or acquired naturally can protect against subsequent infection due to mycobacteria including tuberculosis. Prior infection with nontuberculous mycobacteria and Mycobacterium tuberculosis can confer natural protection against tuberculosis infection.

• #1 History of BCG Vaccine

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3749764/

  Tuberculosis (TB) is still responsible for 2 million deaths every year despite being a treatable airborne infectious disease. Bacille Calmette-Gurin (BCG) is the only vaccine available today and has been used for more than 90 years with astonishing safety records. However, its efficacy remains controversial. […] To date, BCG remains as the most widely used vaccine worldwide and has been given to more than 4 billion individuals with astonishing safety records. […] The method of BCG vaccination was therefore proved to be safe. But just as important was the question of its effectiveness. The statistics of Calmette and Guerin showed a fall in tuberculosis mortality among those susceptible infants who had been vaccinated with BCG. […] Although the efficacy of the BCG vaccine continues to be controversial, live attenuated BCG is still the only vaccine in use for the prevention of TB in humans. It is effective against the severe forms of TB and its use prevents a large number of deaths that would otherwise be caused by TB every year. The choice of the BCG strain to be used for vaccination remains an important issue.

• #1 Tuberculosis (TB) – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/mycobacteria/tuberculosis-tb

  Tuberculosis properly refers only to disease caused by Mycobacterium tuberculosis (for which humans are the main reservoir). Similar disease occasionally results from the closely related mycobacteria, M. bovis, M. africanum, and M. microti. These three bacteria, together with M. tuberculosis and other less common mycobacteria, are known as the Mycobacterium tuberculosis complex. […] TB results almost exclusively from inhalation of airborne particles (droplet nuclei) containing M. tuberculosis. They disperse primarily through coughing, singing, and other forced respiratory maneuvers by people who have active pulmonary or laryngeal TB and whose sputum contains a large number of organisms (about 10,000 organisms/mL, the limit of detection by fluorescent microscopy). […] Tuberculosis (TB) is a leading infectious cause of death in adults worldwide, killing about 1.5 million people in 2020, most of them in low- and middle-income countries.

• #1 BCG vaccine for tuberculosis (TB) – NHS

  https://www.nhs.uk/vaccinations/bcg-vaccine-for-tuberculosis-tb/

  The BCG (Bacillus Calmette-Gurin) vaccine helps protect you against an infection called tuberculosis (TB). It’s mainly given to babies and young children who are at higher risk of getting TB. […] The BCG vaccine helps protect against an infection called tuberculosis (TB). […] TB mainly affects the lungs, but can affect other parts of the body. It can become very serious if not treated. […] The vaccine is particularly helpful in protecting babies and young children against more serious forms of TB, such as TB meningitis (TB that affects the brain). […] The BCG vaccine is not routinely given as part of the NHS vaccination schedule. […] It is only recommended for people at higher risk of getting tuberculosis (TB), such as some babies and children, some travellers and people at risk through their work.

• #1 New TB Vaccine Research

  https://www.who.int/teams/global-programme-on-tuberculosis-and-lung-health/research-innovation/vaccines

  Tuberculosis (TB) is the worlds leading cause of death from a single infectious agent next to coronavirus (COVID-19), and one of the leading causes of death from antimicrobial resistance. […] Neonatal BCG vaccination offers partial protection for infants and young children against severe forms of TB, but it does not protect adolescents and adults, who account for the majority of TB transmission. […] A WHO PPC document for new tuberculosis vaccines was developed to highlight the priority need for vaccines that protect against pulmonary TB in adults, and new TB vaccines with better safety and efficacy characteristic than BCG to administer to neonates and infants. […] Vaccines have the potential to serve as immunotherapeutic adjuncts to antibiotic treatment regimens for TB. […] A therapeutic vaccine for TB patients, administered towards completion of a prescribed course of drug therapy or at certain time(s) during treatment, could improve outcomes through immune-mediated control and clearance of bacteria and prevention of re-infection, and provide on the long-term options to simplify and shorten drug treatment regimen.

• #1

  https://microrao.com/micronotes/bcg.htm

  BCG, or Bacille Calmette-Gurin, is a vaccine for tuberculosis (TB) disease. […] BCG consists of a live attenuated strain derived from Mycobacterium bovis, which has been attenuated by 239 successive in vitro subcultures in glycerol-bile-potato medium for over 13 years. […] It is indicated in primary prophylaxis against tuberculosis in all newborn infants, contacts of those with active pulmonary tuberculosis, health staff those who handle animal species known to be susceptible to tuberculosis, and tuberculin negative children between 10-14 years of age. […] BCG is no longer recommended by CDC for health care workers or other adults who are likely to be exposed to TB. […] The vaccine prevents disseminated tuberculosis in newborns (60-80% effectiveness) but fails to protect against pulmonary tuberculosis in adults.

• #1 TB vaccine: Safety, efficacy, and who should get it

  https://www.medicalnewstoday.com/articles/tb-vaccine

  Tuberculosis (TB) is an infectious condition that can be fatal without treatment. It occurs following infection with the bacterium species Mycobacterium tuberculosis. The Bacille Calmette-Gurin (BCG) vaccine can help protect people from developing TB. […] The BCG vaccine uses an attenuated, or weakened, strain of tuberculosis called Mycobacterium bovis, which scientists isolate from cows. This strain is similar enough to the human strain M.Tuberculosis to stimulate the immune system but not cause disease in healthy people. […] The BCG vaccine is a preventative measure to help limit the spread of TB. It uses a weakened strain of the M.Tuberculosis bacterium to stimulate the immune system and help prevent future infections. […] In the U.S., health experts do not generally recommend administering the vaccine. This is due to a low risk of infection, variable effectiveness, and possible interference with diagnostic tests. However, the vaccine may be suitable for people in high-risk groups, such as children and healthcare workers.

• #1 The double-sided effects of Mycobacterium Bovis bacillus Calmette–Guérin vaccine | npj Vaccines

  https://www.nature.com/articles/s41541-020-00278-0

  Bacillus CalmetteGurin (BCG), the only vaccine proven to be effective against tuberculosis (TB), is the most commonly used vaccine globally. […] Although BCG was specifically developed as a vaccine for TB, numerous studies have shown that BCG has the ability to induce the so-called Non-Specific Effects (NSEs) that provide effective protection against other infectious diseases. […] Clinical evidence also suggests that BCG may be effective against infections caused by viral pathogens, such as respiratory syncytial virus, human papilloma virus, and herpes simplex virus. […] Remarkably, BCG can be used as an expression vector for recombinant antigens to develop novel vaccines for pathogenic bacteria and viruses, as well as for cancer immunotherapy. […] As a complex vaccine consisting live-attenuated mycobacterium, BCG causes local infection and immune activation at the site of administration, where resident monocytes, macrophages, and dendritic cells (DCs) interact with the bacillus.

• #1 The double-sided effects of Mycobacterium Bovis bacillus Calmette–Guérin vaccine | npj Vaccines

  https://www.nature.com/articles/s41541-020-00278-0

  BCG internalized by DCs can live up to 2 weeks inside these cells, triggering the upregulation of costimulatory molecules and the production of immune-polarizing cytokines. […] Activated CD4+ and CD8+ T cells produce high levels of IFN-, which ultimately increases the anti-mycobacterial activity of macrophages. […] An increasing number of studies have suggested that BCG vaccination can exert non-specific protective effects to prevent diseases other than TB, and that BCG may be used as a therapeutic agent to modulate the cellular immune response in treating bladder cancer.

