Editing BCG vaccine (section)

==History==
[[File:BCG advert.jpg|thumb|French poster promoting the BCG vaccine]]
The history of BCG is tied to that of [[smallpox]]. By 1865 [[Jean Antoine Villemin]] had demonstrated that rabbits could be infected with tuberculosis from humans;<ref>{{cite journal |vauthors=Villemin JA |title=Cause et nature de la tuberculose |journal=Bulletin de l'Académie Impériale de Médecine |date=1865 |volume=31 |pages=211–216 |url=https://babel.hathitrust.org/cgi/pt?id=hvd.32044103060562&view=1up&seq=215 |trans-title=Cause and nature of tuberculosis |language=fr |access-date=8 October 2020 |archive-date=9 December 2021 |archive-url=https://web.archive.org/web/20211209200251/https://babel.hathitrust.org/cgi/pt?id=hvd.32044103060562&view=1up&seq=215 |url-status=live }}</ref> by 1868 he had found that rabbits could be infected with tuberculosis from cows and that rabbits could be infected with tuberculosis from other rabbits.<ref>{{cite book |vauthors=Villemin JA |title=Études sur la Tuberculose |trans-title=Studies of Tuberculosis |date=1868 |publisher=J.-B. Baillière et fils |location=Paris, France |pages=528–597 |url=https://books.google.com/books?id=lIpawDQYwtwC&pg=PA528 |language=fr |access-date=8 October 2020 |archive-date=25 July 2024 |archive-url=https://web.archive.org/web/20240725193904/https://books.google.com/books?id=lIpawDQYwtwC&pg=PA528#v=onepage&q&f=false |url-status=live }} (§ ''"Seizième Étude: La tuberculose est inoculable"'' (Sixteenth study: Tuberculosis can be transmitted by inoculation))</ref> Thus, he concluded that tuberculosis was transmitted via some unidentified microorganism (or ''"virus"'', as he called it).<ref>(Villemin, 1868), pp. 598–631. From p. 598: ''"La tuberculose est inoculable, voilà maintenant un fait incontestable. Désormais cette affection devra se placer parmi les maladies ''virulentes'', ... "'' (Tuberculosis [can be transmitted by] inoculation; that's now an incontestable fact. Henceforth this malady should be placed among the ''virulent'' maladies [i.e., those diseases that are transmitted via microorganisms], ... ) From p. 602: ''"Les virus, comme les parasites, se multiplient eux-même, nous ne leur fournissons que les moyens de vivre et de se reproduire, jamais nous les créons."'' (Viruses, like parasites, multiply themselves; we merely furnish them with the means of living and reproducing; we never create them.)</ref><ref>{{cite book | vauthors = Villemin JA |title=De la virulence et de la spécificité de la tuberculose |trans-title=On the virulence [i.e., infectious nature] and specificity of tuberculosis |date=1868a |publisher=Victor Masson et fils |location=Paris, France |url=https://archive.org/details/b30568602 |language=fr}}</ref> In 1882 [[Robert Koch]] regarded human and bovine tuberculosis as identical.<ref>{{cite journal |vauthors=Koch R |title=Die Aetologie der Tuberculose |journal=Berliner Klinische Wochenschrift |date=10 April 1882 |volume=19 |issue=15 |pages=221–230 |url=https://babel.hathitrust.org/cgi/pt?id=mdp.39015020075001&view=1up&seq=235 |trans-title=The etiology of tuberculosis |language=de |access-date=9 October 2020 |archive-date=9 December 2021 |archive-url=https://web.archive.org/web/20211209173628/https://babel.hathitrust.org/cgi/pt?id=mdp.39015020075001&view=1up&seq=235 |url-status=live }} From p. 230: ''"Die Perlsucht ist identisch mit der Tuberculose des Menschen und also eine auf diesen übertragbare Krankheit."'' (Pearl disease [i.e., bovine tuberculosis] is identical to the tuberculosis of humans and thus [is] a disease that can be transmitted to them.)