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. This activity reviews the mode of action of the BCG vaccine and highlights the role of the interprofessional team in educating patients about tuberculosis prevention. […] Bacillus Calmette-Gurin (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 Gurin 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. It is also used in the treatment of superficial carcinoma of the bladder.

• #2 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. In areas where tuberculosis is not common, only children at high risk are typically immunized, while suspected cases of tuberculosis are individually tested for and treated. Adults who do not have tuberculosis and have not been previously immunized, but are frequently exposed, may be immunized, as well. BCG also has some effectiveness against Buruli ulcer infection and other nontuberculous mycobacterial infections. Additionally, it is sometimes used as part of the treatment of bladder cancer. […] 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 vaccine is injected into the skin. No evidence shows that additional doses are beneficial.

• #3 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. […] In the UK the BCG vaccine is not currently part of the routine childhood schedule, although it is offered to people who are at higher risk of contracting TB. […] 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. […] 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 vaccine should not be given to people who are clinically immunosuppressed (either due to drug treatment or underlying illness). This is because the vaccine strain could replicate too much and cause a serious infection.

• #4 Tuberculosis BCG vaccination

  https://www.healthywa.wa.gov.au/Articles/S_T/Tuberculosis-BCG-Vaccination

  BCG is a vaccine against tuberculosis (TB). It uses a live TB germ that has been modified in the laboratory so that it will not cause disease in a healthy person. […] The BCG vaccination is not part of the WA routine vaccination program it is only given in restricted circumstances. […] BCG vaccination reduces the risk of tuberculosis in people who are not already infected with TB. The vaccine does not always prevent disease. […] It is more effective in children 6yrs old, providing 50 to 80 % protection against meningeal and miliary TB. […] Protection against TB will only start 6-8 weeks after the vaccination has been given and lasts for about 10 years. […] BCG vaccination is not recommended for adults.

• #5 Tuberculosis (TB) Treatment & Management: Approach Considerations, Treatment During Pregnancy, Treatment in Children

  https://emedicine.medscape.com/article/230802-treatment

  Most children with TB can be treated with isoniazid and rifampin for 6 months, along with pyrazinamide for the first 2 months if the culture from the source case is fully susceptible. […] The Bacillus Calmette-Gurin (BCG) vaccine is not recommended in infants in the United States but is commonly used worldwide. […] The BCG vaccine continues to be used worldwide and usually protects early childhood. Immunity begins to wane, however, as early as 3 months after administration. […] In early 2020, Darrah et al reported on the promising efficacy of the BCG vaccine administered intravenously rather than intradermally in macaque monkeys. Intravenous immunization resulted in a significantly more robust T-cell response in lung lymph nodes, blood, spleen, and bronchoalveolar lavage than traditional intradermal immunization. These findings have not been confirmed in human studies.

• #6 BCG Vaccination (Tuberculosis Vaccine) | Doctor

  https://patient.info/doctor/bcg-vaccination

  The live attenuated strain of Mycobacterium bovis known as bacillus Calmette-Gurin (BCG) uses shared antigens to stimulate the development of cross-immunity to Mycobacterium tuberculosis and Mycobacterium leprae. […] BCG vaccine contains a live attenuated strain derived from M. bovis. Studies of the effectiveness of BCG vaccine range from no protection to 70-80% protection. However, the vaccine is 70-80% effective against the most severe forms of the disease, such as TB meningitis in children. It is less effective in preventing respiratory disease, which is the more common form in adults. […] Protection has been shown to last for 10 to 15 years. Data on duration of protection after this time are limited, but protection may wane with time. Although the protection afforded by BCG vaccine may lessen with time, there is no evidence that repeat vaccination offers significant additional protection and repeat BCG vaccination is not recommended.

• #7 Bacille Calmette-Guérin (BCG) vaccine: Canadian Immunization Guide – Canada.ca

  https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-2-bacille-calmette-guerin-vaccine.html

  Bacille Calmette-Gurin (BCG) vaccine efficacy is estimated to be about 51% in preventing any TB disease and up to 78% in protecting newborns from miliary (disseminated) or meningeal TB. […] BCG vaccine is not recommended for routine use in any Canadian population. […] Following consideration of local TB epidemiology and if a program of early detection and treatment of latent TB infection cannot be implemented, BCG vaccination may be considered in exceptional circumstances, such as for infants in high risk communities, for persons at high risk of repeated exposure, for certain long-term travellers to high prevalence countries, and in infants born to mothers with infectious TB disease. […] Clinical trials have demonstrated conflicting results regarding BCG vaccine’s efficacy. Meta-analytic reviews have estimated the vaccine efficacy in preventing any TB disease at approximately 51%. The protective effect of BCG vaccine against disseminated TB in the newborn is estimated to be 78%.

• #8 The Tuberculosis Vaccine: Effectiveness, Risks, and More

  https://resources.healthgrades.com/right-care/infections-and-contagious-diseases/tuberculosis-vaccine

  According to the Food and Drug Administration (FDA), vaccine trials report that the BCG vaccine ranges in effectiveness from 0–80%. More recent studies suggest the overall protective effect of BCG against TB infection is 50%, while it may be 70% effective at protecting against some TB complications. […] The BCG vaccine is made from a weakened strain of TB bacteria. […] Introducing this weakened bacteria into your body with a vaccination triggers your immune system to create corresponding antibodies. These antibodies can fight TB bacteria. […] Doctors do not recommend the TB vaccine to everyone. However, it may be recommended to adults who have high exposure to TB, such as healthcare workers and people who work with animals. […] The vaccine is not recommended for people who have allergies to any ingredients of the BCG vaccine, are pregnant, or have weakened immune systems.

• #9 BCG vaccine – Wikipedia

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

  The main use of BCG is for vaccination against tuberculosis. BCG vaccine can be administered after birth intradermally. 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%. […] BCG seems to have its greatest effect in preventing miliary tuberculosis or tuberculosis meningitis, so it is still extensively used even in countries where efficacy against pulmonary tuberculosis is negligible. […] The BCG vaccine is very efficacious against tuberculous meningitis in the pediatric age group, but its efficacy against pulmonary tuberculosis appears variable. Some countries have removed the BCG vaccine from routine vaccination.

• #10 Vaccine profiles: Tuberculosisverifiedverifiedverifiedverifiedverifiedverifiedverifiedverifiedverifiedverified

  https://www.gavi.org/vaccineswork/routine-vaccines-tuberculosis

  Unfortunately, this protection was shown to wane as children get older and the vaccine provided no protection for adolescents or adults – who account for the bulk of TB infections and disease transmission. The BCG vaccine also doesn’t prevent people from becoming infected with Mycobacterium tuberculosis, meaning it can still spread through communities. To end the TB epidemic, vaccines are needed that are effective against all forms of TB in all age groups, and which prevent transmission of the bacteria that cause it. […] More than 100 years since the first administration of the BCG vaccine, hopes are building that a vaccine that could protect all age groups against all types of TB may finally be in reach. Humans have been fighting this ancient pathogen for millennia, but it seems the battle may finally be swinging in our favour.

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

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

  The BCG vaccine is given as an injection into the upper part of your left arm. You only need 1 dose. […] Some children and adults need to have a skin test (called the tuberculin skin test or Mantoux test) a few days before having the BCG vaccine. […] 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. […] Other side effects of the BCG vaccine are uncommon and usually mild.

