SynthesisClinical infectious diseases : an official publication of the Infectious Diseases Society of America2014
Protection by BCG vaccine against tuberculosis: a systematic review of randomized controlled trials.
Synthesis in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 540 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Bacillus Calmette-Guerin Against Covid-19 for Prevention and Amelioration of Severity Trial
Novel Use of an Existing Vaccine (BCG) Alliance: The NUEVA Trial
Prevention of Acute Respiratory Infection in Taiwanese Institutionalized Elderly (PARITIE)
The Role of the Bacillus Calmette-Guérin Vaccine (BCG) in the Clinical Evolution of COVID-19 and in the Efficacy of Anti-SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) Vaccines
Who cites it
540 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Incidence of Bacille Calmette-Guérin associated lymphadenitis in healthy children: A systematic review and meta-analysis.Human vaccines & immunotherapeutics · 2026Pooled it
- Effect of BCG vaccination on the progression of latent tuberculosis infection to active disease in contacts: a systematic review and meta-analysis.BMC infectious diseases · 2025Pooled it
- Incidence, risk factors and outcomes of BCGosis following BCG vaccination in infants: a systematic review and meta-analyses.Frontiers in immunology · 2025Pooled it
- Safety and efficacy of tuberculosis vaccine candidates in low- and middle-income countries: a systematic review of randomised controlled clinical trials.BMC infectious diseases · 2023Pooled it
- Infant BCG vaccination and risk of pulmonary and extrapulmonary tuberculosis throughout the life course: a systematic review and individual participant data meta-analysis.The Lancet. Global health · 2022Pooled it
- Safety and immunogenicity of investigational tuberculosis vaccine M72/AS01The lancet. HIV · 2025Trial
- Live-attenuated Mycobacterium tuberculosis vaccine, MTBVAC, in adults with or without M tuberculosis sensitisation: a single-centre, phase 1b-2a, double-blind, dose-escalation, randomised controlled trial.The Lancet. Global health · 2025Trial
- Safety, reactogenicity, and immunogenicity of MTBVAC in infants: a phase 2a randomised, double-blind, dose-defining trial in a TB endemic setting.EBioMedicine · 2025Trial
- Effect of BCG vaccination against Mycobacterium tuberculosis infection in adult Brazilian health-care workers: a nested clinical trial.The Lancet. Infectious diseases · 2024Trial
- Impact of vaccine platform and BCG vaccination on antibody responses to COVID-19 vaccination.Frontiers in immunology · 2023Trial
- Reframing evidence on the BCG vaccine: What emerging systematic reviews and meta-analyses reveal about efficacy, safety, and heterogeneity.Human vaccines & immunotherapeutics · 2026Article
- BCG vaccination mitigates tau pathology and restores cognitive function in PS19 mice.Science advances · 2026Article
- Article
- An adenovirus-based multiantigen vaccine protects against tuberculosis by coordinating adaptive immunity and curbing immunosuppressive mechanisms.Microbiology spectrum · 2026Article
- Safety of the M72/AS01 Tuberculosis Vaccine in People Living With HIV: A Systematic Review and Meta-Analysis.Open forum infectious diseases · 2026Article
- BCG vaccination elicits protection against M. tuberculosis infection mediated by two phases of T cell immunity.JCI insight · 2026Article
- Antigen-experienced airway CD8Science advances · 2026Article
- Lung Resident T Cells Across the Spectrum of TB Infection and Disease.bioRxiv : the preprint server for biology · 2026Article
- Monocytic niches escape T cell surveillance and promote Mycobacterium tuberculosis persistence in lymph nodes.Immunity · 2026Article
- γδ T Cells at the Crossroads of Tuberculosis and COPD: From Early Immunity to Tissue Remodeling.International journal of molecular sciences · 2026Review
480 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
backgroundRandomized trials assessing BCG vaccine protection against tuberculosis have widely varying results, for reasons that are not well understood.
methodsWe examined associations of trial setting and design with BCG efficacy against pulmonary and miliary or meningeal tuberculosis by conducting a systematic review, meta-analyses, and meta-regression.
resultsWe identified 18 trials reporting pulmonary tuberculosis and 6 reporting miliary or meningeal tuberculosis. Univariable meta-regression indicated efficacy against pulmonary tuberculosis varied according to 3 characteristics. Protection appeared greatest in children stringently tuberculin tested, to try to exclude prior infection with Mycobacterium tuberculosis or sensitization to environmental mycobacteria (rate ratio [RR], 0.26; 95% confidence interval [CI], .18-.37), or infants (RR, 0.41; 95% CI, .29-.58). Protection was weaker in children not stringently tested (RR, 0.59; 95% CI, .35-1.01) and older individuals stringently or not stringently tested (RR, 0.88; 95% CI, .59-1.31 and RR, 0.81; 95% CI, .55-1.22, respectively). Protection was higher in trials further from the equator where environmental mycobacteria are less and with lower risk of diagnostic detection bias. These associations were attenuated in a multivariable model, but each had an independent effect. There was no evidence that efficacy was associated with BCG strain. Protection against meningeal and miliary tuberculosis was also high in infants (RR, 0.1; 95% CI, .01-.77) and children stringently tuberculin tested (RR, 0.08; 95% CI, .03-.25).
conclusionsAbsence of prior M. tuberculosis infection or sensitization with environmental mycobacteria is associated with higher efficacy of BCG against pulmonary tuberculosis and possibly against miliary and meningeal tuberculosis. Evaluations of new tuberculosis vaccines should account for the possibility that prior infection may mask or block their effects.
Indexed as
Identifiers
24336911What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.