• #1 Bacillus Calmette Guerin – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538185/

  Protection against tuberculosis infection is usually due to the immune response to mycobacterial antigens. Prior contained latent infection with Mycobacterium tuberculosis can provide up to 80 percent protection against disease with subsequent exposure. […] BCG vaccination policy is determined by the regional prevalence of tuberculosis infection. Routine neonatal vaccination is recommended by the WHO in countries with moderate to severe prevalence of tuberculosis. […] Routine BCG vaccination is not generally recommended in the United States due to a low incidence of tuberculosis infection and also due to interference of immunization with the PPD test. BCG vaccination is not recommended for health care workers in low-risk areas. Vaccination is also contraindicated in immunosuppressed patients. […] BCG vaccination may be considered in situations where a high percentage of patients are infected with TB strains that are resistant to isoniazid and rifampin.

• #1

  https://www.meningitis.org/meningitis/vaccine-information/bcg-vaccine

  The BCG vaccine is 70-80% effective against the most severe forms of TB, such as TB meningitis. […] The BCG vaccine doesn’t cause meningitis. The BCG vaccine contains a weakened strain of TB bacteria that stimulates the immune system to produce protective antibodies. […] Currently, the BCG vaccine is the only licensed vaccine available that protects against TB. The vaccine provides protection against TB meningitis in children. […] The BCG vaccine provides vital protection for infants from disease. But it does not always stop them from acquiring or carrying the bacteria without showing any symptoms.

• #1 BCG vaccine for TB

  https://www.rch.org.au/kidsinfo/fact_sheets/BCG_vaccine_for_TB/

  The Bacillus CalmetteGurin (BCG) vaccine is used to prevent tuberculosis (TB). The BCG vaccine is named after Dr Albert Calmette and Dr Camille Guerin, who developed the vaccine from a germ called Mycobacterium bovis, which is similar to TB. BCG is a live vaccine that has been processed so that it is not harmful to humans. […] TB is an infectious disease caused by bacteria that affects the lungs, and sometimes other parts of the body. […] The BCG vaccine does not prevent someone being infected with the bacteria that causes TB, but it prevents the development of the disease. It is specifically designed to prevent TB in children. It is very effective in preventing severe TB in young infants, and can be given from birth onwards. […] Children, particularly those under five years of age, who are travelling to countries with a high rate of TB infections. […] The BCG vaccine prevents the development of TB, and is very effective in preventing severe TB in young infants.

• #1

  https://www.gov.uk/government/publications/tb-bcg-and-your-baby-leaflet/tb-bcg-vaccine-and-your-baby

  This leaflet is about the Bacillus Calmette-Gurin (BCG) vaccination that is being offered to protect your baby against tuberculosis (TB). […] BCG vaccine contains a weakened form of the bacteria (germ) that causes TB. Because it is weakened it doesnt cause TB, but it helps your baby develop protection (immunity) against TB in case he or she ever meets it. […] The BCG vaccination is particularly effective in protecting babies and young children against the rarer severe forms of TB such as TB meningitis (swelling of the lining of the brain). […] TB is a bacterial infection; it usually affects the lungs but can also affect any part of the body. […] Infection with the TB germ may not develop into TB disease. […] TB disease develops slowly in the body, and it takes several months for symptoms to appear.

• #1 TB vaccine: WHO expert explains why it’s taken 100 years for a scientific breakthrough, and why it’s such a big deal

  https://theconversation.com/tb-vaccine-who-expert-explains-why-its-taken-100-years-for-a-scientific-breakthrough-and-why-its-such-a-big-deal-215411

  These adverse events include a rare but life threatening condition known as disseminated BCG disease. […] The effectiveness of BCG can vary depending on several factors, including the prevalence of TB in a given area, the strain of the BCG vaccine used, and the age at which BCG was administered. […] The BCG vaccine will not be replaced by another TB vaccine until and unless there is compelling data on the safety and efficacy of an alternative. […] In addition, BCG vaccination has nonspecific beneficial effects on overall mortality and leads to more reductions in child mortality than would be expected by just protecting against tuberculosis.

• #1 BCG vaccine – Wikipedia

  https://en.wikipedia.org/wiki/BCG_vaccine

  The Bacillus Calmette-Gurin (BCG) vaccine is a vaccine primarily used against tuberculosis (TB). In countries where tuberculosis or leprosy is common, one dose is recommended in healthy babies as soon after birth as possible. […] Rates of protection against tuberculosis infection vary widely and protection lasts up to 20 years. Among children, it prevents about 20% from getting infected and among those who do get infected, it protects half from developing disease. […] The main use of BCG is for vaccination against tuberculosis. BCG vaccination can cause a false positive Mantoux test. […] A 1994 systematic review found that BCG reduces the risk of getting tuberculosis by about 50%. […] A systematic review and meta-analysis conducted in 2014 demonstrated that the BCG vaccine reduced infections by 19-27% and reduced progression to active tuberculosis by 71%.

• #1 Tuberculosis | The Australian Immunisation Handbook

  https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/tuberculosis

  BCG vaccination in young children provides: ~25% protection against tuberculosis infection, ~70% protection against active tuberculosis, >70% protection against severe forms of tuberculosis disease in young children, including miliary tuberculosis and tuberculosis meningitis. […] The efficacy of BCG vaccine against pulmonary disease in adults is less consistent, and has ranged from no protection to 80% in controlled trials. […] BCG vaccination offers some protection against Mycobacterium leprae, which causes leprosy.

• #1

  https://www.meningitis.org/meningitis/vaccine-information/bcg-vaccine

  Tuberculosis (TB) is a very serious infectious disease that can cause TB meningitis. […] The Bacillus CalmetteGurin (BCG) vaccine provides protection against TB meningitis in children. […] The BCG vaccine gives good protection against the TB meningitis in babies and young children. […] The BCG vaccine doesn’t protect against TB that causes lung disease in adults. […] TB is the leading cause of infectious death worldwide. It’s a serious infection that can cause TB meningitis. TB meningitis is a life-threatening condition that is fatal without treatment. […] The vaccine saves lives. BCG vaccination has been estimated to prevent one case of TB meningitis for every 3,435 vaccinations given. […] People should have the BCG vaccine to protect themselves from severe forms of TB, including TB meningitis if they are identified to be at increased risk.

• #1 Efficacy of the BCG Tuberculosis Vaccine: Time for Change? – European Medical Journal

  https://www.emjreviews.com/respiratory/news/efficacy-of-the-bcg-tuberculosis-vaccine-time-for-change/

  LONGITUDINAL study data reveals that immune protection following the bacille CalmetteGurin (BCG) tuberculosis (TB) vaccine wanes after 5 years. […] The results showed that following vaccination in infancy, immunoprotection against TB wanes after 5 years of age. In terms of efficacy, the BCG vaccine was found to be 37% effective in children under 5 years of age and showed no conclusive evidence of protection in persons over 10 years of age. […] However, the authors reported that due to the waning protective immunity offered by the BCG vaccine with age, a BCG booster vaccination should be offered to adults and children over 10 years of age. […] This study highlights that booster vaccines should be considered in those over 10 years of age, and that there is a need for improved TB vaccines that can offer longer protection and support vaccination programmes in endemic areas.