</ref> But in 1895, [[Theobald Smith]] presented differences between human and bovine tuberculosis, which he reported to Koch.<ref>{{cite journal |vauthors=Smith T |title=Investigations of diseases of domesticated animals |journal=Annual Report of the Bureau of Animal Industry |publisher=U.S. Department of Agriculture |date=1895 |volume=12/13 |pages=119–185 |url=https://books.google.com/books?id=bZkp_4YTdu0C&pg=PA149 }} See § "Two varieties of the tubercle bacillus from mammals." pp. 149-161.
* {{cite journal |vauthors=Smith T |title=Two varieties of the tubercle bacillus from mammals |journal=Transactions of the Association of American Physicians |date=1896 |volume=11 |pages=75–95 |url=https://babel.hathitrust.org/cgi/pt?id=hvd.32044103006490&view=1up&seq=109 |access-date=9 October 2020 |archive-date=25 July 2024 |archive-url=https://web.archive.org/web/20240725193929/https://babel.hathitrust.org/cgi/pt?id=hvd.32044103006490&view=1up&seq=109 |url-status=live }}</ref><ref>{{cite journal | vauthors = Palmer MV, Waters WR | title = Bovine tuberculosis and the establishment of an eradication program in the United States: role of veterinarians | journal = Veterinary Medicine International | volume = 2011 | issue = 1 | pages = 816345 | date = May 2011 | pmid = 21647341 | pmc = 3103864 | doi = 10.4061/2011/816345 | s2cid = 18020962 | doi-access = free }} From p. 2: "In 1895, Smith visited Koch in Europe and described his findings."</ref> By 1901 Koch distinguished ''Mycobacterium bovis'' from ''[[Mycobacterium tuberculosis]]''.<ref>{{cite journal |vauthors=Koch R |title=An address on the combatting of tuberculosis in the light of experience that has been gained in the successful combatting of other infectious diseases. |journal=The Lancet |date=27 July 1901 |volume=158 |issue=4065 |pages=187–191 |doi=10.1016/S0140-6736(01)85122-9 |url=https://babel.hathitrust.org/cgi/pt?id=uiug.30112114890558&view=1up&seq=225 |access-date=9 October 2020 |archive-date=25 July 2024 |archive-url=https://web.archive.org/web/20240725193926/https://babel.hathitrust.org/cgi/pt?id=uiug.30112114890558&view=1up&seq=225 |url-status=live }} From p. 189: "Considering all these facts, I feel justified in maintaining that human tuberculosis differs from bovine and cannot be transmitted to cattle."</ref> Following the success of [[vaccination]] in preventing smallpox, established during the 18th century, scientists thought to find a corollary in tuberculosis by drawing a parallel between bovine tuberculosis and [[cowpox]]: it was hypothesized that infection with bovine tuberculosis might protect against infection with human tuberculosis. In the late 19th century, clinical trials using ''M. bovis'' were conducted in Italy with disastrous results, because ''M. bovis'' was found to be just as virulent as ''M. tuberculosis''.<ref>{{cite journal | vauthors = Mitermite M, Elizari JM, Ma R, Farrell D, Gordon SV | title = Exploring virulence in Mycobacterium bovis: clues from comparative genomics and perspectives for the future | journal = Irish Veterinary Journal | volume = 76 | issue = Suppl 1 | pages = 26 | date = September 2023 | pmid = 37770951 | pmc = 10540498 | doi = 10.1186/s13620-023-00257-6 | doi-access = free }}</ref>