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

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

  The BCG vaccination is now given when the SCID screening outcome is available, which is approximately 14 to 17 days after birth, so that those with this rare condition can be identified and treated early. […] 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. […] This is to ensure that babies with SCID are not given the live attenuated BCG vaccine, which could result in severe side-effects as all live vaccines are not advised (contraindicated) in babies with a SCID diagnosis.

• #13 BCG vaccine Uses, Side Effects & Warnings

  https://www.drugs.com/mtm/bcg-vaccine.html

  BCG vaccine is used to help prevent tuberculosis (TB) in adults and children who have never had this disease and test negative for tuberculosis. […] This vaccine helps your body develop immunity to the TB, but will not treat an active infection you already have. […] BCG vaccine may also be used for purposes not listed in this medication guide. […] You should not receive this vaccine if you have a weak immune system caused by disease such as HIV or cancer, or by using steroids or receiving chemotherapy or radiation. […] You should not receive BCG vaccine if you are allergic to it, or if you have a weak immune system caused by: HIV or AIDS; leukemia, lymphoma, or other cancers; chemotherapy or radiation; or steroid medication. […] BCG vaccine is not given with a needle and syringe, as most other vaccines are. Instead, the BCG vaccine is a liquid placed directly onto the skin of your upper arm.

• #14 BCG vaccination strategies against tuberculosis: updates and perspectives

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8903987/

  Intravenously (IV) BCG immunization can effectively prevent Mtb infection. As early as the 1970s, IV BCG in rhesus monkeys had been shown to provide more protection compared with other conventional BCG inoculation methods. A study published in 2016 further confirmed that IV immunization could induce the highest IFN spot-forming units and multifunctional CD4 + T cell frequency to reduce disease pathology caused by TB. The latest research has shown that IV administration of BCG could achieve unprecedented levels of protection to resist Mtb infections and diseases in non-human primates (NHP). […] It is hard to imagine that BCG as a 100 years old vaccine has remarkable high protection level against TB after changing vaccination route. Importantly, the limited set of clinical safety parameters measured suggested that IV BCG might be well tolerated in NHP, which indicates that this immunization strategy may have good prospects in human applications.

• #15 Tuberculosis (TB) Treatment & Management: Approach Considerations, Treatment During Pregnancy, Treatment in Children

  https://emedicine.medscape.com/article/230802-treatment

  Most children with TB can be treated with isoniazid and rifampin for 6 months, along with pyrazinamide for the first 2 months if the culture from the source case is fully susceptible. […] The Bacillus Calmette-Gurin (BCG) vaccine is not recommended in infants in the United States but is commonly used worldwide. […] The BCG vaccine continues to be used worldwide and usually protects early childhood. Immunity begins to wane, however, as early as 3 months after administration. […] In early 2020, Darrah et al reported on the promising efficacy of the BCG vaccine administered intravenously rather than intradermally in macaque monkeys. Intravenous immunization resulted in a significantly more robust T-cell response in lung lymph nodes, blood, spleen, and bronchoalveolar lavage than traditional intradermal immunization. These findings have not been confirmed in human studies.

• #16 BCG vaccination strategies against tuberculosis: updates and perspectives

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8903987/

  By improving BCG immunization strategies, new and remarkable immune effects have been demonstrated. This has rekindled the hope of BCG to be more effective against TB. Under the raging of the global Corona Virus Disease 2019 (COVID-19) pandemic in 2020, BCG has also shown its potential to be protective against COVID-19, which has reignited the research interest in it. […] Therefore, it is extremely necessary to summarize and update the immunization strategies based on BCG vaccination against TB to provide guidance and inspiration for future research. […] The immunogenicity and immuno-protection level of BCG may be improved to some extent by changing the administration route. In recent years, the research of BCG mucosal delivery and intravenous injection has produced satisfactory results, revealed the importance of immune approaches on the immune response, and also provided a paradigm shift in TB vaccine research.

• #17 Bacillus Calmette Guerin (BCG Therapy) – MD Searchlight

  https://mdsearchlight.com/oncology-2/bacillus-calmette-guerin-bcg-therapy/

  The Bacillus Calmette-Gurin (BCG) vaccine is a type of vaccine thats given to protect against tuberculosis, a serious lung disease, and other similar infections. […] The BCG vaccine is typically given either directly under the skin or in-between layers of the skin. Researchers are currently investigating if it might be more effective to give the vaccine through the respiratory system. This is because the bacteria that causes tuberculosis typically infects humans through the respiratory system. […] The BCG vaccine, which fights against tuberculosis (TB) a severe lung infection, is recommended for various groups of people: […] In addition to preventing TB, the BCG vaccine can also be used to treat some non-invasive forms of bladder cancer. The vaccine, containing a strain of bacteria called M. bovis bacillus Calmette-Gurin, is administered directly into the bladder where it can help delay and prevent the growth of cancer cells.

• #18 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). […] 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. […] You only need to have the BCG vaccine once. […] The BCG vaccine is recommended for children aged 1 to 16 if any of the following apply: they have a parent or grandparent born in a country where there is a higher risk of getting TB; they were born or lived for at least 3 months in a country where there is a higher risk of getting TB; they have been living with, or in regular close contact with, someone who has or had TB.

• #19 BCG Vaccination (Tuberculosis Vaccine) | Doctor

  https://patient.info/doctor/bcg-vaccination

  The live attenuated strain of Mycobacterium bovis known as bacillus Calmette-Gurin (BCG) uses shared antigens to stimulate the development of cross-immunity to Mycobacterium tuberculosis and Mycobacterium leprae. […] BCG vaccine contains a live attenuated strain derived from M. bovis. Studies of the effectiveness of BCG vaccine range from no protection to 70-80% protection. However, the vaccine is 70-80% effective against the most severe forms of the disease, such as TB meningitis in children. It is less effective in preventing respiratory disease, which is the more common form in adults. […] Protection has been shown to last for 10 to 15 years. Data on duration of protection after this time are limited, but protection may wane with time. Although the protection afforded by BCG vaccine may lessen with time, there is no evidence that repeat vaccination offers significant additional protection and repeat BCG vaccination is not recommended.

• #20 Bacillus Calmette-Guerin (BCG) Vaccine – Green Valley Orthopedics

  https://gvortho.com/patient-information/patient-education/health-library?DOCHWID=a682809

  BCG vaccine provides immunity or protection against tuberculosis (TB). The vaccine may be given to persons at high risk of developing TB. […] When the vaccine is given to protect against TB, it usually is given only one time but may be repeated if there is not a good response in 2-3 months. Response is measured by a TB skin test.

• #21 BCG vaccination strategies against tuberculosis: updates and perspectives

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8903987/

  Bacillus Calmette-Gurin (BCG) is the only licensed vaccine against tuberculosis (TB). However, BCG has variable efficacy and cannot completely prevent TB infection and transmission. Therefore, the worldwide prevalence of TB calls for urgent development of a more effective TB vaccine. In the absence of other approved vaccines, it is also necessary to improve the efficacy of BCG itself. Intravenous (IV) BCG administration and BCG revaccination strategies have recently shown promising results for clinical usage. Therefore, it is necessary for us to revisit the BCG vaccination strategies and summarize the current research updates related to BCG vaccination. This literature review provides an updated overview and perspectives of the immunization strategies against TB using BCG, which may inspire the following research on TB vaccine development.

