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The BCG vaccine’s benefits are not established, its efficacy against tuberculosis is variable to non-existent, its non-specific effects fail to replicate in rigorous trials, its mechanism remains unknown after a century of use, its safety profile includes deaths and disseminated infection, and its formulation has never undergone preclinical toxicological evaluation.

So why did vaccine sceptic Gavin de Becker praise it in his book ’Forbidden Facts’?

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Gavin de Becker is an American security specialist, author and founder of Gavin de Becker & Associates.  He has been appointed to the President’s Advisory Board at the US Department of Justice three times.

In September 2025, de Becker published his book ‘Forbidden Facts: Government Deceit & Suppression about Brain Damage from Childhood Vaccines’ in which he documents his investigation into US government and pharmaceutical industry collusion to suppress or manipulate scientific evidence regarding the safety of childhood vaccines, particularly in relation to brain damage.

Despite the book’s negative view of the safety and efficacy of the hepatitis B, rotavirus, pertussis, measles and covid-19 vaccines, de Becker praises the Bacillus Calmette-Guérin (“BCG”) vaccine, which is primarily used against tuberculosis (“TB”).

Here is a man who has seen through the entire vaccine enterprise, but falls for one vaccine while rejecting all others.  Why? Because every successful deception needs a pressure valve, Lie are Unbekoming writes. And BCG is that pressure valve.

Unbekoming then goes on to describe why the BCG vaccine fails on precisely the same grounds as every other vaccine de Becker dismantles.

Note: Lies are Unbekoming has written his/her essay in the context of the USA childhood vaccine schedule.  In the UK, the BCG vaccine is not part of the routine childhood vaccination schedule for all children. It is offered to babies, children and young adults at higher risk of TB exposure, such as those living in areas with high TB rates or with close family links to high-incidence countries.

Related:

• ‘Forbidden Facts,’ Gavin de Becker’s New Book About Childhood Vaccines, Children’s Health Defense, 12 September 2025
• Book Review Forbidden Facts Government Deceit & Suppression about Brain Damage from Childhood Vaccines By Gavin de Becker, Solari Report, 13 October 2025

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The BCG Deception: How the “Good Vaccine” Fails on Every Count

By Lies are Unbekoming

Table of Contents

1. Introduction
2. The Efficacy Collapse
3. The Non-Specific Effects Mirage
4. The Product Insert Revelations
   1. The Infant Vaccine (BCG Vaccine AJV)
   2. The Bladder Cancer Product (TICE BCG / OncoTICE)
   3. The Contrast
5. What’s Being Injected
6. The Deeper Problem: What Is Tuberculosis?
   1. The Transmission Paradox
   2. Koch’s Postulates
   3. The Decline Before Medicine
   4. Terrain Theory Framework
7. The Pressure Valve
8. Conclusion
9. References

Introduction

Gavin de Becker’s ‘Forbidden Facts’ is less a systematic vaccine analysis than an indictment of the institutions that recommend them. The Institute of Medicine’s (“IOM’s”) methods for dismissing vaccine injury claims, the Centres for Disease Control and Prevention (“CDC’s”) conflicts of interest, pharmaceutical industry crimes, the media’s failure to investigate – these occupy most pages. But when de Becker does examine individual vaccines in Chapter Eleven, the pattern is consistent: overstated disease risk, underacknowledged vaccine risk, untrustworthy authorities. Hepatitis B, rotavirus, pertussis, measles, covid-19 – each receives the same sceptical treatment.

Then something unexpected happens.  De Becker praises BCG.

The Bacille Calmette-Guérin vaccine, he writes, “has far and away the most beneficial health results of any vaccine.” He lists its alleged benefits: protection against respiratory infections, sepsis, eczema, asthma, allergies, type 1 diabetes, multiple sclerosis, bladder cancer. Available for more than a hundred years. Used in almost every country on Earth. And yet not routinely given in the United States.

“Go figure,” de Becker concludes, presenting BCG’s American absence as evidence of policy irrationality.

Here is a man who has seen through the entire vaccine enterprise – who understands the regulatory corruption, the statistical manipulation, the captured science – embracing a single exception. Why would someone with his analytical sophistication fall for one vaccine while rejecting all others?

The answer reveals something important about how medical mythology maintains itself. Every successful deception needs a pressure valve, a designated exception that makes the critique seem extreme and the system seem reasonable. BCG is that pressure valve. And under scrutiny, it fails on precisely the same grounds as every other vaccine de Becker dismantles.

