Cambridge: Cambridge University Press. Serious side effects from the BCG vaccine, such as a serious allergic reaction (anaphylactic reaction), are very rare. “B.C.G. It conducted epidemiological surveys and focused staffers’ efforts on diagnosis, quarantine, and disinfection (He 2011, 131–132). Although BCG vaccination in China is often dated to the 1950s, when the government of the People’s Republic of China expanded a number of mass immunization programs (Zhang and Elvin 1998, 524), He Ling shows that it actually began much earlier, in the 1930s. PhD diss., Université de Paris VII. Procedures for manufacturing the vaccine generally followed international norms—using a solution called Sauton’s medium—but the wartime institute changed these methods to adapt production to wartime scarcity. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Mayo Clinic College of Medicine and Science, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Bacillus Of Calmette And Guerin Vaccine, Live (Intravesical Route), FREE book offer – Mayo Clinic Health Letter. BCG Vaccination Protects against Experimental Viral Infection in Humans through the Induction of Cytokines Associated with Trained Immunity. 2018 Aug;13(10):1193-1208. doi: 10.2217/fmb-2018-0026. Although the campaign originally earmarked $500,000 for work in China, it ultimately spent only $27,191 there—yet most of this sum went toward a donation of laboratory equipment for production of BCG, in a departure from typical spending patterns on non-European countries that participated in the campaign (International Tuberculosis Campaign 1951, 19, 30–32). By the early 1930s, tuberculosis was identified as a crisis of Chinese health, society, and family. BCG-osteomyelitis and 3. The immunity produced by contracting tuberculosis was not strong, and reinfection was relatively easy, so a vaccine—which generally worked by introducing the disease pathogen in an attenuated form to the body—would not be very strong, either. O 0, 2. Sources: 1939. Shanghai to Paris, Paris to Chongqing: The Introduction of BCG to China. Zhang, Yixia, and Mark Elvin. 2009, 72–75). Cui gave a stock answer to the question of what a vaccine was and what it did—it involved injecting killed or nontoxic pathogens into the body and increased the strength of resistance to infection by producing a strong reaction to the invading tubercle. Chen set up a laboratory at the National Vaccine and Serum Institute in Beijing to produce the vaccine, and Wei did likewise at the Shanghai branch of the Vaccine and Serum Institute (Chen, Wei, and Zhu 1982, 437–438). Yet such changes in priority for the central Japanese state did not necessarily translate to colonial settings, especially during the war, and were often articulated in different configurations of personnel and institutions (Liu 2008). Epub 2018 Aug 17. Aronson, Joseph D., Erma I. Parr, and Robert M. Saylor. “BCG Vaccination in the U.S.S.R.” Chinese Medical Journal 66 (10): 564–567. Content: Discovering Tuberculosis: A Global History, 1900 to the Present. These effects are thought to be mediated via the induction of innate immune memory and heterologous lymphocyte activation, resulting in enhanced cytokine production, macrophage activity, T-cell responses and antibody titres. He first discussed the BCG vaccine, describing it simply as “French” and that it “used a kind of special method” to produce an attenuated bovine tubercle bacillus suitable for inoculation of infants younger than one week., Publication Ethics & Malpractice Statement, Creative Commons Attribution-NonCommercial-NoDerivs 3.0 United States License. A survey of medical research and writing shows that Chinese researchers and physicians participated actively in global efforts to promote the BCG vaccine in the immediate postwar era, when the disease swept Europe. To emphasize the reliability of BCG, Wang discussed its acceptance by the international immunological community. The dry vaccine was not as fresh, nor as effective, as the vaccine prepared in suspension, but to Qiao, its capacity for long-term storage was worth the trade-off. For example, Wu claimed that since the BCG vaccine had proven only partially effective, it should be combined with other preventive means like proper nutrition and quarantining active cases (Wu 1947). Physicians and researchers who promoted BCG between 1945 and 1949 were enthusiastic about the vaccine, but pointed out that it did not exclude the role of other, social measures of improving public health, in part because concerns about its efficacy lingered. Shanghai: Heji yinshuguan. Next review due: 23 April 2022, Booking your child's vaccination appointment. Some were passed by the touch of humans or animals, others infected water and food supplies, and perhaps the most fearsome spread through the air.  |  [3] Imamura claimed that the BCG vaccine was not very effective in terms of prevention, so it would be important to combine getting the vaccine with careful maintenance of personal and environmental hygiene. The microneedle vaccine patch induced … Yiyao xinzhi 1 (5): 209. Virtually everyone when given the BCG vaccination will develop a raised bubble at the site of the injection, which may disappear soon afterwards. Under these auspices, Song Guobin, a former student of Calmette and professor of bacteriology at Fudan University Medical School —best known today for his role in establishing the field of medical ethics in China—received and preserved a shipment of the BCG strain as early as 1929. Disease and Class: Tuberculosis and the Shaping of Modern North American Society. Imamura Arao. By identifying the factors that impact the non-specific effects of BCG, we will take an important step towards novel therapeutic options and vaccination strategies, which might lead to a reduction in severe morbidity and mortality associated with viral infections. The distribution of the vaccine on a national level also posed many logistical issues, which Wang Liang discussed in a 1948 article in the journal Xin Chongqing (The new Chongqing). Ann Arbor, MI: Association of Asian Studies. 1982. Vaccination: Eleven Years of Experience.” Chinese Medical Journal 67 (5): 275–278. provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Tomes, Nancy. More serious complications, such as abscesses or bone inflammation, are rare. Especially after the Nationalist government—and with it a host of medical administrators, physicians, and researchers—relocated to southwest China to make its headquarters at Chongqing, new institutions were built, expertise in Western and Chinese medicine was remade, and groups like women and the overseas Chinese became prominent actors in spheres of medicine and public health (Watt 2014; Barnes 2018; Soon 2016). It's common to have flu-like symptoms, such as fever, achiness, chills, and fatigue. Intimate Communities: Wartime Healthcare and the Birth of Modern China, 1937–45. 3. Core, Rachel. Soon, Wayne S. 2016. These sources suggest that in Japan and China, as in Europe, prevention and treatment of tuberculosis were not always clearly separable; moreover, in the 1930s the BCG vaccine lacked a stable, standardized definition (Bonah 2008, 279). In the case of BCG, these processes bore fruit only in the years after the war ended, when a review of medical literature suggests that in the tumultuous years of civil war between 1945 and 1949, health administrators began to plan for implementation of the BCG vaccine on a large scale for the first time. In the decades after Robert Koch’s 1890 failed attempt to use this extract of tubercle bacillus as the basis for a tuberculosis vaccine, the activity and toxicity of the bacillus remained poorly understood in Europe. Under Japanese occupation, Shanghai, previously the epicenter of anti-tuberculosis work, saw a substantial rise in infection rates as refugees flooded into the region and air raids destroyed sanatoriums and clinics. In Austria with January 1st 1990 the routineously vaccinations of the newborns was stopped, and since this date only special indications for BCG-vaccination are recommended (high risk of Tbc-infection). Reactions to the BCG vaccine are uncommon and generally mild. So the danger of routineously made BCG-vaccinations in newborns got higher than the risk of Tbc-infections. Aronson, Joseph D., and C. E. Palmer. Although the two bacteriologists who received training from the campaign went unnamed in its final report, as plans for the Campaign were coalescing in 1947, the WHO funded a scholarship for three Chinese researchers—Chen Zhengren, Wei Xihua, and Zhu Zongyao—to visit Denmark’s State Serum Institute and Anti-Tuberculosis Dispensary in November 1947. Tuberculin was primarily used for diagnosis—then as now, a positive reaction to an injection of tuberculin indicates infection with the disease—but researchers continued to search for ways to use a modified form of bacillus extract to halt the spread of the disease. Cross-Currents: East Asian History and Culture Review (e-journal) 30: 35–54. Translated by S. F. Silberbauer and Lu Yongchun. Clipboard, Search History, and several other advanced features are temporarily unavailable. 