• #22 BCG vaccination strategies against tuberculosis: updates and perspectives

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8903987/

  The immune effect of BCG will be affected by the infection status. This is one of the reasons for the variable immune effect of BCG. Therefore, it is very important to see whether BCG revaccination will be affected by the Mtb infection status, since approximately just under a quarter of the global population are latent tuberculosis infection (LTBI) patients in 2014. […] The protectiveness of BCG revaccination against Mtb infection in LTBI patients still needs further research.

• #23 BCG Treatment: What It Is, Procedure & Side Effects

  https://my.clevelandclinic.org/health/treatments/17908-bacillus-calmette-guerin-bcg-treatment

  Bacillus Calmette-Guerin (BCG) treatment is a type of intravesical (in your bladder) immunotherapy. This liquid drug is made from a strain of Mycobacterium bovis the same bacterium used to create the tuberculosis vaccine. When used in medicine, Mycobacterium bovis is weakened to reduce harm to your body. […] BCG treatment is used to address early-stage bladder cancer. This includes bladder cancers that haven’t invaded your bladder wall muscle, like carcinoma in situ (in its original location) bladder cancers and non-muscle invasive bladder cancers (NMIBCs). BCG treatment isn’t effective against bladder cancer that has metastasized (spread to other parts of your body). […] BCG cancer treatment can slow tumor growth and reduce your chance of needing a cystectomy in the future. […] BCG sepsis (a tuberculosis-like illness that can happen if BCG solution enters your bloodstream) […] For people with early-stage bladder cancer, BCG cancer treatment is the go-to approach.

• #24 BCG into the bladder for non muscle invasive bladder cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/bladder-cancer/treatment/non-muscle-invasive/bcg

  BCG is a vaccine for tuberculosis (TB). It is also helps to stop or delay bladder cancers growing back or spreading into the deeper layers of the bladder. […] BCG helps to stop bladder cancers coming back in many people. […] You have a course of BCG after surgery to remove the bladder tumours (TURBT). […] You usually have BCG into the bladder once a week for 6 weeks. This is called the induction course. […] You may then have BCG into the bladder every few weeks or months for the next 1 to 3 years. This is called maintenance BCG therapy. […] There is a very small chance that some of the BCG could get into your system. This causes an infection similar to TB, which needs treatment. This rare side effect could happen during or some months after treatment.

• #25 Bacillus Calmette-Guérin (BCG) Therapy for Bladder Cancer | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/bladder/treatment/bacillus-calmette-guerin-therapy

  Bacillus Calmette-Gurin (BCG) therapy is a type of immunotherapy that treats bladder tumors. Its the most common kind of intravesical immunotherapy used to treat early-stage bladder cancer. […] The BCG in this drug is inactivated tuberculosis (TB) bacteria made from a type of Mycobacterium bovis. This is a liquid drug that goes into your bladder through a catheter (small tube) placed in your urethra. BCG triggers an inflammatory response in your bladder that stops the tumor from coming back. […] MSK offers BCG treatment is an alternative to chemotherapy for high grade non-muscle invasive bladder cancer (NMIBC). People often come to MSK for BCG treatment after their healthcare provider offered chemotherapy as the only treatment option. […] This liquid drug is given through a catheter into the bladder. You will get this treatment once a week, for 6 weeks. You will get inactivated tuberculosis (TB) bacteria through a catheter (small tube) placed in your urethra. […] Some early-stage bladder cancers dont respond to BCG therapy. If bladder cancer returns, we may recommend other drugs, including chemotherapy drugs. They also are given through your urethra.

• #26 BCG into the bladder for non muscle invasive bladder cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/bladder-cancer/treatment/non-muscle-invasive/bcg

  BCG is a vaccine for tuberculosis (TB). It is also helps to stop or delay bladder cancers growing back or spreading into the deeper layers of the bladder. […] BCG helps to stop bladder cancers coming back in many people. […] You have a course of BCG after surgery to remove the bladder tumours (TURBT). […] You usually have BCG into the bladder once a week for 6 weeks. This is called the induction course. […] You may then have BCG into the bladder every few weeks or months for the next 1 to 3 years. This is called maintenance BCG therapy. […] There is a very small chance that some of the BCG could get into your system. This causes an infection similar to TB, which needs treatment. This rare side effect could happen during or some months after treatment.

• #27 BCG Treatment: What It Is, Procedure & Side Effects

  https://my.clevelandclinic.org/health/treatments/17908-bacillus-calmette-guerin-bcg-treatment

  Bacillus Calmette-Guerin (BCG) treatment is a type of intravesical (in your bladder) immunotherapy. This liquid drug is made from a strain of Mycobacterium bovis the same bacterium used to create the tuberculosis vaccine. When used in medicine, Mycobacterium bovis is weakened to reduce harm to your body. […] BCG treatment is used to address early-stage bladder cancer. This includes bladder cancers that haven’t invaded your bladder wall muscle, like carcinoma in situ (in its original location) bladder cancers and non-muscle invasive bladder cancers (NMIBCs). BCG treatment isn’t effective against bladder cancer that has metastasized (spread to other parts of your body). […] BCG cancer treatment can slow tumor growth and reduce your chance of needing a cystectomy in the future. […] BCG sepsis (a tuberculosis-like illness that can happen if BCG solution enters your bloodstream) […] For people with early-stage bladder cancer, BCG cancer treatment is the go-to approach.

• #28 BCG Vaccine? – American Bladder Cancer Society

  https://bladdercancersupport.org/discussion/bcg-vaccine/

  BCG remains the most important vaccine for tuberculosis. […] BCG is a vaccine which is used to treat Tuberculosis. Also BCG is used to treat the Bladder Carcinoma (CIS or Papillary) which are in the initial/early stages (pTa, pT1, CIS) and which are also high grade/aggressive tumors. BCG is an old treatment which is given to patients which has bladder cancer mentioned above. This is a 40 year old treatment which is enhancing the body’s own immune system and kills the tumor cells. The exact mechanism of how it works is not known till now. […] BCG is the gold standard for initial Bladder tumors and is trusted by all Urologists throughout the Globe. But BCG also has toxicity/side effects which can rage up to 80% of patients.

• #29 TB vaccine shrinks liver cancer tumors in mice

  https://health.ucdavis.edu/news/headlines/tb-vaccine-shrinks-liver-cancer-tumors-in-mice/2024/02

  A UC Davis Health study found that a single dose of Bacillus Calmette-Gurin (BCG), the vaccine for tuberculosis (TB), reduced liver tumor burden and extended the survival of mice with liver cancer. […] BCG, the century-old TB vaccine, is derived from the live bacteria Mycobacterium bovis. It is considered safe and widely used around the world. […] The new study, led by Distinguished Professor Yu-Jui Yvonne Wan, showed that one dose of BCG delivered under the skin reduced tissue scarring (fibrosis), improved liver function, lowered liver lipid, and shrunk the tumor. […] We had a good reason to believe that the BCG vaccine could stimulate an immune response. So, we gave a dose of BCG to mice with liver cancer, and to our surprise, it was enough to activate the body’s immune system and reduce tumor load.