The Efficacy Collapse

Between 1968 and 1971, the World Health Organisation helped conduct a massive field trial in Chingleput, India – often described as the largest vaccine trial in medical history. Approximately 360,000 people were randomised to receive the BCG vaccine or a placebo. The population was followed for fifteen years. The results, when they emerged, should have ended the BCG story.

The vaccine provided zero protection against pulmonary tuberculosis in adults.

Over the fifteen-year follow-up, tuberculosis cases were essentially identical across groups: 189 cases in the high-dose BCG arm, 191 in the low-dose arm, and 180 in the placebo group among tuberculin-negative people. The researchers’ conclusion was unequivocal: “BCG offered no overall protection in adults.” A 1980 Lancet editorial noted that “the Chingleput study seemed to give another zero effect” and observed that “no study had ever shown a protective effect of BCG in the developing world, where tuberculosis control was most needed.”

This was not a marginal disappointment or a statistical anomaly. This was a WHO-supported trial in a high-TB-burden country showing that the vaccine designed to prevent tuberculosis provided no protection whatsoever. The Lancet suggested it “might well be the deathblow to BCG.” It was not. The vaccine continues to be administered to over 120 million infants annually.

The Chingleput trial is not an outlier. It sits at one end of an efficacy range so wide as to be meaningless. Different trials in different locations have produced protection estimates ranging from 0% to 80%. The BCG Vaccine AJV product insert  acknowledges this directly: vaccination “elicits a cell-mediated immune response that confers a variable degree of protection to infection with M. tuberculosis.”

Variable. Ranging from none to substantial, depending on factors no one fully understands.

The insert continues: “The duration of immunity after BCG vaccination is not known, but there are some indications of a waning immunity after 10 years.”

Not known. Some indications. Waning.

This is the language of uncertainty dressed in the costume of medicine. A product given to over 120 million infants annually, and the manufacturer cannot state how long – or whether – it provides protection.

The research literature confirms what the product insert hedges. A 2023 review in Frontiers in Immunology states plainly: “Its efficacy in children with tuberculous meningitis and miliary tuberculosis is consistent, but its effectiveness in adults with pulmonary TB is variable.” The UK NHS acknowledges: “There’s no evidence the BCG vaccine works for people over the age of 35.” The US CDC does not routinely recommend it because “BCG does not always protect people from getting TB.”

Does not always. Variable. Not known. These are the actual claims behind the confident assertions about BCG’s benefits.

The standard explanation for BCG’s variable efficacy involves geographic differences in environmental mycobacteria, genetic variation in BCG strains and prior exposure to non-tuberculous mycobacteria “masking” the vaccine’s true effect. What these explanations share is an unfalsifiable quality – they explain away failure rather than predict success. A vaccine that works sometimes, in some places, for some people, for some duration, against some forms of disease, is not a successful medical intervention. It is a placeholder maintained by institutional momentum.

The fallback position – the claim that survives when adult pulmonary TB protection collapses – is that BCG reliably prevents severe childhood tuberculosis: meningitis and miliary (disseminated) disease. This is presented as the vaccine’s irreducible benefit; the reason it remains in use despite everything else.

The research literature states that efficacy against these forms “is consistent,” with meta-analyses claiming 70-80% protection.  Several problems undermine this claim.

Childhood tuberculous meningitis was already declining before BCG entered widespread use, following the same trajectory as all tuberculosis forms. The improvements in nutrition, sanitation and living conditions that drove the 96.8% decline in TB mortality did not selectively spare childhood meningitis while affecting only adult pulmonary disease. The historical decline preceded the vaccine.

The evidence for childhood protection derives largely from meta-analyses combining case-control studies, historical cohort comparisons and a limited number of trials – the typical evidence base for rare disease outcomes. These study designs cannot fully control for the confounding that occurs when vaccinated and unvaccinated populations differ systematically in TB burden, healthcare access, nutrition and diagnostic practices. Countries that vaccinate at birth differ from those that do not in ways that independently affect tuberculosis outcomes.

The logical inconsistency deserves attention. BCG supposedly trains the immune system to recognise and control mycobacteria. If this mechanism works reliably against Mycobacterium tuberculosis in childhood meningitis and miliary disease, why does it fail so completely against the same organism causing pulmonary tuberculosis? The bacterium is identical. The immune system is the same. The claimed mechanism should apply across disease forms. That it apparently protects against rare severe childhood presentations while offering 0-80% protection against the common adult form suggests the “consistent” childhood efficacy may reflect confounding, historical trends, or diagnostic differences rather than genuine vaccine effect.