• #1 Is There a Vaccine for Tuberculosis (TB)?

  https://www.healthline.com/health/is-there-a-vaccine-for-tb

  In countries where TB is common, BCG is mainly used to protect against two types of severe TB in infants and young children: TB meningitis and disseminated TB. […] Against these types of TB, BCG provides up to 80% protection. […] However, this protection doesnt last forever. A 2022 study found that BCG vaccination at birth only provided significant protection against any type of TB to children under 5 years old. It was not effective for older children and adults. […] A 2016 study looked into the effectiveness of BCG in protecting against pulmonary (lung) TB. Researchers found that vaccine effectiveness against this specific type of TB became statistically insignificant 20 years after vaccination. […] As you may have noticed, the vaccine effectiveness estimates for BCG in adults are highly variable. According to one 2021 review of research, studies have found that the effectiveness of BCG in adults has ranged from zero to 80%.

• #1 TB vaccine: WHO expert explains why it’s taken 100 years for a scientific breakthrough, and why it’s such a big deal

  https://theconversation.com/tb-vaccine-who-expert-explains-why-its-taken-100-years-for-a-scientific-breakthrough-and-why-its-such-a-big-deal-215411

  The BCG vaccine for TB has been used for 100 years. It is largely effective for children under five, but less so in older people and cant be used on patients who have certain medical conditions. […] The Bacille Calmette-Gurin (BCG) vaccine has saved tens of millions of lives and is effective in children under the age of five in preventing TB deaths and severe forms of the disease. […] The vaccine has variable efficacy for protection against pulmonary TB (TB affecting the lungs) in adolescents and adults and it is pulmonary TB thats responsible for the majority of TB transmission. […] The current BCG vaccine is not recommended for use in people living with HIV, for safety reasons. […] Although BCG is a safe vaccine in immunocompetent infants (those whose immune systems are working properly), severe adverse events can occur in HIV-infected infants following vaccination with BCG.

• #1 Tuberculosis – Eradication & Prevention

  https://www.gatesfoundation.org/our-work/programs/global-health/tuberculosis

  Bacille Calmette-Gurin(BCG), the only available TB vaccine, was developed almost 100 years ago and has limited efficacy after childhood. A more effective option is needed to prevent TB. […] The BCG vaccine protects young children against severe forms of TB but offers limited protection against pulmonary TB in adults, which is the most common form of the disease. […] A more effective vaccine would be the single most powerful tool to reduce the incidence of TB. Even a partially effective new vaccine, if introduced in 2024, could decrease TB incidence by up to 70 percent by 2050, according to some projections.

• #1 The success and failure of BCG — implications for a novel tuberculosis vaccine | Nature Reviews Microbiology

  https://www.nature.com/articles/nrmicro1211

  Over the past 50 years, the Mycobacterium bovis bacille Calmette-Gurin (BCG) vaccine against tuberculosis (TB) has maintained its position as the world’s most widely used vaccine, despite showing highly variable efficacy (0-80%) in different trials. […] The efficacy of BCG in adults is particularly poor in tropical and subtropical regions. […] Studies in animal models of TB, supported by data from clinical BCG trials in humans, indicate that this failure is related to pre-existing immune responses to antigens that are common to environmental mycobacteria and Mycobacterium tuberculosis. […] Here, we discuss the potential mechanisms behind the variation of BCG efficacy and their implications for an improved TB vaccination strategy. […] Failure of the Mycobacterium bovis BCG vaccine: some species of environmental mycobacteria block multiplication of BCG and induction of protective immunity to tuberculosis.

• #1 History and Modern Use of the Tuberculosis Vaccine

  https://www.verywellhealth.com/tuberculosis-vaccine-7089756

  The tuberculosis vaccine, also known as the bacille Calmette-Gurin (BCG) vaccine, is used to protect against tuberculosis (TB) and related complications. The BCG vaccine is no longer routinely given in the United States and isn’t recommended for the general population according to the Centers for Disease Control and Prevention (CDC). However, it’s still given to babies and young children in many countries worldwide. […] The tuberculosis vaccine may also be considered in the United States for certain people with significant risk factors for prolonged exposure to TB. […] The BCG vaccine is given to infants on a regular basis in over 180 countries. According to the World Health Organization (WHO), many countries in Southeast Asia, sub-Saharan Africa, and the former Soviet Union have high rates of TB disease.

• #1 BCG vaccine for tuberculosis (TB) – NHS

  https://www.nhs.uk/vaccinations/bcg-vaccine-for-tuberculosis-tb/

  You may need the BCG vaccine if you’re at risk of getting TB because of your work, for example: you’re a health worker who works with people with TB. […] You may need the BCG vaccine if you’ve come to live in the UK from sub-Saharan Africa or a country where there is a very high risk of getting TB. […] The BCG vaccine is not given to: anyone who has TB or has had it before you can have a test to check this if needed. […] The BCG vaccine is given as an injection into the upper part of your left arm. You only need 1 dose. […] If the test shows you’re likely to have TB or have had it before, you should not have the BCG vaccine. […] The main side effect of the BCG vaccine is a blister where the injection was given. […] More serious side effects are rare and include: a severe allergic reaction (anaphylaxis) the person who vaccinates you will be trained to deal with allergic reactions and treat them immediately.

• #1 Health: Infectious Disease Epidemiology & Prevention Division: BCG Vaccine

  https://www.in.gov/health/idepd/tuberculosis/tb-basics/bcg-vaccine/

  Are untreated or ineffectively treated for TB disease (if the child cannot be given long-term treatment for infection); or […] Have TB caused by strains resistant to isoniazid and rifampin. […] BCG vaccination of health care workers should be considered on an individual basis in settings in which […] A high percentage of TB patients are infected with M. tuberculosis strains resistant to both isoniazid and rifampin; […] There is ongoing transmission of such drug-resistant M. tuberculosis strains to health care workers and subsequent infection is likely; or […] Comprehensive TB infection-control precautions have been implemented, but have not been successful. […] BCG vaccination should not be given to persons who are immunosuppressed (e.g., persons who are HIV infected) or who are likely to become immunocompromised (e.g., persons who are candidates for organ transplant).

• #1 Bacille Calmette-Guérin (BCG) Vaccine for Tuberculosis | Tuberculosis (TB) | CDC

  https://www.cdc.gov/tb/hcp/vaccines/index.html

  Bacille Calmette-Gurin (BCG) is a vaccine for tuberculosis (TB) disease. […] The vaccine can cause a false-positive TB skin test reaction. […] The vaccines potential to cause a false-positive TB skin test reaction. […] The BCG vaccine may cause a false-positive TB skin test reaction. There is no reliable way to distinguish a positive TB skin test reaction caused by BCG vaccination from a reaction caused by true TB infection. […] Multiple BCG doses (as practiced in some countries) increases a person’s sensitivity to the TB skin test and the duration of positive TB skin test results after BCG administration. […] TB skin test reactivity caused by BCG vaccine generally wanes with the passage of time, but periodic skin testing may prolong (boost) reactivity in vaccinated people. […] Persons who are immunosuppressed (e.g., persons who have HIV) or who are likely to become immunocompromised (e.g., persons who are candidates for organ transplant) should not receive BCG vaccination. […] Pregnant women should not receive BCG vaccination.

• #1 Tuberculosis Vaccine | Tuberculosis (TB) | CDC

  https://www.cdc.gov/tb/vaccines/index.html

  Bacille Calmette-Gurin (BCG) is a vaccine for tuberculosis (TB) disease. […] The BCG TB vaccine does not always protect people from getting TB. […] The vaccine can cause a false positive TB skin test reaction. […] TB blood tests are the preferred tests for people who have received the BCG TB vaccine.