1988. Cambridge, MA: Harvard University Press. These activities had shaped the experiences of many biomedical researchers and doctors during the war with Japan, and they also shaped the enthusiastic support for BCG that emerged from 1945 to 1949, along with the emergence of a global endorsement for the vaccine. Aronson, Joseph D. 1948. Wang’s work—as well as that of Calmette, who had established the Pasteur Institute in Saigon before undertaking work on BCG—speaks to the importance of the medical networks that connected China, Southeast Asia, and France, especially the role that medical schools in French Indochina played in training Chinese physicians in Western medicine (Bretelle-Establet 2000). 2012. Advertising revenue supports our not-for-profit mission. 2010. 2014. Ding Huikang. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic. It's a vaccine which is a type of immunotherapy medicine. While you are being treated with BCG, and for 6 to 12 weeks after you stop treatment with it, avoid contact with people who have tuberculosis. Find NCBI SARS-CoV-2 literature, sequence, and clinical content: New Brunswick, NJ: Rutgers University Press. Because the tubercle bacillus reproduces slowly, it is possible for infected persons to become disease vectors without displaying any obvious symptoms or realizing the extent of their illness. Despite this enthusiasm, Imamura went on to reserve final judgment, saying that “now it is just the problem of quality [literally, chengji 成績 (grades)], which still has not reached a definite judgment.” He concluded ambiguously, “It’s the most interesting vaccine in the world” (Imamura 1935, 173). COVID-19 is an emerging, rapidly evolving situation. 1933. Implications: Wang Liang presented an overview of the efficacy of BCG vaccination programs in European countries, Canada, Brazil, and Uruguay, as well as the United States. During the deprivations of war, the link between poverty and illness was starkly apparent; Zhu continued, “Once [the teachers at Shanghai National Medical College] fell ill, there was no one to care for them at home, and the expensive fees of hospitalization were well beyond the reach of their puny incomes” (1946, 19). If you're worried that your or your child's skin reaction is abnormal or that the spot may have become infected, contact a GP. 1998. After discussing BCG, for example, Imamura noted the existence of a method of using two or three “preventive injections” to prevent the onset of tuberculosis, saying, “This is not at all the idea meant by ‘immunization.’” Yet Imamura went on to say that because such “preventive injection” did prevent the onset of disease by healing lesions, it “could only be termed, in contrast to immunization, a kind of vaccine therapy [yimiao liaofa 疫苗療法].”  He stressed that vaccines were the only kind of injection that could prevent disease, and any “substitutions” (daiyongpin 代用品) were not dependable, suggesting a concern with reliability and quality of vaccines for the time (Imamura 1935, 174). “Tuberculosis and the Assimilation of Germ Theory in China, 1895–1937.” Journal of the History of Medicine and Allied Sciences 52 (1): 114–157. “The Specificity and Sensitivity of the Tuberculin Reaction Following Vaccination with BCG.” American Journal of Hygiene 33, section B (2): 42–49. Bryder, Linda. 1949. Wang claimed that none of those immunized fell ill with tuberculosis. 1930. ], and Chengzhou Guo [C. C. Kouo]. TB prevention and control would benefit from an improved method of BCG vaccination that simplifies logistics and eliminates dangers posed by hypodermic … 1936. Danger in the Air: Tuberculosis Control and BCG Vaccination in the Republic of China, 1930–1949. NIH While Chinese institutions in occupied territory continued their work under dramatically altered circumstances, the Japanese occupation regime made medical interventions of its own. Even if BCG vaccine is shown to be effective, that’s no reason to stockpile. 