Childhood TB meningitis is rare.  Even in high-burden settings, it represents a small fraction of TB cases. Demonstrating efficacy against rare outcomes with statistical confidence requires enormous sample sizes or extended observation periods. The alternative is reliance on observational data, case-control studies and historical comparisons – all susceptible to the confounding that plagues this literature. The “consistent” protection claim rests on weaker evidence than its confident presentation suggests.

Related:  What is Tuberculosis? Lies are Unbekoming, 1 January

The Non-Specific Effects Mirage

When BCG’s failure against tuberculosis became undeniable, the narrative shifted. The vaccine might not reliably prevent TB, proponents acknowledged, but it offers something potentially more valuable: “non-specific effects” that protect against unrelated diseases. This is the claim de Becker absorbed – that BCG trains the immune system to fight pathogens beyond tuberculosis.

The theoretical mechanism is called “trained immunity.” BCG supposedly reprogrammes innate immune cells through epigenetic modifications, creating a state of enhanced readiness against diverse threats. Monocytes and natural killer cells, having encountered the mycobacteria, become more responsive to subsequent infections of all types. The concept is elegant, plausible-sounding and heavily promoted.  The clinical trials tell a different story.

The Melbourne Infant Study: BCG for Allergy and Infection Reduction (“MIS BAIR”) was a Phase 3 randomised controlled trial designed specifically to test BCG’s non-specific effects in a high-income setting. Researchers in Australia randomised 1,272 infants to receive BCG-Denmark vaccine or no BCG at birth, then followed them for five years. The outcomes were precisely those de Becker lists as BCG benefits.

Lower respiratory tract infections in the first year: 54.8% in the BCG group versus 58.0% in controls. Risk difference: -3.2 percentage points. Confidence interval crossing zero. The researchers’ conclusion: “There is insufficient evidence to support the use of neonatal BCG vaccination to prevent LRTI [lower respiratory tract infection] in the first year of life in high-income settings.”

Eczema at 12 months: 32.2% in the BCG group versus 36.6% in controls. Adjusted risk difference: -4.3 percentage points. Confidence interval: -9.9% to 1.3%. Not statistically significant in the primary analysis.

Atopic sensitisation at one year: 22.9% in the BCG group versus 18.9% in controls. The BCG group had higher rates of allergic sensitisation – the opposite of the claimed benefit.

Food allergy: No difference between groups.

Asthma at five years: 14.4% in the BCG group versus 16.0% in controls. Adjusted risk difference: -1.7 percentage points. Confidence interval: -7.4 to 3.9. Not statistically significant.

The researchers, to their credit, report these findings honestly. Their conclusions are appropriately hedged: “While the point estimates suggested BCG vaccination might protect against asthma, the wide uncertainty around the estimates means further studies with larger sample sizes are needed.”

Might protect. Wide uncertainty. Further studies needed.

This is what rigorous science looks like when it doesn’t find the effect it was looking for. The problem is how these hedged conclusions transform into confident promotional claims.

The covid-19 pandemic provided a natural experiment for trained immunity claims. If BCG genuinely enhanced broad-spectrum immune responses, vaccinated populations should have experienced milder pandemic outcomes. More than 30 clinical trials were launched worldwide to test this hypothesis.  The results arrived, and they were negative.

A multicentre, randomised, double-blind, placebo-controlled Phase 3 trial in Poland revaccinated healthcare workers with BCG. No significant difference in covid-19 incidence between BCG and placebo groups. A double-blind, randomised, controlled Phase 3 trial in South Africa found that “vaccinating HCWs [healthcare workers] with BCG did not reduce the risk of covid-19 and hospitalisation for severe covid-19.”

The trained immunity hypothesis failed its most direct test.

A 2023 meta-analysis in Vaccines attempted to synthesise the evidence across trials. For respiratory infections, BCG showed a 44% risk reduction – but with “substantial heterogeneity between trials” (I²=77%). For covid-19 specifically: no evidence of protection (HR 0.88, confidence interval 0.68-1.14). For all-cause hospitalisation: no evidence of improvement (HR 1.01, confidence interval 0.91-1.11).

What explains the heterogeneity? The meta-analysis found that BCG’s apparent benefits were concentrated in specific subgroups: adolescents or adults rather than infants, low-birth-weight children rather than healthy ones, Western European trials rather than those from Africa or Asia, studies with follow-up under six months, and – critically – trials where outcomes were determined by medical diagnosis rather than participant reporting.

This last finding deserves attention. When outcomes were collected by interviewing parents, BCG showed minimal effect. When outcomes required medical diagnosis, BCG appeared more protective. The researchers note that “BCG vaccination causes a visible scar hindering the blinding of participants and thereby introducing a possible source of bias.”

