Long-term Efficacy of BCG Vaccine in American Indians and Alaska Natives

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Abstract
Bacille Calmette-Guérin (BCG) is an attenuated strain of Mycobacterium bovis that is used worldwide as a tuberculosis vaccine. Although the reported efficacy of BCG vaccines in controlled trials varies greatly, a meta-analysis found that overall, the vaccine reduced the risk of tuberculosis by 50% but that the duration of the protective effect could not be quantified.1 A meta-analysis of efficacy over time among randomized controlled trials reported a 5% to 14% annual decrease among 7 trials and an increase in efficacy of up to 18% among 3 others.2