[[Albert Calmette]], a French physician and bacteriologist, and his assistant and later colleague, [[Camille Guérin]], a veterinarian, were working at the [[Institut Pasteur de Lille]] ([[Lille]], France) in 1908. Their work included subculturing virulent strains of the tuberculosis bacillus and testing different culture media. They noted a glycerin-bile-potato mixture grew bacilli that seemed less virulent and changed the course of their research to see if repeated subculturing would produce a strain that was attenuated enough to be considered for use as a vaccine. The BCG strain was isolated after subculturing 239 times during 13 years from a virulent strain on [[glycerine]] potato medium. The research continued throughout World War I until 1919 when the now avirulent bacilli were unable to cause tuberculosis disease in research animals. Calmette and Guerin transferred to the Paris [[Pasteur Institute]] in 1919. The BCG vaccine was first used in humans in 1921.<ref name="WHO 1999" />

Public acceptance was slow, and the [[Lübeck disaster]], in particular, did much to harm it. Between 1929 and 1933 in [[Lübeck]], 251 infants were vaccinated in the first 10 days of life; 173 developed tuberculosis and 72 died. It was subsequently discovered that the BCG administered there had been contaminated with a virulent strain that was being stored in the same incubator, which led to legal action against the vaccine's manufacturers.<ref>{{cite book | vauthors = Rosenthal SR | title=BCG vaccination against tuberculosis | publisher=Little, Brown & Co. | location=Boston | year=1957 }}</ref>

Dr. [[R. G. Ferguson]], working at the [[Fort San, Saskatchewan|Fort Qu'Appelle Sanatorium]] in Saskatchewan, was among the pioneers in developing the practice of vaccination against tuberculosis. In Canada, more than 600 children from [[Canadian Indian residential school system|residential schools]] were used as involuntary participants in BCG vaccine trials between 1933 and 1945.<ref>{{Cite news|vauthors=Blackburn M|date=24 July 2013|title=First Nation infants subject to "human experimental work" for TB vaccine in 1930s-40s|url=https://www.aptnnews.ca/national-news/first-nation-infants-subject-to-human-experimental-work-for-tb-vaccine-in-1930s-40s/|access-date=31 March 2021|website=APTN News|archive-date=26 April 2021|archive-url=https://web.archive.org/web/20210426093642/https://www.aptnnews.ca/national-news/first-nation-infants-subject-to-human-experimental-work-for-tb-vaccine-in-1930s-40s/|url-status=live}}</ref> In 1928, the BCG vaccine was adopted by the Health Committee of the [[League of Nations]] (predecessor to the [[World Health Organization]] (WHO)). Because of opposition, however, it only became widely used after World War II. From 1945 to 1948, relief organizations (International Tuberculosis Campaign or Joint Enterprises) vaccinated over eight million babies in Eastern Europe and prevented the predicted typical increase of tuberculosis after a major war.<ref>{{cite journal | vauthors = Brimnes N | title = Vikings against tuberculosis: the International Tuberculosis Campaign in India, 1948-1951 | journal = Bulletin of the History of Medicine | volume = 81 | issue = 2 | pages = 407–430 | date = 2007 | pmid = 17844722 | doi = 10.1353/bhm.2007.0022 }}</ref>

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. Two countries that have never used it routinely are the United States and the Netherlands (in both countries, it is felt that having a reliable [[Mantoux test]] and therefore being able to accurately detect active disease is more beneficial to society than vaccinating against a relatively rare condition).<ref name="CDC BCG" /><ref name="CDC Tuberculosis" /><ref>{{cite book |year=2011 |title=Vaccination of young children against tuberculosis |issue=2011/04 |publisher=The Hague:Health Council of the Netherlands |isbn=978-90-5549-844-4 |url=http://www.gezondheidsraad.nl/sites/default/files/Summary_vaccine_tegen_tuberculose.pdf |access-date=12 July 2013 |url-status=live |archive-url=https://web.archive.org/web/20140219093821/http://www.gezondheidsraad.nl/sites/default/files/Summary_vaccine_tegen_tuberculose.pdf |archive-date=19 February 2014 }}</ref>

Other names include "Vaccin Bilié de Calmette et Guérin vaccine" and "Bacille de Calmette et Guérin vaccine".<ref>{{Cite web |title=🔎 Vaccin Bilié de Calmette et Guérin - Définition et Explications |url=https://www.techno-science.net/glossaire-definition/Vaccin-Bilie-de-Calmette-et-Guerin.html |access-date=27 June 2024 |website=Techno-Science.net |language=fr |archive-date=27 June 2024 |archive-url=https://web.archive.org/web/20240627120910/https://www.techno-science.net/glossaire-definition/Vaccin-Bilie-de-Calmette-et-Guerin.html |url-status=live }}</ref>