BCG vaccine
BCG vaccine
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BCG vaccine

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BCG vaccine

The Bacillus Calmette–Guérin (BCG) vaccine is a vaccine primarily used against tuberculosis (TB). It is named after its inventors Albert Calmette and Camille Guérin. 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 often 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.

Serious side effects are rare. Redness, swelling, and mild pain often occur at the injection site. A small ulcer may also form with some scarring after healing. Side effects are more common and potentially more severe in those with immunosuppression. Although no harmful effects on the fetus have been observed, there is insufficient evidence about the safety of BCG vaccination during pregnancy. Therefore, the vaccine is not recommended for use during pregnancy. The vaccine was originally developed from Mycobacterium bovis, which is commonly found in cattle. Although it has been weakened, it is still live.

The BCG vaccine was first used medically in 1921. It is on the World Health Organization's List of Essential Medicines. As of 2004, the vaccine is given to about 100 million children per year globally. However, it is not commonly administered in the United States.

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.

The most controversial aspect of BCG is the variable efficacy found in different clinical trials, which appears to depend on geography. Trials in the UK consistently show a 60 to 80% protective effect. Still, those trials conducted elsewhere have shown no protective effect, and efficacy appears to fall the closer one gets to the equator.

A 1994 systematic review found that BCG reduces the risk of getting tuberculosis by about 50%. Differences in effectiveness depend on region, due to factors such as genetic differences in the populations, changes in environment, exposure to other bacterial infections, and conditions in the laboratory where the vaccine is grown, including genetic differences between the strains being cultured and the choice of growth medium.

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%. The studies included in this review were limited to those that used interferon gamma release assay.

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