• #1 FAQs • I am an adult, but I had the BCG vaccine as a child.

  https://www.snohd.org/FAQ.aspx?QID=486

  I am an adult, but I had the BCG vaccine as a child. I should be immune to TB, right? The BCG vaccine protects against childhood TB. It does not protect you as an adult because the effectiveness of the vaccine decreases over time. […] If you were vaccinated with BCG, you may have a positive reaction to a TB skin test and should ask your medical care provider for a TB blood test instead. If your blood test is positive, further testing may be required. […] There are many misconceptions about TB. It is only transmitted through inhaling germs from a person with active TB when they cough, sing, or speak. TB often appears to cluster in families because they spend a lot of time together and share the same air, not because it is inherited.

• #1 Cutaneous tuberculosis (TB)

  https://dermnetnz.org/topics/cutaneous-tuberculosis

  Cutaneous tuberculosis (TB) results from skin infection with Mycobacterium tuberculosis (M. tuberculosis), the same bacterium that causes tuberculosis of the lungs (pulmonary TB). […] BCG vaccination can be complicated by skin infection with the bacillus Calmette-Guerin (BCG), an attenuated strain of M. tuberculosis. […] Cutaneous tuberculosis is nearly always caused by Mycobacterium tuberculosis, the tubercle bacillus. […] The immune response to the tubercle bacillus influences the clinical manifestations of infection. Prior infection with the tubercle bacillus or BCG vaccination results in moderate to high immunity. […] Rarely, infection can occur following use of the BCG bacillus vaccine used to immunise against TB, producing BCG vaccination-induced lupus vulgaris. […] Individuals who are on TNF alpha inhibitors, and infants born to mothers exposed to TNF alpha inhibitors in pregnancy must not receive BCG as they are at risk of developing disseminated BCG infection.

• #1 Health: Infectious Disease Epidemiology & Prevention Division: BCG Vaccine

  https://www.in.gov/health/idepd/tuberculosis/tb-basics/bcg-vaccine/

  BCG vaccination should not be given during pregnancy. Even though no harmful effects of BCG vaccination on the fetus have been observed, further studies are needed to prove its safety. […] The tuberculin skin test (TST) and blood tests to detect TB infection are not contraindicated for persons who have been vaccinated with BCG. […] BCG vaccination may cause a false-positive reaction to the TST, which may complicate decisions about prescribing treatment. […] Treatment of LTBI substantially reduces the risk that TB infection will progress to disease. Careful assessment to rule out the possibility of TB disease is necessary before treatment for LTBI is started.

• #1 BCG Challenge Study of a Novel TB Vaccine (TB045) — The Jenner Institute

  https://www.jenner.ac.uk/volunteer/recruiting-trials/tb045

  Tuberculosis (also known as TB) is a disease caused by a bacterium (Mycobacterium tuberculosis). TB disease remains one of the top fifteen causes of death worldwide. BCG (Bacille Calmette-Gurin) is the only vaccine currently licenced for use against TB, but it is not always protective. […] The BCG vaccine contains bacteria which are still alive but, because they are weakened, they do not cause disease in healthy individuals. […] BCG is a strain of the bacterium that causes infection in cattle. BCG is a live vaccine, meaning the bacteria in the vaccine are still alive but are weakened so that they do not cause TB disease. […] BCG is one of the most widely used vaccines in the world. Several billion people have been given the vaccine over the past 100 years and no serious side effects have been seen in healthy people.

• #1 New TB Vaccine Research

  https://www.who.int/teams/global-tuberculosis-programme/research-innovation/vaccines

  Tuberculosis (TB) is the worlds leading cause of death from a single infectious agent next to coronavirus (COVID-19), and one of the leading causes of death from antimicrobial resistance. […] Neonatal BCG vaccination offers partial protection for infants and young children against severe forms of TB, but it does not protect adolescents and adults, who account for the majority of TB transmission. […] A WHO PPC document for new tuberculosis vaccines was developed to highlight the priority need for vaccines that protect against pulmonary TB in adults, and new TB vaccines with better safety and efficacy characteristic than BCG to administer to neonates and infants. […] Vaccines have the potential to serve as immunotherapeutic adjuncts to antibiotic treatment regimens for TB. […] WHO also convened in Geneva a meeting to generate consensus on the clinical development pathway for the M72/AS01E TB vaccine candidate developed by GSK.

• #1 The Other Pandemic: The Promise of TB Vaccines | International Vaccine Access Center

  https://publichealth.jhu.edu/ivac/the-other-pandemic-the-promise-of-tb-vaccines

  The Bacille Calmette-Gurin (BCG) vaccine is the only vaccine currently available to protect against TB. BCG has been in use for a century and provides critical protection to 100 million newborns globally each year. While the BCG vaccine provides good protection for young children, the vaccines efficacy wanes throughout the lifespan, providing negligible protection to those over 5 years old. TB mainly affects adults, leaving millions vulnerable to the devastating effects of this vaccine-preventable disease. […] To end the TB epidemic, it is critical to develop vaccines that are effective against TB in all age groups. […] New, more effective vaccines are needed to reduce the morbidity and mortality of TB, fight the rising threat of AMR, and address inequities in disease burden and economic impact. The BCG vaccine does not adequately protect older children, adolescents, and adults against TB, and continuing to neglect these populations will only exacerbate this growing crisis. […] There are at least 16 new TB vaccines currently in development, but significant funding is needed to push these new vaccines through the research pipeline.

• #1 New TB Vaccine Research

  https://www.who.int/teams/global-tuberculosis-programme/research-innovation/vaccines

  WHO-commissioned a full value assessment for new TB vaccines to provide early evidence for national and global decision-makers involved in TB vaccine development and implementation, who include stakeholders involved in vaccine research, financing, regulation and policy-making, manufacturing, introduction and procurement. […] WHOs Director-General established a TB vaccine accelerator Council in 2023 to facilitate the development, testing, authorization, and use of new TB vaccines, drawing on lessons learned from the response to the COVID-19 pandemic.

• #1 New, Safer, TB Vaccine with BCG

  https://www.genengnews.com/topics/infectious-diseases/new-safer-tb-vaccine-with-bcg-kill-switch-protects-mice-and-monkeys/

  Researchers headed by a team at Pitt University, in collaboration with scientists at Cornell University, have developed a self-destructing, intravenous (i.v.) Bacillus Calmette-Guérin (BCG) vaccine that in preclinical tests provided additional safety and protection against tuberculosis (TB) caused by Mycobacterium tuberculosis (Mtb) in macaque monkeys. […] The in-built safety mechanism—a BCG “kill switch”—in the live, attenuated Mycobacterium bovis strain circumvents the possibility of accidental self-infection with the weakened mycobacteria, which the developers say offers a safe and effective way to combat TB. […] A 2024 World Health Organization report suggested that TB represents the world’s leading infectious disease killer, but despite the ongoing global public health burden of the disease, safe and effective protection strategies against the infection are lacking, the authors suggested. BCG vaccine—named for its developers—contains inactivated mycobacteria that infect cattle and remains the only vaccination strategy against the infection in humans. Injected into the skin, it provides only partial protection against TB in young children and no protection in adults.

• #1 TB prevention has relied on the same vaccine for 100 years. It’s time for innovation

  https://theconversation.com/tb-prevention-has-relied-on-the-same-vaccine-for-100-years-its-time-for-innovation-164735

  The BCG vaccine is very effective at protecting against TB meningitis and is a great example of how vaccines can be of huge benefit. […] However, this immunity usually wanes in adolescence and thereafter. Protection by BCG in adults is highly variable ranging from 0% to 80% depending on the country and environment. […] The first is a study that demonstrates that re-vaccination with BCG does indeed provide protection against TB disease. […] The second comes from a study that demonstrates a new vaccine from GSK (M72/AS01E) gave good protection in a clinical trial setting.