• #30 TB vaccine shrinks liver cancer tumors in mice

  https://health.ucdavis.edu/news/headlines/tb-vaccine-shrinks-liver-cancer-tumors-in-mice/2024/02

  The researchers gave a BCG dose under the skin to mice with liver cancer. This is the same way the BCG vaccine is given to humans. […] We discovered that the BCG treatment resulted in the movement of T cells and macrophages to the tumor. It also activated the body’s immunity and enhanced IFN- signaling, which contributes to an anti-HCC effect, Wan said. […] Bacterial immunotherapy, such as BCG, offers an alternative to current immunotherapy based on immune checkpoint inhibitors. It has the potential to revolutionize the treatment approach for HCC. […] Our study showed that BCG immunotherapy for HCC is different from and superior to other immunotherapies. It requires only a single injection. […] The study findings suggest that the BCG vaccine could be repurposed as an HCC treatment. The discovery is significant, since BCG is already used safely around the world. […] If BCG treated a tough tumor like liver cancer, I’m optimistic it can work well on other hard-to-treat cancers.

• #31 Modified bladder cancer treatment shows promise in animal studies

  https://www.txbiomed.org/news-press/news/bladder-cancer-bcg/

  The Mycobacterium bovis bacille Calmette-Gurin (BCG) vaccine was developed for tuberculosis in the 1920s, and has also been used to treat non-muscle invasive bladder cancer since the late 1970s by stimulating an immune response at the cancer site. […] BCG is a live attenuated vaccine used to protect against the development of tuberculosis disease, and is also used as the gold standard treatment for bladder cancer. […] The Texas Biomed team delipidated the BCG vaccine by removing some, but not all, of these lipids from the outer layer. […] Dr. Torrelles and his lab made two versions of the delipidated vaccine based on different TB bacteria strains: one known as sub-strain TICE, which is developed in the U.S., and one known as sub-strain Tokyo, which is developed in Japan. […] We were not expecting such a clear difference between the strains, says Dr. Torrelles, who has patented the modified vaccine for bladder cancer.

• #32 Modified tuberculosis vaccine as a therapy for cancer of the bladder

  https://www.mpg.de/14491738/0219-mpin-116799-modified-tuberculosis-vaccine-as-a-therapy-for-cancer-of-the-bladder

  The tuberculosis vaccine Bacille Calmette-Gurin (BCG) that was introduced back in the 1920ies contains weakened pathogens of bovine tuberculosis, which can also be transmitted to humans. […] Tests in the 1970ies showed that BCG is also effective against bladder cancer, one of the most common tumour diseases in Europe. […] During this treatment, the bladder is repeatedly flushed with the weakened germ over a period of six weeks. […] Nevertheless, the share of patients who have managed to fully overcome cancer after the BCG therapy is low. […] The researchers modified the weakened tuberculosis bacteria in a way that it can be recognized better by the immune system. […] Improved protection against infection with tuberculosis bacteria has already been proven using VPM1002. […] A Phase I study showed that the new vaccine is safe and well tolerated. […] Over 49 percent of the patients treated with VPM1002 were free from tumours in the bladder after 60 weeks. […] The results have encouraged the developers to apply for early regulatory approval as soon as possible.

• #33 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. This activity reviews the mode of action of the BCG vaccine and highlights the role of the interprofessional team in educating patients about tuberculosis prevention. […] Bacillus Calmette-Gurin (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 Gurin 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. It is also used in the treatment of superficial carcinoma of the bladder.

• #34 Tuberculosis | The Australian Immunisation Handbook

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

  BCG (bacille Calmette–Guérin) vaccine is recommended for: […] BCG vaccine is given as a single dose by intradermal injection. […] The World Health Organization considers tuberculosis a global emergency. BCG vaccine is recommended for those at highest risk of severe outcomes of tuberculosis. […] Aboriginal and Torres Strait Islander children aged <5 years in certain parts of Australia are recommended to receive BCG vaccine. [...] Healthcare workers with a high-risk of exposure to tuberculosis, particularly drug-resistant tuberculosis, may benefit from BCG vaccination. [...] Children aged <5 years who are travelling to countries with high tuberculosis incidence are recommended to receive BCG vaccine before travel, based on an individual risk assessment. [...] BCG vaccination offers some protection against Mycobacterium leprae, which causes leprosy.

• #35 BCG: how a century-old vaccine is being used against everything from cancer to autoimmune diseases

  https://theconversation.com/bcg-how-a-century-old-vaccine-is-being-used-against-everything-from-cancer-to-autoimmune-diseases-198708

  Later observations and trials also reported non-specific protective effects of BCG against lung infections unrelated to TB. […] BCGs ability to induce a general state of readiness in the immune system, a phenomenon known as trained immunity, is tied to its identity as a live microorganism with a complex outer cell wall. […] BCG is immunostimulatory. […] BCG can reduce and prevent immune-mediated damage to the nervous system in multiple sclerosis. It can also counteract rogue immune cells that attack insulin production in the pancreas of diabetic patients. […] A better understanding of the environment in which BCG works most consistently to deliver its specific and non-specific effects will surely enable the effective use of this most versatile of vaccines in future.

• #36 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/

  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. […] While BCG is not currently recommended for use in this context, if trials are successful, the vaccine could provide an alternative means of protection against severe Covid-19 in countries where coronavirus vaccine supplies are limited.

• #37 BCG: how a century-old vaccine is being used against everything from cancer to autoimmune diseases

  https://theconversation.com/bcg-how-a-century-old-vaccine-is-being-used-against-everything-from-cancer-to-autoimmune-diseases-198708

  In March 2020, as the UK was preparing to go into lockdown, two new trials were posted on the clinicaltrials.gov database. The researchers were proposing that BCG, an old vaccine against tuberculosis (TB), should be tested for its protective effect against COVID. […] In fact, almost since its first use against TB just over 100 years ago, BCG has been known to have non-specific protective effects. In other words, it can prevent diseases other than TB. […] Within a few years, BCG was being injected into children, delivering high levels of protection against TB with few side-effects. In 1931, Calmette suggested that BCG also prevented death from infectious diseases other than TB, an observation partly supported by data from studies in Sweden. […] A recent reanalysis of the Swedish data concluded that although there was an element of healthy vaccinee bias in some of the data (that is, people in better health are more likely to get vaccinated), the results did support a non-specific protective effect of BCG.

• #38

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

  On this page youll find an overview of the BCG vaccine, including how it can protect against TB meningitis. […] The Bacillus CalmetteGurin (BCG) vaccine provides protection against TB meningitis in children. […] The World Health Organisation (WHO) recommends that all infants in countries with high TB rates get the BCG vaccine at or shortly after birth. […] Vaccination is the best way to prevent TB meningitis in children. With growing antibiotic resistance, its now more important than ever. […] The BCG vaccine gives good protection against the TB meningitis in babies and young children. […] The BCG vaccine is recommended for certain groups of people: […] The BCG vaccine is also recommended for children travelling to a country which has a high TB rate. […] The BCG vaccine is safe.

• #39 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). […] 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. […] You only need to have the BCG vaccine once. […] The BCG vaccine is recommended for children aged 1 to 16 if any of the following apply: they have a parent or grandparent born in a country where there is a higher risk of getting TB; they were born or lived for at least 3 months in a country where there is a higher risk of getting TB; they have been living with, or in regular close contact with, someone who has or had TB.

