Attenuated strain of Mycobacterium bovis.

Vaccine reduces risk of tuberculosis by 50% with a long duration of protection up to 60 years.

Reported to result in an annual reduction of tuberculosis of 5-14% in randomized controlled studies.

Increases time to progression in muscle invasive carcinoma of the bladder. BCG-side effects of intravesical therapy bladder irritability, hematuria, fever, malaise, nausea, chills, arthralgias, and pruritus.

Intravesical bacillus Calmette-Guerin is the main treatment for carcinoma in situ or high grade superficial bladder carcinoma.

Efficacy of 65-90% in protecting severe forms of tuberculosis in infants.

Efficacy in protecting older children and adults from tuberculosis ranges from 0-80% in various trials.

Efficacy of preventing tuberculosis much better for women than men.

BCG vaccination correlates with a lower risk of lung cancer.

When given for bladder cancer, the vaccine is instilled into the bladder through the urethra.


The BCG immunization generally causes some pain and scarring at the site of injection. 


Its adverse effects include keloids.


The deltoid muscle is most frequently used as the site for insertion because the local complication rate is least when that site is used. 


The  buttock is an alternative site of administration because it provides better cosmetic outcomes.


Rarely, hematogenous spread of  breast and gluteal abscesses can occur, as well as lymphangiomatous spread.



Bone infection with BCG osteomyelitis and disseminated BCG infection are rare complications of BCG vaccination.


Systemic anti-tuberculous therapy may be helpful in severe complications.


BCG administered to an an immuno-compromised patient, it can cause disseminated or life-threatening infection. 


The World Health Organization (WHO) currently recommends childhood BCG for all countries with a high incidence of TB and/or high leprosy burden.


The US has never used mass immunization of BCG due to the rarity of TB in the US.


Evidence exists for a beneficial non-specific effect of BCG vaccination on overall mortality in low income countries, or for its reducing other health problems including sepsis and respiratory infections when given early.


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