• #2 BCG / TB vaccine – Information for health professionals – Public Health Wales

  https://phw.nhs.wales/topics/immunisation-and-vaccines/vaccines-professionals/bcg-tb-vaccine-information-for-health-professionals/

  Human tuberculosis (TB) is caused by infection with bacteria of the Mycobacterium tuberculosis complex (M. tuberculosis, M. bovis, M. africanum or M.microti) and may affect almost any part of the body, the most common form is pulmonary TB. […] The symptoms of TB are varied and depend on the site of infection. […] Pulmonary TB typically causes a persistent productive cough, which may be accompanied by blood streaked sputum or, more rarely, frank haemoptysis. […] Untreated, TB in most otherwise healthy adults is a slowly progressive disease that may eventually be fatal. […] BCG vaccine must be administered strictly intradermally, normally into the lateral aspect of the left upper arm at the level of the insertion of the deltoid muscle (just above the middle of the left upper arm as recommended by WHO). […] More information about the vaccine: Tuberculosis: the green book, chapter 32 – GOV.UK. […] Bacillus Calmette-Gurin Vaccine (BCG) / TB vaccine.

• #2 New TB Vaccine Research

  https://www.who.int/teams/global-tuberculosis-programme/research-innovation/vaccines

  Tuberculosis (TB) is the worlds leading cause of death from a single infectious agent next to coronavirus (COVID-19), and one of the leading causes of death from antimicrobial resistance. […] Neonatal BCG vaccination offers partial protection for infants and young children against severe forms of TB, but it does not protect adolescents and adults, who account for the majority of TB transmission. […] A WHO PPC document for new tuberculosis vaccines was developed to highlight the priority need for vaccines that protect against pulmonary TB in adults, and new TB vaccines with better safety and efficacy characteristic than BCG to administer to neonates and infants. […] Vaccines have the potential to serve as immunotherapeutic adjuncts to antibiotic treatment regimens for TB. […] WHO also convened in Geneva a meeting to generate consensus on the clinical development pathway for the M72/AS01E TB vaccine candidate developed by GSK.

• #2 BCG Challenge Study of a Novel TB Vaccine (TB045) — The Jenner Institute

  https://www.jenner.ac.uk/volunteer/recruiting-trials/tb045

  Tuberculosis (also known as TB) is a disease caused by a bacterium (Mycobacterium tuberculosis). TB disease remains one of the top fifteen causes of death worldwide. BCG (Bacille Calmette-Gurin) is the only vaccine currently licenced for use against TB, but it is not always protective. […] The BCG vaccine contains bacteria which are still alive but, because they are weakened, they do not cause disease in healthy individuals. […] BCG is a strain of the bacterium that causes infection in cattle. BCG is a live vaccine, meaning the bacteria in the vaccine are still alive but are weakened so that they do not cause TB disease. […] BCG is one of the most widely used vaccines in the world. Several billion people have been given the vaccine over the past 100 years and no serious side effects have been seen in healthy people.

• #2 The double-sided effects of Mycobacterium Bovis bacillus Calmette–Guérin vaccine | npj Vaccines

  https://www.nature.com/articles/s41541-020-00278-0

  BCG internalized by DCs can live up to 2 weeks inside these cells, triggering the upregulation of costimulatory molecules and the production of immune-polarizing cytokines. […] Activated CD4+ and CD8+ T cells produce high levels of IFN-, which ultimately increases the anti-mycobacterial activity of macrophages. […] An increasing number of studies have suggested that BCG vaccination can exert non-specific protective effects to prevent diseases other than TB, and that BCG may be used as a therapeutic agent to modulate the cellular immune response in treating bladder cancer.

• #2 TB vaccine candidate provides ‘elite’ protection – Texas Biomed

  https://www.txbiomed.org/news-press/news/tb-vaccine-candidate-provides-elite-protection/

  A tuberculosis vaccine candidate under development at Texas Biomed shows complete protection and superior immune response in nonhuman primates compared to the existing BCG vaccine. […] The only licensed vaccine on the market – the Bacille Calmette-Guerin (BCG) vaccine – was invented more than 100 years ago and its effectiveness is limited in adults. […] The delta sigH vaccine resulted in a much higher recruitment of critical B and T immune cells to the airways. Importantly, this did not result in excessive, harmful inflammation. Rather, a cascade of responses led to a more balanced and effective elimination of the bacteria. […] Notably, the delta sigH group had much lower levels of IDO, a protein known to cause more inflammation and make it difficult for the immune system to combat TB, compared to the BCG group.

• #2 Definition of BCG vaccine – NCI Dictionary of Cancer Terms – NCIFacebookFollow on XInstagramYoutubeLinkedin

  https://www.cancer.gov/publications/dictionaries/cancer-terms/def/bcg-vaccine

  A vaccine used to prevent tuberculosis (TB) in people who are at a high risk of TB or where TB is common. […] It is made from a weakened form of a bacterium called Mycobacterium bovis (bacillus Calmette-Guérin), which is similar to the bacteria that cause TB. […] The vaccine may help the body’s immune system make antibodies to destroy the TB bacteria.

• #2

  https://microrao.com/micronotes/bcg.htm

  BCG vaccinations greatest utility appears to be in the prevention of meningeal and miliary TB in children. […] Multiple field trials have failed to conclusively demonstrate protective efficacy of BCG against uncomplicated TB. […] BCG does not protect from infection by M. tuberculosis. […] It is not effective in preventing reactivation tuberculosis.

• #2

  https://www.gov.uk/government/publications/tb-bcg-and-your-baby-leaflet/tb-bcg-vaccine-and-your-baby

  Most people who have TB infection will never develop TB disease. […] In other people (for example, those who have weak immune systems), the TB germ may become active and cause TB disease. […] In the UK, like many other countries, BCG is offered to babies who are likely to spend time with someone with TB. […] This includes babies who live in an area with high rates of TB or babies with parents or grandparents from a country with high rates of TB.

• #2 Is There a Vaccine for Tuberculosis (TB)?

  https://www.healthline.com/health/is-there-a-vaccine-for-tb

  In countries where TB is common, BCG is mainly used to protect against two types of severe TB in infants and young children: TB meningitis and disseminated TB. […] Against these types of TB, BCG provides up to 80% protection. […] However, this protection doesnt last forever. A 2022 study found that BCG vaccination at birth only provided significant protection against any type of TB to children under 5 years old. It was not effective for older children and adults. […] A 2016 study looked into the effectiveness of BCG in protecting against pulmonary (lung) TB. Researchers found that vaccine effectiveness against this specific type of TB became statistically insignificant 20 years after vaccination. […] As you may have noticed, the vaccine effectiveness estimates for BCG in adults are highly variable. According to one 2021 review of research, studies have found that the effectiveness of BCG in adults has ranged from zero to 80%.

• #2 Reasons for TB vaccination failure unravelled | New Scientist

  https://www.newscientist.com/article/dn1918-reasons-for-tb-vaccination-failure-unravelled/

  The existing vaccine for tuberculosis is a gamble sometimes it works, sometimes it doesnt. […] TB is caused by a bacterium that spreads through the air and infects the lungs. […] The standard vaccine, developed in the 1920s, is a weakened strain of Mycobacterium bovis, the bacterium that gives cattle TB. The jab is called Bacillus Calmette-Gurin, or BCG. While the vaccine has saved millions of lives, it still fails to prevent TB in as many as 80 per cent of the people who get the shots. […] Through experiments on mice, his team has pinned the blame on weaker relatives of Mycobacterium tuberculosis, the bug that causes TB in people. […] Essentially, they immunise people against BCG, says Andersen, by preventing the BCG vaccine from multiplying inside the body. But these related bacteria dont themselves trigger enough immunity to protect against TB.