• #40 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). […] 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. […] You only need to have the BCG vaccine once. […] The BCG vaccine is recommended for children aged 1 to 16 if any of the following apply: they have a parent or grandparent born in a country where there is a higher risk of getting TB; they were born or lived for at least 3 months in a country where there is a higher risk of getting TB; they have been living with, or in regular close contact with, someone who has or had TB.

• #41 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 work in a laboratory where you may come into contact with TB bacteria; you work with animals that could be infected with TB; you work with people who may be more at risk of TB such as some homeless people, asylum seekers and refugees, people who misuse drugs and people in prison. […] The BCG vaccine is recommended if you’re staying for more than 3 months in a country where there is a higher risk of getting 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 already had the BCG vaccine; anyone who has TB or has had it before; anyone who has had a severe allergic reaction (anaphylaxis) to any ingredients in the BCG vaccine; babies whose mother had biological medicines to suppress their immune system during pregnancy; babies who may have a weakened immune system; children and adults with a weakened immune system.

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

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

  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). […] 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.

• #43 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 work in a laboratory where you may come into contact with TB bacteria; you work with animals that could be infected with TB; you work with people who may be more at risk of TB such as some homeless people, asylum seekers and refugees, people who misuse drugs and people in prison. […] The BCG vaccine is recommended if you’re staying for more than 3 months in a country where there is a higher risk of getting 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 already had the BCG vaccine; anyone who has TB or has had it before; anyone who has had a severe allergic reaction (anaphylaxis) to any ingredients in the BCG vaccine; babies whose mother had biological medicines to suppress their immune system during pregnancy; babies who may have a weakened immune system; children and adults with a weakened immune system.

• #44 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 work in a laboratory where you may come into contact with TB bacteria; you work with animals that could be infected with TB; you work with people who may be more at risk of TB such as some homeless people, asylum seekers and refugees, people who misuse drugs and people in prison. […] The BCG vaccine is recommended if you’re staying for more than 3 months in a country where there is a higher risk of getting 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 already had the BCG vaccine; anyone who has TB or has had it before; anyone who has had a severe allergic reaction (anaphylaxis) to any ingredients in the BCG vaccine; babies whose mother had biological medicines to suppress their immune system during pregnancy; babies who may have a weakened immune system; children and adults with a weakened immune system.

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

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

  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. Even though no harmful effects of BCG vaccination on the fetus have been observed, further studies are needed to prove its safety.

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

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

  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). […] 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.

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

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

  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. Even though no harmful effects of BCG vaccination on the fetus have been observed, further studies are needed to prove its safety.

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

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

  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). […] 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.

• #49 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 work in a laboratory where you may come into contact with TB bacteria; you work with animals that could be infected with TB; you work with people who may be more at risk of TB such as some homeless people, asylum seekers and refugees, people who misuse drugs and people in prison. […] The BCG vaccine is recommended if you’re staying for more than 3 months in a country where there is a higher risk of getting 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 already had the BCG vaccine; anyone who has TB or has had it before; anyone who has had a severe allergic reaction (anaphylaxis) to any ingredients in the BCG vaccine; babies whose mother had biological medicines to suppress their immune system during pregnancy; babies who may have a weakened immune system; children and adults with a weakened immune system.

• #50 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 work in a laboratory where you may come into contact with TB bacteria; you work with animals that could be infected with TB; you work with people who may be more at risk of TB such as some homeless people, asylum seekers and refugees, people who misuse drugs and people in prison. […] The BCG vaccine is recommended if you’re staying for more than 3 months in a country where there is a higher risk of getting 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 already had the BCG vaccine; anyone who has TB or has had it before; anyone who has had a severe allergic reaction (anaphylaxis) to any ingredients in the BCG vaccine; babies whose mother had biological medicines to suppress their immune system during pregnancy; babies who may have a weakened immune system; children and adults with a weakened immune system.

• #51 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 work in a laboratory where you may come into contact with TB bacteria; you work with animals that could be infected with TB; you work with people who may be more at risk of TB such as some homeless people, asylum seekers and refugees, people who misuse drugs and people in prison. […] The BCG vaccine is recommended if you’re staying for more than 3 months in a country where there is a higher risk of getting 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 already had the BCG vaccine; anyone who has TB or has had it before; anyone who has had a severe allergic reaction (anaphylaxis) to any ingredients in the BCG vaccine; babies whose mother had biological medicines to suppress their immune system during pregnancy; babies who may have a weakened immune system; children and adults with a weakened immune system.

• #52 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 work in a laboratory where you may come into contact with TB bacteria; you work with animals that could be infected with TB; you work with people who may be more at risk of TB such as some homeless people, asylum seekers and refugees, people who misuse drugs and people in prison. […] The BCG vaccine is recommended if you’re staying for more than 3 months in a country where there is a higher risk of getting 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 already had the BCG vaccine; anyone who has TB or has had it before; anyone who has had a severe allergic reaction (anaphylaxis) to any ingredients in the BCG vaccine; babies whose mother had biological medicines to suppress their immune system during pregnancy; babies who may have a weakened immune system; children and adults with a weakened immune system.

• #53 Tuberculosis Vaccine – A New Dawn in TB Treatment | 01

  https://vocal.media/01/tuberculosis-vaccine-a-new-dawn-in-tb-treatment

  BCG Vaccine – The Only Vaccine Currently Available Against TB […] The Bacillus CalmetteGurin (BCG) vaccine is currently the only vaccine available for TB. It was first used in 1921 and offers some protection against severe forms of TB like TB meningitis or miliary TB in children. However, its effectiveness in preventing pulmonary TB in adults is limited. BCG vaccine efficacy varies from 0% to 80% depending on the population and study design. There has been limited success in boosting the efficacy of BCG with second generation vaccines. […] […] […] Several vaccines are currently in clinical trials hoping to overcome the limitations of BCG. These new vaccines target adults and adolescents to prevent pulmonary TB. Some key vaccines in clinical trials include M72/AS01E, VPM1002, DAR-901 and H56:IC31. M72/AS01E has shown 54.0% efficacy in preventing active TB in a phase 2b trial. VPM1002, a live mycobacterial vaccine, has completed phase 2a testing showing good safety and immunogenicity. DAR-901 uses a recombinant protein from M. tuberculosis and adenovirus vector to trigger immune response. Phase 1 and 2 trials showed it has a good safety profile and immunogenic. H56:IC31 uses an array of M. tuberculosis antigens combined with IC31 adjuvant and has completed phase 1 and 2 trials showing promise.

• #54 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. This vaccine is not generally used in the United States. The vaccine can cause a false-positive TB skin test reaction. […] Bacille Calmette-Gurin (BCG) is a vaccine for tuberculosis (TB) disease. […] 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. […] BCG vaccination should only be considered for children who have a negative TB test and who are continually exposed, and cannot be separated from adults who: […] Health care workers considered for BCG vaccination should be counseled regarding the risks and benefits associated with both BCG vaccination and treatment of latent TB infection.

• #55 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 vaccine is not generally used in the United States. […] Tell your health care provider if you have received the TB vaccine, especially if you are getting tested for TB infection. 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. Unlike the TB skin test, TB blood tests are not affected by BCG TB vaccination. […] Yes, a person can have or get TB even if they received the TB vaccine (BCG). The BCG TB vaccine does not always protect people from getting TB. […] TB blood tests are the preferred tests for people who have received the BCG TB vaccine. The vaccine can cause a false positive TB skin test reaction. Unlike the TB skin test, TB blood tests are not affected by BCG vaccination.

