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      100 years of Mycobacterium bovis bacille Calmette-Guérin.

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          Mycobacterium bovis bacille Calmette-Guérin (BCG), an experimental vaccine designed to protect cattle from bovine tuberculosis, was administered for the first time to a newborn baby in Paris in 1921. Over the past century, BCG has saved tens of millions of lives and has been given to more humans than any other vaccine. It remains the sole tuberculosis vaccine licensed for use in humans. BCG provides long-lasting strong protection against miliary and meningeal tuberculosis in children, but it is less effective for the prevention of pulmonary tuberculosis, especially in adults. Evidence mainly from the past two decades suggests that BCG has non-specific benefits against non-tuberculous infections in newborn babies and in older adults, and offers immunotherapeutic benefit in certain malignancies such as non-muscle invasive bladder cancer. However, as a live attenuated vaccine, BCG can cause localised or disseminated infections in immunocompromised hosts, which can also occur following intravesical installation of BCG for the treatment of bladder cancer. The legacy of BCG includes fundamental discoveries about tuberculosis-specific and non-specific immunity and the demonstration that tuberculosis is a vaccine-preventable disease, providing a foundation for new vaccines to hasten tuberculosis elimination.

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          Author and article information

          Lancet Infect Dis
          The Lancet. Infectious diseases
          Elsevier BV
          January 2022
          : 22
          : 1
          [1 ] Division of Clinical Infectious Diseases, Medical Clinic, Research Center Borstel, Borstel, Germany; German Center for Infection Research (DZIF) Tuberculosis Unit, Borstel, Germany; Respiratory Medicine and International Health, University of Lübeck, Lübeck, Germany; Global TB Program, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA. Electronic address: clange@fz-borstel.de.
          [2 ] Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau; Bandim Health Project, Southern Danish University, Copenhagen, Denmark.
          [3 ] McGill International TB Centre and Department of Medicine, McGill University, Montreal, QC, Canada.
          [4 ] Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
          [5 ] Max Planck Institute for Infection Biology, Berlin, Germany; Max Planck Institute for Biophysical Chemistry, Göttingen, Germany; Hagler Institute for Advanced Study, Texas A&M University, College Station, TX, USA.
          [6 ] Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Netherlands; Department of Immunology and Metabolism, Life and Medical Sciences Institute, University of Bonn, Bonn, Germany.
          [7 ] Global TB Program, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA.


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