• #2 Tuberculosis | The Australian Immunisation Handbook

  https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/tuberculosis

  Tuberculosis is caused by the bacterium Mycobacterium tuberculosis. Most people who become infected with M. tuberculosis have latent tuberculosis infection, which means they are not ill and not infectious. People with tuberculosis disease, in contrast, are ill and usually infectious. […] BCG (bacille Calmette–Guérin) vaccine is recommended for: Aboriginal and Torres Strait Islander children aged <5 years in some parts of Australia, Healthcare workers with a high risk of exposure to tuberculosis, Young children who will be travelling to settings with high tuberculosis incidence, Some children born to parents from countries with high tuberculosis incidence, Young children who are a household contact of a person with leprosy. [...] The World Health Organization considers tuberculosis a global emergency. BCG vaccine is recommended for those at highest risk of severe outcomes of tuberculosis.

• #2 BCG vaccine for tuberculosis (TB) – NHS

  https://www.nhs.uk/vaccinations/bcg-vaccine-for-tuberculosis-tb/

  You may need the BCG vaccine if you’re at risk of getting TB because of your work, for example: you’re a health worker who works with people with TB. […] You may need the BCG vaccine if you’ve come to live in the UK from sub-Saharan Africa or a country where there is a very high risk of getting TB. […] The BCG vaccine is not given to: anyone who has TB or has had it before you can have a test to check this if needed. […] The BCG vaccine is given as an injection into the upper part of your left arm. You only need 1 dose. […] If the test shows you’re likely to have TB or have had it before, you should not have the BCG vaccine. […] The main side effect of the BCG vaccine is a blister where the injection was given. […] More serious side effects are rare and include: a severe allergic reaction (anaphylaxis) the person who vaccinates you will be trained to deal with allergic reactions and treat them immediately.

• #2 BCG Vaccine (TB vaccine) | Vaccine Knowledge Project

  https://vaccineknowledge.ox.ac.uk/bcg-vaccine

  This vaccine gives protection against tuberculosis (TB) infection, a disease spread person to person through the air. […] The BCG vaccine does not work well in adults, although adults aged 35 or under may also be offered the vaccine if their job has a high risk of contact with people or animals infected with TB. […] The BCG vaccine used in the UK contains strains of a bacterium closely related to the one that causes TB in humans. The bacterium used for the vaccine is called Mycobacterium bovis, which causes TB in animals such as cows and badgers. […] The BCG vaccine is given just under the skin (intradermally), usually in the left upper arm. This is the recommended site, so that small scar left after vaccination can be easily found in the future as evidence of previous vaccination. […] The vaccine is 70-80% effective against the most severe forms of TB, such as TB meningitis. However, it is less effective in preventing the form of TB that affects the lungs.

• #2 Bacille Calmette-Guérin (BCG) Vaccine for Tuberculosis | Tuberculosis (TB) | CDC

  https://www.cdc.gov/tb/hcp/vaccines/index.html

  Bacille Calmette-Gurin (BCG) is a vaccine for tuberculosis (TB) disease. […] The vaccine can cause a false-positive TB skin test reaction. […] The vaccines potential to cause a false-positive TB skin test reaction. […] The BCG vaccine may cause a false-positive TB skin test reaction. There is no reliable way to distinguish a positive TB skin test reaction caused by BCG vaccination from a reaction caused by true TB infection. […] Multiple BCG doses (as practiced in some countries) increases a person’s sensitivity to the TB skin test and the duration of positive TB skin test results after BCG administration. […] TB skin test reactivity caused by BCG vaccine generally wanes with the passage of time, but periodic skin testing may prolong (boost) reactivity in vaccinated people. […] Persons who are immunosuppressed (e.g., persons who have HIV) or who are likely to become immunocompromised (e.g., persons who are candidates for organ transplant) should not receive BCG vaccination. […] Pregnant women should not receive BCG vaccination.

• #2

  https://journals.lww.com/joms/fulltext/2018/38050/bacille_calmette_guerin_lymphadenitis_in_infants_.8.aspx

  Bacille CalmetteGuerin (BCG) vaccine containing live-attenuated Mycobacterium bovis was first used in humans to prevent tuberculosis (TB) in 1921. […] BCG-induced lymphadenitis is the most common complication of BCG vaccination. […] BCG vaccination is done by intradermal inoculation of 0.05 ml vaccine at left deltoid region (In India). […] Reported incidence of BCG vaccine-related complications varies from 0.1% to 17% in different studies worldwide. BCG-related lymphadenitis is the most common complication of BCG vaccination. […] The term BCG lymphadenitis applies when lymph node(s) have become large enough to be easily palpable and a cause of concern for the parents, likely with a diameter to 1 cm. […] Disseminated BCG infection is the most serious complication of BCG vaccination.

• #2 Tice BCG Vaccine Side Effects: Common, Severe, Long Term

  https://www.drugs.com/sfx/tice-bcg-vaccine-side-effects.html

  Bacillus of Calmette and Guérin (BCG) infections have been reported in health care workers and in patients because of exposure to the vaccine during preparation and administration. […] Serious and fatal disseminated BCG infections have occurred with intravesical administration. […] Uncommon (0.1% to 1%): Tuberculosis infections. […] Very rare (less than 0.01%): Disseminated BCG infection.

• #2 TB vaccine: WHO expert explains why it’s taken 100 years for a scientific breakthrough, and why it’s such a big deal

  https://theconversation.com/tb-vaccine-who-expert-explains-why-its-taken-100-years-for-a-scientific-breakthrough-and-why-its-such-a-big-deal-215411

  These adverse events include a rare but life threatening condition known as disseminated BCG disease. […] The effectiveness of BCG can vary depending on several factors, including the prevalence of TB in a given area, the strain of the BCG vaccine used, and the age at which BCG was administered. […] The BCG vaccine will not be replaced by another TB vaccine until and unless there is compelling data on the safety and efficacy of an alternative. […] In addition, BCG vaccination has nonspecific beneficial effects on overall mortality and leads to more reductions in child mortality than would be expected by just protecting against tuberculosis.

• #2 The double-sided effects of Mycobacterium Bovis bacillus Calmette–Guérin vaccine | npj Vaccines

  https://www.nature.com/articles/s41541-020-00278-0

  Bacillus CalmetteGurin (BCG), the only vaccine proven to be effective against tuberculosis (TB), is the most commonly used vaccine globally. […] Although BCG was specifically developed as a vaccine for TB, numerous studies have shown that BCG has the ability to induce the so-called Non-Specific Effects (NSEs) that provide effective protection against other infectious diseases. […] Clinical evidence also suggests that BCG may be effective against infections caused by viral pathogens, such as respiratory syncytial virus, human papilloma virus, and herpes simplex virus. […] Remarkably, BCG can be used as an expression vector for recombinant antigens to develop novel vaccines for pathogenic bacteria and viruses, as well as for cancer immunotherapy. […] As a complex vaccine consisting live-attenuated mycobacterium, BCG causes local infection and immune activation at the site of administration, where resident monocytes, macrophages, and dendritic cells (DCs) interact with the bacillus.