• #56 Tuberculosis (TB) Blood Test (IGRA) – MN Dept. of Health

  https://www.health.state.mn.us/diseases/tb/basics/factsheets/igra.html

  The BCG vaccine (TB vaccine) may help protect young children from getting very sick with TB. This protection goes away as people get older. People who have had BCG vaccine still can get latent TB infection and active TB disease. […] If you had the BCG vaccine and you have a choice of having a TB blood test or a TB skin test, it is better for you to have the TB blood test. This is because the TB blood test is not affected by the BCG vaccine. This means that your TB blood test will be positive only if you have TB germs in your body.

• #57 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 vaccine is not generally used in the United States. […] Tell your health care provider if you have received the TB vaccine, especially if you are getting tested for TB infection. 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. Unlike the TB skin test, TB blood tests are not affected by BCG TB vaccination. […] Yes, a person can have or get TB even if they received the TB vaccine (BCG). The BCG TB vaccine does not always protect people from getting TB. […] TB blood tests are the preferred tests for people who have received the BCG TB vaccine. The vaccine can cause a false positive TB skin test reaction. Unlike the TB skin test, TB blood tests are not affected by BCG vaccination.

• #58 BCG vaccine – Wikipedia

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

  The main use of BCG is for vaccination against tuberculosis. BCG vaccine can be administered after birth intradermally. 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%. […] BCG seems to have its greatest effect in preventing miliary tuberculosis or tuberculosis meningitis, so it is still extensively used even in countries where efficacy against pulmonary tuberculosis is negligible. […] The BCG vaccine is very efficacious against tuberculous meningitis in the pediatric age group, but its efficacy against pulmonary tuberculosis appears variable. Some countries have removed the BCG vaccine from routine vaccination.

• #59 Bacillus Calmette-Guérin (BCG) Therapy for Bladder Cancer | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/bladder/treatment/bacillus-calmette-guerin-therapy

  Bacillus Calmette-Gurin (BCG) therapy is a type of immunotherapy that treats bladder tumors. Its the most common kind of intravesical immunotherapy used to treat early-stage bladder cancer. […] The BCG in this drug is inactivated tuberculosis (TB) bacteria made from a type of Mycobacterium bovis. This is a liquid drug that goes into your bladder through a catheter (small tube) placed in your urethra. BCG triggers an inflammatory response in your bladder that stops the tumor from coming back. […] MSK offers BCG treatment is an alternative to chemotherapy for high grade non-muscle invasive bladder cancer (NMIBC). People often come to MSK for BCG treatment after their healthcare provider offered chemotherapy as the only treatment option. […] This liquid drug is given through a catheter into the bladder. You will get this treatment once a week, for 6 weeks. You will get inactivated tuberculosis (TB) bacteria through a catheter (small tube) placed in your urethra. […] Some early-stage bladder cancers dont respond to BCG therapy. If bladder cancer returns, we may recommend other drugs, including chemotherapy drugs. They also are given through your urethra.

• #60 BCG Treatment: What It Is, Procedure & Side Effects

  https://my.clevelandclinic.org/health/treatments/17908-bacillus-calmette-guerin-bcg-treatment

  Bacillus Calmette-Guerin (BCG) treatment is a type of intravesical (in your bladder) immunotherapy. This liquid drug is made from a strain of Mycobacterium bovis the same bacterium used to create the tuberculosis vaccine. When used in medicine, Mycobacterium bovis is weakened to reduce harm to your body. […] BCG treatment is used to address early-stage bladder cancer. This includes bladder cancers that haven’t invaded your bladder wall muscle, like carcinoma in situ (in its original location) bladder cancers and non-muscle invasive bladder cancers (NMIBCs). BCG treatment isn’t effective against bladder cancer that has metastasized (spread to other parts of your body). […] BCG cancer treatment can slow tumor growth and reduce your chance of needing a cystectomy in the future. […] BCG sepsis (a tuberculosis-like illness that can happen if BCG solution enters your bloodstream) […] For people with early-stage bladder cancer, BCG cancer treatment is the go-to approach.

• #61 BCG Treatment: What It Is, Procedure & Side Effects

  https://my.clevelandclinic.org/health/treatments/17908-bacillus-calmette-guerin-bcg-treatment

  Bacillus Calmette-Guerin (BCG) treatment is a type of intravesical (in your bladder) immunotherapy. This liquid drug is made from a strain of Mycobacterium bovis the same bacterium used to create the tuberculosis vaccine. When used in medicine, Mycobacterium bovis is weakened to reduce harm to your body. […] BCG treatment is used to address early-stage bladder cancer. This includes bladder cancers that haven’t invaded your bladder wall muscle, like carcinoma in situ (in its original location) bladder cancers and non-muscle invasive bladder cancers (NMIBCs). BCG treatment isn’t effective against bladder cancer that has metastasized (spread to other parts of your body). […] BCG cancer treatment can slow tumor growth and reduce your chance of needing a cystectomy in the future. […] BCG sepsis (a tuberculosis-like illness that can happen if BCG solution enters your bloodstream) […] For people with early-stage bladder cancer, BCG cancer treatment is the go-to approach.

• #62 Modified tuberculosis vaccine as a therapy for cancer of the bladder

  https://www.mpg.de/14491738/0219-mpin-116799-modified-tuberculosis-vaccine-as-a-therapy-for-cancer-of-the-bladder

  The tuberculosis vaccine Bacille Calmette-Gurin (BCG) that was introduced back in the 1920ies contains weakened pathogens of bovine tuberculosis, which can also be transmitted to humans. […] Tests in the 1970ies showed that BCG is also effective against bladder cancer, one of the most common tumour diseases in Europe. […] During this treatment, the bladder is repeatedly flushed with the weakened germ over a period of six weeks. […] Nevertheless, the share of patients who have managed to fully overcome cancer after the BCG therapy is low. […] The researchers modified the weakened tuberculosis bacteria in a way that it can be recognized better by the immune system. […] Improved protection against infection with tuberculosis bacteria has already been proven using VPM1002. […] A Phase I study showed that the new vaccine is safe and well tolerated. […] Over 49 percent of the patients treated with VPM1002 were free from tumours in the bladder after 60 weeks. […] The results have encouraged the developers to apply for early regulatory approval as soon as possible.

• #63 Key advances in vaccine development for tuberculosis—success and challenges | npj Vaccines

  https://www.nature.com/articles/s41541-023-00750-7

  The ineffectiveness of BCG against pulmonary TB has prompted many groups to design alternative vaccines to enhance or replace BCG. […] The best example of a live whole cell vaccine is BCG, which is an attenuated form of Mycobacterium bovis, a mycobacterial species that is closely related to M. tuberculosis. […] The safety record and clinical familiarity of BCG has prompted development of recombinant BCG strains to improve the immune responses elicited by vaccination. […] The VPM1002 vaccine is a promising example that is in Phase 3 clinical trial. […] An emerging strategy is attenuation of M. tuberculosis itself. […] Recent NHP studies have suggested that the efficacy of BCG itself may be improved when delivered through the intravascular (IV) route. […] Although deploying universal IV BCG vaccination does not seem feasible, it is currently the most efficacious vaccine strategy, and highlights the route of immunization as an important determinant of vaccine-induced protection.

