Interventions for Tuberculosis Control and Elimination
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It is not obvious why BCG should provide such a large range of protective efficacy. What appears to be evident is that it provides good protection against death, against disseminated tuberculosis, and against meningeal tuberculosis. Furthermore, it provides reasonably good protection against tuberculosis of any form if vaccination is given in infancy while the protection afforded against any form of tuberculosis among children other than infants or among adults is poor.
Nevertheless, even among vaccinees other than infants, BCG has offered high protection in some but not in other settings. A variety of possible hypotheses has been offered to provide possible explanations for these apparent differences. The most comprehensive evaluation of these hypotheses has been offered by researchers at the London School of Hygiene and Tropical Medicine.
However, in the following only hypotheses that have not been thorougly rejected will be considered.