• #2 New TB Vaccine Research

  https://www.who.int/teams/global-programme-on-tuberculosis-and-lung-health/research-innovation/vaccines

  Tuberculosis (TB) is the worlds leading cause of death from a single infectious agent next to coronavirus (COVID-19), and one of the leading causes of death from antimicrobial resistance. […] Neonatal BCG vaccination offers partial protection for infants and young children against severe forms of TB, but it does not protect adolescents and adults, who account for the majority of TB transmission. […] A WHO PPC document for new tuberculosis vaccines was developed to highlight the priority need for vaccines that protect against pulmonary TB in adults, and new TB vaccines with better safety and efficacy characteristic than BCG to administer to neonates and infants. […] Vaccines have the potential to serve as immunotherapeutic adjuncts to antibiotic treatment regimens for TB. […] A therapeutic vaccine for TB patients, administered towards completion of a prescribed course of drug therapy or at certain time(s) during treatment, could improve outcomes through immune-mediated control and clearance of bacteria and prevention of re-infection, and provide on the long-term options to simplify and shorten drug treatment regimen.

• #2 New TB Vaccine Research

  https://www.who.int/teams/global-programme-on-tuberculosis-and-lung-health/research-innovation/vaccines

  WHO also convened in Geneva a meeting to generate consensus on the clinical development pathway for the M72/AS01E TB vaccine candidate developed by GSK. […] WHO-commissioned a full value assessment for new TB vaccines to provide early evidence for national and global decision-makers involved in TB vaccine development and implementation, who include stakeholders involved in vaccine research, financing, regulation and policy-making, manufacturing, introduction and procurement. […] The Council is anticipated to work in multiple ways. These include identifying needs for, and types of innovative sustainable financial solutions, as well as partnerships between the public, private and philanthropic sectors that can expedite the translation of science into TB vaccines, and ensure their equitable access once available.

• #2 New, Safer, TB Vaccine with BCG

  https://www.genengnews.com/topics/infectious-diseases/new-safer-tb-vaccine-with-bcg-kill-switch-protects-mice-and-monkeys/

  “BCG has probably been administered to more humans than any other vaccine and is generally safe,” the team wrote. “BCG protects children against disseminated TB and TB meningitis but is only partially protective against pulmonary TB.” […] To improve the safety of iv. BCG delivery, in the newly reported study the researchers engineered two built-in mechanisms that instruct the BCG particles to lyse either upon exposure to the antibiotic doxycycline, or when chronic doxycycline treatment is stopped. […] Mouse experiments showed that the BCG vaccine containing this dual safety switch protected the animals against TB comparable to a standard (wild type; WT) BCG vaccination, but had the added benefit of faster elimination and safety, even for mice that were immunocompromised. […] In macaque monkeys, the updated self-destructing BCG vaccine caused an even stronger immune response and better protection against TB than a standard intravenously administered BCG injection.

• #3 Reasons for TB vaccination failure unravelled | New Scientist

  https://www.newscientist.com/article/dn1918-reasons-for-tb-vaccination-failure-unravelled/

  Paul Fine, professor of communicable disease epidemiology at the London School of Hygiene and Tropical Medicine, says that the paper comes up with the best evidence yet that prior exposure to related bacteria nullifies BCG. […] The good news is that new vaccines made from fragments of dead TB bacteria did protect the pre-infected mice from TB. Unlike the live BCG vaccines, these inanimate assemblies dont need to multiply in the body to be effective.

• #3 History and Modern Use of the Tuberculosis Vaccine

  https://www.verywellhealth.com/tuberculosis-vaccine-7089756

  The BCG vaccine may be considered for children and adults with a high risk of tuberculosis exposure. Examples include healthcare workers and children who are regularly cared for by adults with drug-resistant tuberculosis or untreated TB. […] Evidence of the effectiveness of the tuberculosis vaccine is somewhat mixed. According to a 2022 systematic review and meta-analysis, the BCG vaccine was found to be 18% effective overall in protecting against tuberculosis disease and related complications. […] It is primarily effective in infants and young children. It is, however, very effective in preventing young children from getting severe forms of tuberculosis like tuberculosis meningitis and miliary tuberculosis. […] The BCG vaccine is a live vaccine. It uses a weakened strain of Mycobacterium bovis (M. bovis), a bacterium closely related to the one that causes TB.

• #3 Health: Infectious Disease Epidemiology & Prevention Division: BCG Vaccine

  https://www.in.gov/health/idepd/tuberculosis/tb-basics/bcg-vaccine/

  Are untreated or ineffectively treated for TB disease (if the child cannot be given long-term treatment for infection); or […] Have TB caused by strains resistant to isoniazid and rifampin. […] BCG vaccination of health care workers should be considered on an individual basis in settings in which […] A high percentage of TB patients are infected with M. tuberculosis strains resistant to both isoniazid and rifampin; […] There is ongoing transmission of such drug-resistant M. tuberculosis strains to health care workers and subsequent infection is likely; or […] Comprehensive TB infection-control precautions have been implemented, but have not been successful. […] BCG vaccination should not be given to persons who are immunosuppressed (e.g., persons who are HIV infected) or who are likely to become immunocompromised (e.g., persons who are candidates for organ transplant).

• #3 BCG vaccine | NHS inform

  https://www.nhsinform.scot/healthy-living/immunisation/vaccines/bcg-vaccine/

  The BCG vaccine (Bacillus Calmette-Gurin) helps protect a baby against tuberculosis (TB). […] The BCG vaccine contains a weakened form of the bacteria (germs) that cause TB. The vaccine doesn’t actually cause TB, but it helps a baby develop protection (immunity) against the disease in case they ever come into contact with it. […] The BCG vaccine should also not be given if the baby is suffering from a generalised septic skin condition. Babies with eczema, however, can be given the vaccine in an area without broken skin.

• #3

  https://journals.lww.com/joms/fulltext/2018/38050/bacille_calmette_guerin_lymphadenitis_in_infants_.8.aspx

  Diagnosis of BCG lymphadenitis depends on the history and clinical examination. […] BCG lymphadenitis is often difficult to differentiate from tuberculous lymphadenitis. […] Antimycobacterial drugs cannot prevent suppuration nor shorten the duration of healing, therefore are not recommended. […] Nonsuppurative BCG lymphadenitis is a relatively common benign condition that will regress spontaneously over a matter of weeks to months.

• #3 The double-sided effects of Mycobacterium Bovis bacillus Calmette–Guérin vaccine | npj Vaccines

  https://www.nature.com/articles/s41541-020-00278-0

  BCG internalized by DCs can live up to 2 weeks inside these cells, triggering the upregulation of costimulatory molecules and the production of immune-polarizing cytokines. […] Activated CD4+ and CD8+ T cells produce high levels of IFN-, which ultimately increases the anti-mycobacterial activity of macrophages. […] An increasing number of studies have suggested that BCG vaccination can exert non-specific protective effects to prevent diseases other than TB, and that BCG may be used as a therapeutic agent to modulate the cellular immune response in treating bladder cancer.

• #3 New, Safer, TB Vaccine with BCG

  https://www.genengnews.com/topics/infectious-diseases/new-safer-tb-vaccine-with-bcg-kill-switch-protects-mice-and-monkeys/

  Our data indicate that this ‘kill-switch’ BCG strain induces greater CD4 T-cell responses in lungs and may provide even more robust protection than WT BCG in macaques, the investigators further noted. Sterilizing immunity occurred in 6 of 8 macaques compared with 2 of 8 wild-type BCG-immunized macaques. Thus, a ‘kill-switch’ BCG strain provides additional safety and robust protection against Mtb infection. […] Flynn added, “The live-attenuated form of the mycobacteria does not need to be alive for very long to provide outstanding protection and with this strain, there is essentially no chance for a vaccine-derived infection, even in an immunocompromised host.” […] “We hope that this ‘kill switch’ BCG strain could limit safety concerns over intravenous vaccine administration and provide an option for a safer and more effective vaccination route for individuals who are immunocompromised,” Flynn said.