• #64 Tuberculosis Vaccines — Vax-Before-Travel

  https://www.vax-before-travel.com/tuberculosis-vaccines

  Tuberculosis is a vaccine preventable disease with the BCG vaccine. […] Versions of the Bacille Calmette-Gurin (BCG) vaccine have been used for about 100 years. Since 1921, over 4 billion BCG vaccinations have been completed worldwide. […] According to the U.S. Centers for Disease Control and Prevention (CDC), BCG vaccination is considered for people who meet specific criteria, such as children with a negative TB test who are continually exposed and cannot be separated from adults who are untreated or ineffectively treated for TB. […] The Serum Institute of India (SII) rBCG vaccine TUBERVAC-rBCG was approved in 2023 as a single-dose vaccine for the prevention of TB. […] BCG vaccine AJV (A.J. Vaccines) is the only licensed BCG vaccine in the UK in 2023. […] In France, BCG vaccination is recommended from 1 month of age for children at high risk of TB and may also be offered up to 15 years, in unvaccinated children at risk.

• #65 Key advances in vaccine development for tuberculosis—success and challenges | npj Vaccines

  https://www.nature.com/articles/s41541-023-00750-7

  The ineffectiveness of BCG against pulmonary TB has prompted many groups to design alternative vaccines to enhance or replace BCG. […] The best example of a live whole cell vaccine is BCG, which is an attenuated form of Mycobacterium bovis, a mycobacterial species that is closely related to M. tuberculosis. […] The safety record and clinical familiarity of BCG has prompted development of recombinant BCG strains to improve the immune responses elicited by vaccination. […] The VPM1002 vaccine is a promising example that is in Phase 3 clinical trial. […] An emerging strategy is attenuation of M. tuberculosis itself. […] Recent NHP studies have suggested that the efficacy of BCG itself may be improved when delivered through the intravascular (IV) route. […] Although deploying universal IV BCG vaccination does not seem feasible, it is currently the most efficacious vaccine strategy, and highlights the route of immunization as an important determinant of vaccine-induced protection.

• #66 Modified bladder cancer treatment shows promise in animal studies

  https://www.txbiomed.org/news-press/news/bladder-cancer-bcg/

  The Mycobacterium bovis bacille Calmette-Gurin (BCG) vaccine was developed for tuberculosis in the 1920s, and has also been used to treat non-muscle invasive bladder cancer since the late 1970s by stimulating an immune response at the cancer site. […] BCG is a live attenuated vaccine used to protect against the development of tuberculosis disease, and is also used as the gold standard treatment for bladder cancer. […] The Texas Biomed team delipidated the BCG vaccine by removing some, but not all, of these lipids from the outer layer. […] Dr. Torrelles and his lab made two versions of the delipidated vaccine based on different TB bacteria strains: one known as sub-strain TICE, which is developed in the U.S., and one known as sub-strain Tokyo, which is developed in Japan. […] We were not expecting such a clear difference between the strains, says Dr. Torrelles, who has patented the modified vaccine for bladder cancer.

• #67 Tuberculosis Vaccine – A New Dawn in TB Treatment | 01

  https://vocal.media/01/tuberculosis-vaccine-a-new-dawn-in-tb-treatment

  BCG Vaccine – The Only Vaccine Currently Available Against TB […] The Bacillus CalmetteGurin (BCG) vaccine is currently the only vaccine available for TB. It was first used in 1921 and offers some protection against severe forms of TB like TB meningitis or miliary TB in children. However, its effectiveness in preventing pulmonary TB in adults is limited. BCG vaccine efficacy varies from 0% to 80% depending on the population and study design. There has been limited success in boosting the efficacy of BCG with second generation vaccines. […] […] […] Several vaccines are currently in clinical trials hoping to overcome the limitations of BCG. These new vaccines target adults and adolescents to prevent pulmonary TB. Some key vaccines in clinical trials include M72/AS01E, VPM1002, DAR-901 and H56:IC31. M72/AS01E has shown 54.0% efficacy in preventing active TB in a phase 2b trial. VPM1002, a live mycobacterial vaccine, has completed phase 2a testing showing good safety and immunogenicity. DAR-901 uses a recombinant protein from M. tuberculosis and adenovirus vector to trigger immune response. Phase 1 and 2 trials showed it has a good safety profile and immunogenic. H56:IC31 uses an array of M. tuberculosis antigens combined with IC31 adjuvant and has completed phase 1 and 2 trials showing promise.

• #68 New TB Vaccine Research

  https://www.who.int/teams/global-tuberculosis-programme/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. […] 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.

• #69 Tuberculosis Vaccine – A New Dawn in TB Treatment | 01

  https://vocal.media/01/tuberculosis-vaccine-a-new-dawn-in-tb-treatment

  BCG Vaccine – The Only Vaccine Currently Available Against TB […] The Bacillus CalmetteGurin (BCG) vaccine is currently the only vaccine available for TB. It was first used in 1921 and offers some protection against severe forms of TB like TB meningitis or miliary TB in children. However, its effectiveness in preventing pulmonary TB in adults is limited. BCG vaccine efficacy varies from 0% to 80% depending on the population and study design. There has been limited success in boosting the efficacy of BCG with second generation vaccines. […] […] […] Several vaccines are currently in clinical trials hoping to overcome the limitations of BCG. These new vaccines target adults and adolescents to prevent pulmonary TB. Some key vaccines in clinical trials include M72/AS01E, VPM1002, DAR-901 and H56:IC31. M72/AS01E has shown 54.0% efficacy in preventing active TB in a phase 2b trial. VPM1002, a live mycobacterial vaccine, has completed phase 2a testing showing good safety and immunogenicity. DAR-901 uses a recombinant protein from M. tuberculosis and adenovirus vector to trigger immune response. Phase 1 and 2 trials showed it has a good safety profile and immunogenic. H56:IC31 uses an array of M. tuberculosis antigens combined with IC31 adjuvant and has completed phase 1 and 2 trials showing promise.

• #70 Tuberculosis Vaccine – A New Dawn in TB Treatment | 01

  https://vocal.media/01/tuberculosis-vaccine-a-new-dawn-in-tb-treatment

  BCG Vaccine – The Only Vaccine Currently Available Against TB […] The Bacillus CalmetteGurin (BCG) vaccine is currently the only vaccine available for TB. It was first used in 1921 and offers some protection against severe forms of TB like TB meningitis or miliary TB in children. However, its effectiveness in preventing pulmonary TB in adults is limited. BCG vaccine efficacy varies from 0% to 80% depending on the population and study design. There has been limited success in boosting the efficacy of BCG with second generation vaccines. […] […] […] Several vaccines are currently in clinical trials hoping to overcome the limitations of BCG. These new vaccines target adults and adolescents to prevent pulmonary TB. Some key vaccines in clinical trials include M72/AS01E, VPM1002, DAR-901 and H56:IC31. M72/AS01E has shown 54.0% efficacy in preventing active TB in a phase 2b trial. VPM1002, a live mycobacterial vaccine, has completed phase 2a testing showing good safety and immunogenicity. DAR-901 uses a recombinant protein from M. tuberculosis and adenovirus vector to trigger immune response. Phase 1 and 2 trials showed it has a good safety profile and immunogenic. H56:IC31 uses an array of M. tuberculosis antigens combined with IC31 adjuvant and has completed phase 1 and 2 trials showing promise.