2012 Jan-Feb;32(1):4-8. doi: 10.5144/0256-4947.2012.4. In 1928, after a 1926 Norwegian clinical trial found the vaccine to prevent tuberculosis in 80 percent of human subjects (Flower 2008, 45), the League of Nations declared that the oral BCG vaccine was safe. PhD diss., National University of Singapore. NIH Yet the vaccine’s promotion in China before 1949, especially during the Civil War, was the result of attention to bacteriological research on a global stage, perceived connections between the prevalence of tuberculosis in China and its state of economic crisis, and a genuinely national vision for public health and immunization work. Mass Vaccination: Citizens’ Bodies and State Power in Modern China. Tuberculosis (TB) caused by Mycobacterium tuberculosis continues to be a leading cause of mortality among bacterial diseases, and the bacillus Calmette-Guérin (BCG) is the only licensed vaccine for human use against this disease. Vaccinul BCG (denumirea provine de la bacilul Calmette–Guérin) este un vaccin utilizat în principal împotriva tuberculozei. Source: Baoding Shi fang lao wei yuan hui (1950?). BCG vaccine should be given to all infants as soon as possible after birth. In retrospect, Wang presented his research in France as a fundamentally patriotic endeavor: “Thinking of the needs of our nation to fight tuberculosis,” he wrote in 1948, “I traveled across the oceans, and went to Calmette’s laboratory” (Wang 1948, 13).[2]. Jacquerod, M. 1933. doi: 10.18295/squmj.2020.20.03.013. Li Hengjun. The vaccine used today is essentially the same, Offit says. After the Second Sino-Japanese War, as Nationalist and Communist forces lurched toward a renewal of civil war, physicians and medical researchers promoted BCG vaccination as an effective, cost-efficient means of preventing tuberculosis transmission that could save China from economic ruin. Lei, Sean Hsiang-lin. So the danger of routineously made BCG-vaccinations in newborns got higher than the risk of Tbc-infections. Li Hengjun also argues that Chinese physicians and administrators who sought to treat and prevent tuberculosis selectively integrated Western medicine into traditional social, cultural, and medical systems (Li 2014, 3–4). Get the latest public health information from CDC:  |  [1] It provided new opportunities for members of China’s biomedical research community—many of whom had moved with the Nationalist government to the nation’s plague-prone western hinterlands—to develop new methods of producing and distributing vaccines and controlling epidemics. Get the latest research from NIH: This site needs JavaScript to work properly. This bacterium is resistant to heat and can survive in dark spaces for six to eight months, so tuberculosis infection rates tend to correlate with dark, damp, stuffy, and crowded spaces. Qiao pointed out that mass immunization would cost “but an infinitesimal fraction of the millions of dollars it costs to run sanatoria [sic]” (Qiao 1948, 568). NLM 2019 Dec;25(12):1457-1458. doi: 10.1016/j.cmi.2019.05.024. [Comparative evaluation of the effectiveness of vaccination of newborn infants with BCG and BCG-M vaccines]. BCG treatment may result in fewer side effects than systemic chemotherapy, which affects your entire body. Once healed, the sore may leave a small scar. Tuberculosis was counted among these epidemics. A year later, authorities immunized 250 babies in Lübeck, Germany, but the vaccines were contaminated with virulent bacilli and seventy-two infants died. However the vaccine should not be given to people who are clinically immunosuppressed (either due to drug treatment or underlying illness). National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. The immunization programs sponsored by the bureau laid the foundations for national disease control programs in the postwar and post-1949 periods, and brought together Chinese microbiologists with foreign colleagues involved in medical aid programs sponsored by groups like the League of Nations Health Organization and the American Bureau for Medical Aid to China (ABMAC) (Brazelton forthcoming 2019).  |  Liu, Michael Shiyung. purulent BCG-lymphadenitis), 2. This is normal and nothing to worry about. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Ann Saudi Med. We review evidence for non-specific protection induced by BCG vaccination against viral infections, discuss possible mechanisms of action, and summarize implications for vaccination policies and vaccine discovery. Who should have the pneumococcal vaccine? The success of trials in the Ukraine and Russia during the 1920s resulted in a larger campaign in 1934 and a nationwide movement in 1937. Published materials show that efforts to introduce this vaccine during the early 1930s met with skepticism on the part of Chinese physicians and inaction on the part of the state. “Vikings against Tuberculosis: The International Tuberculosis Campaign in India, 1948–1951.” Bulletin of the History of Medicine 81 (2): 407–430. Which babies should have the MenB vaccine. For example, in 1942, staff members at the institute replaced asparagine, an ingredient in Sauton’s medium, with sodium glutamate, a common ingredient in Chinese cuisine (Liu and Guo 1949, 276). BCG is a vaccine for tuberculosis (TB). 