• #4 Health: Infectious Disease Epidemiology & Prevention Division: BCG Vaccine

  https://www.in.gov/health/idepd/tuberculosis/tb-basics/bcg-vaccine/

  Are untreated or ineffectively treated for TB disease (if the child cannot be given long-term treatment for infection); or […] Have TB caused by strains resistant to isoniazid and rifampin. […] BCG vaccination of health care workers should be considered on an individual basis in settings in which […] A high percentage of TB patients are infected with M. tuberculosis strains resistant to both isoniazid and rifampin; […] There is ongoing transmission of such drug-resistant M. tuberculosis strains to health care workers and subsequent infection is likely; or […] Comprehensive TB infection-control precautions have been implemented, but have not been successful. […] BCG vaccination should not be given to persons who are immunosuppressed (e.g., persons who are HIV infected) or who are likely to become immunocompromised (e.g., persons who are candidates for organ transplant).

• #4 BCG: the history and modern-day uses of the tuberculosis vaccine – Pharmaceutical Technology

  https://www.pharmaceutical-technology.com/features/bcg-vaccine-history-modern-uses-tuberculosis/

  In 1921, the Bacillus Calmette-Gurin (BCG) tuberculosis vaccine was first administered to a human. The vaccine was developed by French scientists Albert Calmette and Camille Gurin to protect against tuberculosis of the lungs, a leading cause of death in the early 1900s. […] German physician and microbiologist Robert Koch first identified Mycobacterium tuberculosis (M. tuberculosis) as the cause of tuberculosis infection in the 19th century. […] The tuberculosis vaccine has been found to offer some protection against leprosy and Buruli ulcer, other diseases also caused by mycobacteria. […] The protective effect of BCG against leprosy an infectious disease that can lead to damage of the nerves, respiratory tract, skin and eyes ranges between 20% and 80%, according to the WHO. […] Over 20 clinical trials are currently taking place to investigate whether the BCG jab could be repurposed to protect against Covid-19, or reduce the risk of severe lung damage from the virus. […] One study by researchers at the Indian Council of Medical Researchs National Institute for Research in Tuberculosis has suggested that the vaccine could reduce Covid-induced inflammation in elderly people.

• #4 New TB Vaccine Research

  https://www.who.int/teams/global-programme-on-tuberculosis-and-lung-health/research-innovation/vaccines

  Tuberculosis (TB) is the worlds leading cause of death from a single infectious agent next to coronavirus (COVID-19), and one of the leading causes of death from antimicrobial resistance. […] Neonatal BCG vaccination offers partial protection for infants and young children against severe forms of TB, but it does not protect adolescents and adults, who account for the majority of TB transmission. […] A WHO PPC document for new tuberculosis vaccines was developed to highlight the priority need for vaccines that protect against pulmonary TB in adults, and new TB vaccines with better safety and efficacy characteristic than BCG to administer to neonates and infants. […] Vaccines have the potential to serve as immunotherapeutic adjuncts to antibiotic treatment regimens for TB. […] A therapeutic vaccine for TB patients, administered towards completion of a prescribed course of drug therapy or at certain time(s) during treatment, could improve outcomes through immune-mediated control and clearance of bacteria and prevention of re-infection, and provide on the long-term options to simplify and shorten drug treatment regimen.

• #5 Health: Infectious Disease Epidemiology & Prevention Division: BCG Vaccine

  https://www.in.gov/health/idepd/tuberculosis/tb-basics/bcg-vaccine/

  BCG vaccination should not be given during pregnancy. Even though no harmful effects of BCG vaccination on the fetus have been observed, further studies are needed to prove its safety. […] The tuberculin skin test (TST) and blood tests to detect TB infection are not contraindicated for persons who have been vaccinated with BCG. […] BCG vaccination may cause a false-positive reaction to the TST, which may complicate decisions about prescribing treatment. […] Treatment of LTBI substantially reduces the risk that TB infection will progress to disease. Careful assessment to rule out the possibility of TB disease is necessary before treatment for LTBI is started.

• #5 Study: TB Vaccine Linked to Lower Risk of COVID-19

  https://www.cedars-sinai.org/newsroom/study-tb-vaccine-linked-to-lower-risk-of-contracting-covid-19/

  A widely used tuberculosis vaccine is associated with reduced likelihood of contracting COVID-19 (coronavirus), according to a new study by Cedars-Sinai. […] The vaccine, known as Bacillus Calmette-Gurin (BCG), was developed between 1908 and 1921 and is administered to more than 100 million children around the world every year. […] They found that workers who had received BCG vaccinations in the past nearly 30% of those studied were significantly less likely to test positive for SARS-CoV-2 antibodies in their blood or to report having had infections with coronavirus or coronavirus-associated symptoms over the prior six months than those who had not received BCG. […] „We were interested in studying the BCG vaccine because it has long been known to have a general protective effect against a range of bacterial and viral diseases other than TB, including neonatal sepsis and respiratory infections.”

• #5 Understanding the Mechanisms of Intravenous BCG-Induced Protection Against Tuberculosis in Nonhuman Primates (TB Vaccine) | FNIH

  https://fnih.org/our-programs/understanding-the-mechanisms-of-intravenous-bcg-induced-protection-against-tuberculosis-in-nonhuman-primates-tb-vaccine/

  The BCG vaccine is the only vaccine currently approved for use in infants to prevent TB. […] The need for an effective TB vaccine is urgent. […] Researchers are exploring alternative, more effective methods to deliver the vaccine to patients. […] TB Vaccine Researchers will study the effects of using a new intravenous (IV) delivery method for the BCG vaccine to treat TB. […] This method may better activate T cells (white blood cells) that help trigger an important, long-term immune response in the lungs to prevent TB.

• #6 Efficacy of the BCG Tuberculosis Vaccine: Time for Change? – European Medical Journal

  https://www.emjreviews.com/respiratory/news/efficacy-of-the-bcg-tuberculosis-vaccine-time-for-change/

  LONGITUDINAL study data reveals that immune protection following the bacille CalmetteGurin (BCG) tuberculosis (TB) vaccine wanes after 5 years. […] The results showed that following vaccination in infancy, immunoprotection against TB wanes after 5 years of age. In terms of efficacy, the BCG vaccine was found to be 37% effective in children under 5 years of age and showed no conclusive evidence of protection in persons over 10 years of age. […] However, the authors reported that due to the waning protective immunity offered by the BCG vaccine with age, a BCG booster vaccination should be offered to adults and children over 10 years of age. […] This study highlights that booster vaccines should be considered in those over 10 years of age, and that there is a need for improved TB vaccines that can offer longer protection and support vaccination programmes in endemic areas.

• #7 TB prevention has relied on the same vaccine for 100 years. It’s time for innovation

  https://theconversation.com/tb-prevention-has-relied-on-the-same-vaccine-for-100-years-its-time-for-innovation-164735

  The BCG vaccine is very effective at protecting against TB meningitis and is a great example of how vaccines can be of huge benefit. […] However, this immunity usually wanes in adolescence and thereafter. Protection by BCG in adults is highly variable ranging from 0% to 80% depending on the country and environment. […] The first is a study that demonstrates that re-vaccination with BCG does indeed provide protection against TB disease. […] The second comes from a study that demonstrates a new vaccine from GSK (M72/AS01E) gave good protection in a clinical trial setting.

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