BCG vaccination is not recommended in the United States primarily because of the low prevalence of Mtb. Additionally, it does not provide sufficient protection against adult pulmonary TB and the vaccine can produce false positive tuberculin skin test (TST) results. 

Negatives of BCG Vaccine

The most frequently used live-attenuated bacterial vaccine is the BCG vaccine. Derived from the bovine strain of Mycobacterium tuberculosis, this vaccine prevents childhood tuberculosis meningitis. Although BCG is a routine vaccination for children in European countries, it is not used in the United States. 

Tulane University

Similar to live-attenuated viral vaccines, these bacterial vaccines are more effective at eliciting protective immunity because the attenuated bacteria can continue to replicate in order to mimic a real bacterial infection. Although there is still ongoing research to produce new live-attenuated bacterial vaccines, the number remains relatively small. 

Ex:

- Bacille Calmette-Guérin (BCG) Vaccine

- Salmonella typhi Vaccine

Live-attenuated Bacterial Vaccines

Parham, P. (2009). Vaccination to Prevent Infectious Disease. In 1145902806 862124677 J. Foltin (Ed.), The Immune System (3rd ed., pp. 439-440). New York, New York: Garland Science, Taylor &amp; Francis Group.

The Immune System

BCG Vaccine

In this vaccine, a strain of Salmonella typhi was produced through the removal of a lipopolysaccharide necessary for pathogenesis. An enzyme necessary for lipopolysaccharide synthesis is defective, therefore the pathogenicity of the bacterium is reduced. 

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