1948. Many foreign-born persons have been BCG-vaccinated. They reflected changing understandings of tuberculosis, bacteriology, and vaccination in China, and they resulted in the gradual acceptance of BCG immunization as a technical, pharmaceutical approach to a disease that had taken on a variety of social and cultural meanings, and one that could reasonably work alongside—not in place of—practices of weisheng. You may report them to the FDA. Yet after news of the Lübeck incident spread to China, concerns about the safety of BCG forestalled its production and implementation, despite Song’s promotion of the vaccine in medical literature (He 2011, 117). Yet the report concluded that the upheaval of civil war meant that “it was not feasible to start the usual kind of ITC-aided BCG programme in China” (International Tuberculosis Campaign 1951, 46). Their hesitation—often expressed in the assertion that preventive measures might include BCG but certainly ought to continue to stress social measures—also supported broader, environmental efforts to control tuberculosis by transforming local health infrastructures and personal, familial behaviors. The association sponsored public lectures, posters, and programs to educate the public about the dangers of tuberculosis, albeit with limited success. Although historians of medicine have begun to understand the modern history of tuberculosis in global terms (McMillen 2015), China’s place in those narratives has remained unclear. Pepper, Suzanne. “Biao san: Zhongyang fangyi chu zhipin chanliang” 衛生,表三:中央防疫處製品產量 [Table 3: Biological products of the National Epidemic Prevention Bureau]. “Protective Vaccination against Tuberculosis with Special Reference to BCG Vaccination.” American Review of Tuberculosis 58 (3): 255–281. Over six months in Copenhagen, these researchers studied BCG vaccine production, standardization, and distribution. “B.C.G. [9] Original source: “假令卡介苗毫無功效,則早已棄置不用,不至使現今美國學者籌設製造機關以接種美國之小兒矣.”. 2011. Copyright © 2019 European Society of Clinical Microbiology and Infectious Diseases. Although Cui, writing for a broader audience than Imamura, did not delve into the technicalities of immunology, he referred to multiple versions of an anti-tuberculosis vaccine, specifically versions produced in England and Japan. In the early twentieth century, in Western languages, the term “vaccine” referred to a microbiological substance in which a pathogen was somehow weakened, but there was some debate over whether a vaccine was necessarily prophylactic in nature. Cerner Multum, Inc. "Australian Product Information." Baltimore, MD: Johns Hopkins University Press. It's important to leave the area uncovered as the air will help it to heal. 1935. BCG, or bacille Calmette-Guerin, is a vaccine for tuberculosis (TB) disease. In September 1947, physician Shaoqing Wu wrote that BCG vaccines represented a chance to break pernicious cycles of tubercular infection that had weakened China’s labor force: “More ignorance and poverty, more tuberculosis! In 1924, the Paris Pasteur Institute began to distribute the BCG strain around the world. [5] Original source: “世上對於結核菌素及其他菌裝劑療法 (例如百瀨氏液或志賀氏感作結核苗裝等。均為結核菌素之一種。 其作用並無異點).” I have translated 苗裝 (miao zhuang) as “vaccine material” because in the context of microbiology, 苗 (miao) is a term strongly associated with immunizations—i.e., Doumiao 痘苗 (Vaccinia), yimiao 疫苗 (vaccine), etc. New York: Routledge. 2020 Oct 29;16(10):e1008969. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: After you stop using this medicine, it may still produce some side effects that need attention. 2018. In China, physicians trained in Western medicine selectively assimilated germ theory into Chinese medical, political, and social spheres (Andrews 1997). However, Imamura introduced the BCG vaccine in glowing terms, noting that Calmette had reported a successful experimental trial with four hundred thousand human subjects. The vaccine itself proved difficult to produce and implement, but its promotion reflected the transformations that war had wrought in China’s public health system, as well as the particular meaning that physicians gave to the economic implications of the tuberculosis crisis and their engagement with global networks of bacteriology.

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