• #71 Tuberculosis Vaccine – A New Dawn in TB Treatment | 01

  https://vocal.media/01/tuberculosis-vaccine-a-new-dawn-in-tb-treatment

  BCG Vaccine – The Only Vaccine Currently Available Against TB […] The Bacillus CalmetteGurin (BCG) vaccine is currently the only vaccine available for TB. It was first used in 1921 and offers some protection against severe forms of TB like TB meningitis or miliary TB in children. However, its effectiveness in preventing pulmonary TB in adults is limited. BCG vaccine efficacy varies from 0% to 80% depending on the population and study design. There has been limited success in boosting the efficacy of BCG with second generation vaccines. […] […] […] Several vaccines are currently in clinical trials hoping to overcome the limitations of BCG. These new vaccines target adults and adolescents to prevent pulmonary TB. Some key vaccines in clinical trials include M72/AS01E, VPM1002, DAR-901 and H56:IC31. M72/AS01E has shown 54.0% efficacy in preventing active TB in a phase 2b trial. VPM1002, a live mycobacterial vaccine, has completed phase 2a testing showing good safety and immunogenicity. DAR-901 uses a recombinant protein from M. tuberculosis and adenovirus vector to trigger immune response. Phase 1 and 2 trials showed it has a good safety profile and immunogenic. H56:IC31 uses an array of M. tuberculosis antigens combined with IC31 adjuvant and has completed phase 1 and 2 trials showing promise.

• #72 New TB Vaccine Research

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

  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.

• #73 New TB Vaccine Research

  https://www.who.int/teams/global-tuberculosis-programme/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. […] 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.

• #74 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. […] Despite its inability to protect adults from TB, BCG is a life-saving vaccine for infants and children under five. […] The fight against AMR and MDR-TB will require a multi-pronged approach, and it will not be easy. TB vaccines can help by reducing the incidence and transmission of TB, which would in turn reduce the need for antimicrobial treatment and help to slow the emergence of AMR. Because vaccines prevent infections in the first place, they play an indispensable role in combatting the global crisis of drug resistance.

• #75 BCG Vaccine Prevents Tuberculosis in Young Children, but Not Adults | SPH

  https://www.bu.edu/sph/news/articles/2022/bcg-vaccine-prevents-tuberculosis-in-young-children-but-not-adults/

  BCG vaccination at birth does provide significant protection against TB disease but only among children under 5 years old. The vaccine provided no protection among adolescents or adults in this study. […] These results suggest that protectiveness from the BCG vaccine may begin to wane as children get older and, thus, children over 10 years old and adults should receive a booster BCG vaccine and eventually a new, supplemental vaccine, as the researchers note that the BCG booster may also have limited efficacy for immunity against TB beyond childhood. […] Our findings indicate that BCG vaccination is effective at preventing tuberculosis in young children. Since tuberculosis in children is a highly debilitating and severe disease, BCG vaccination should continue to be used. […] However, since the results show that the vaccine was ineffective in adolescents and adults, boosting immunoprotection is needed for older populations. […] We urgently need vaccines that are effective against tuberculosis in adults.

• #76 Vaccine profiles: Tuberculosisverifiedverifiedverifiedverifiedverifiedverifiedverifiedverifiedverifiedverified

  https://www.gavi.org/vaccineswork/routine-vaccines-tuberculosis

  More than 100 years since the first administration of the BCG vaccine, hopes are building that a vaccine that could protect all age groups against all types of TB may finally be in reach. […] While the Bacillus Calmette–Guérin (BCG) vaccine provides significant protection against TB disease in infants and young children, new vaccines that block infection and prevent TB disease in adolescents and adults, who account for the greatest burden of disease, are urgently needed. […] However, while it has saved many lives, the BCG vaccine is not perfect: Estimates of its efficacy in preventing TB and how long immunity lasts for vary between countries, but according to a recent review and meta-analysis published in The Lancet Global Health, BCG vaccination at birth provides significant protection against TB disease until children are around five years old, which is important because tuberculosis in children is a highly debilitating and severe disease.

• #77 BCG Vaccine: A Breakthrough in Bladder Cancer Treatment

  https://www.genengnews.com/news/bcg-vaccine-a-breakthrough-in-bladder-cancer-treatment/

  Bacillus Calmette-Guérin (BCG) vaccine is the live attenuated vaccine form of Mycobacterium bovis used to prevent tuberculosis and other mycobacterial infections. […] “The Bacillus Calmette–Guérin (BCG) vaccine is the oldest cancer immunotherapeutic agent in use,” the researchers wrote. […] “BCG immunotherapy is still rather empirically used” says Martínez-López. “However, since it works for many people, it has become a gold standard treatment. Surprisingly, it is a very effective immunotherapy, even when compared to so many fancy immunotherapies that are being developed.” […] The treatment consists of instilling the BCG vaccine directly into the bladder. […] Until now, the way the BCG vaccine works as an immunomodulator to clear bladder tumors was not fully known. […] The researchers further showed that, when macrophages were depleted in the zAvatar, the anti-tumor effects of the BCG vaccine were completely blocked, suggesting that macrophages are crucial for the initial anti-tumor response. […] “Not only did we unravel the mechanisms involved in the first steps of the vaccine’s anti-tumoral action, we also demonstrated that the zebrafish Avatar model is a powerful preclinical tool for drug discovery in oncology,” concluded Martínez-López.

• #78 Vaccine profiles: Tuberculosisverifiedverifiedverifiedverifiedverifiedverifiedverifiedverifiedverifiedverified

  https://www.gavi.org/vaccineswork/routine-vaccines-tuberculosis

  Unfortunately, this protection was shown to wane as children get older and the vaccine provided no protection for adolescents or adults – who account for the bulk of TB infections and disease transmission. The BCG vaccine also doesn’t prevent people from becoming infected with Mycobacterium tuberculosis, meaning it can still spread through communities. To end the TB epidemic, vaccines are needed that are effective against all forms of TB in all age groups, and which prevent transmission of the bacteria that cause it. […] More than 100 years since the first administration of the BCG vaccine, hopes are building that a vaccine that could protect all age groups against all types of TB may finally be in reach. Humans have been fighting this ancient pathogen for millennia, but it seems the battle may finally be swinging in our favour.

• #79 BCG: how a century-old vaccine is being used against everything from cancer to autoimmune diseases

  https://theconversation.com/bcg-how-a-century-old-vaccine-is-being-used-against-everything-from-cancer-to-autoimmune-diseases-198708

  Later observations and trials also reported non-specific protective effects of BCG against lung infections unrelated to TB. […] BCGs ability to induce a general state of readiness in the immune system, a phenomenon known as trained immunity, is tied to its identity as a live microorganism with a complex outer cell wall. […] BCG is immunostimulatory. […] BCG can reduce and prevent immune-mediated damage to the nervous system in multiple sclerosis. It can also counteract rogue immune cells that attack insulin production in the pancreas of diabetic patients. […] A better understanding of the environment in which BCG works most consistently to deliver its specific and non-specific effects will surely enable the effective use of this most versatile of vaccines in future.

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