The visible scar. Parents who know their child received BCG might interpret symptoms differently, might seek medical care differently, might report differently. The “protection” partially evaporates when this bias is controlled.

The surrogate endpoint problem runs deeper. “Trained immunity” is measured by laboratory markers – cytokine production, epigenetic modifications, immune cell responsiveness. These are easy to measure and generate publishable findings. The assumption is that enhanced laboratory markers translate to enhanced clinical protection.

The MIS BAIR trial tested this assumption directly by measuring infant cytokine responses seven months after vaccination. The findings were instructive: “BCG vaccination leads to changes in IFN-γ responsiveness to heterologous stimulation. BCG-induced changes in other cytokine responses to heterologous stimulation vary by pathogen.”

Changes. Vary by pathogen. Not uniformly enhanced – differently altered, in ways that depend on which pathogen is studied. The simplistic narrative of “trained immunity makes you more protected” does not survive contact with actual immunological data.

Measuring cytokines is not measuring protection. Measuring antibodies is not measuring immunity. The vaccine enterprise has built its evidence base on surrogate endpoints because surrogate endpoints can be made to look favourable even when clinical outcomes disappoint. BCG follows this pattern precisely.

The Product Insert Revelations

Pharmaceutical companies are required to disclose certain information in product inserts. What they choose to emphasise for different audiences reveals what they know versus what they promote.

BCG exists in two forms with different regulatory pathways: the intradermal vaccine given to infants for tuberculosis prevention and the intravesical preparation instilled into bladders for cancer treatment. Comparing these inserts illuminates how the same organism generates different levels of candour depending on context.

The Infant Vaccine (BCG Vaccine AJV)

The product insert for the infant vaccine maintains a reassuring tone while admitting significant unknowns:

1. “Vaccination with BCG Vaccine AJV elicits a cell-mediated immune response that confers a variable degree of protection to infection with M. tuberculosis.”

Variable – not reliable, not consistent, not quantifiable.

2. “The duration of immunity after BCG vaccination is not known, but there are some indications of a waning immunity after 10 years.”

Not known – after a century of use in billions of people.

3. “A positive tuberculin skin test does indicate a response of the immune system to the BCG vaccination or to a mycobacterial infection, however the relationship between the post vaccination tuberculin skin test reaction and the degree of protection afforded by BCG remains unclear.”

Remains unclear – the primary evidence of “working” (tuberculin conversion) has no established connection to actual protection.

The safety section lists adverse events with studied casualness: injection site ulceration, regional lymph node enlargement, suppurative lymphadenitis, fever, headache. Then, under “rare,” the serious admissions appear: osteitis, osteomyelitis, disseminated BCG infection requiring anti-tuberculosis treatment.

The most significant admission is buried in Section 5.3: “No preclinical safety data information is available for BCG Vaccine AJV.“

No preclinical safety data. The formulation – live attenuated mycobacteria combined with excipients – was never subjected to the toxicological studies that preclinical evaluation implies. No carcinogenicity studies. No genotoxicity studies. No reproductive toxicity studies. The section that should contain this information contains instead an admission of its absence.

The Bladder Cancer Product (TICE BCG / OncoTICE)

The same organism, prepared for instillation into adult bladders to treat cancer, generates a markedly different document. The warnings are prominent and explicit:

1. “Deaths have been reported as a result of systemic BCG infection and sepsis.”

Deaths. Reported. The infant vaccine insert mentions no deaths.

2. “The use of OncoTICE has been associated with disseminated BCG infection and in some cases death has resulted.”

Disseminated infection. Death. Stated directly.

3. “BCG is capable of dissemination when administered by intravesical route and serious reactions, including fatal infections, have been reported in patients receiving intravesical BCG.”

Fatal infections. The same organism causing the same disseminated disease, acknowledged explicitly for the cancer indication while minimised for the infant indication.

The mechanism section contains an admission absent from the infant vaccine insert: “OncoTICE is an immunostimulating agent. It has anti-tumour activity, but the exact mechanism of action is not known.”

Not known. After decades of use as a first-line bladder cancer treatment, the mechanism remains unexplained. The insert continues: “Study data suggest that an active nonspecific immune response takes place. BCG invokes a local inflammatory response involving a variety of immune cells.”

Suggest. Nonspecific. This is the trained immunity concept described honestly – a nonspecific inflammatory response with an unknown mechanism that somehow produces anti-tumour effects.

The adverse event profile is extensive and alarming. Approximately 60% of patients experience dysuria (painful urination). Forty percent experience increased urinary frequency. Thirty-three percent develop flu-like syndrome. Systemic complications include granulomatous prostatitis, hepatic granuloma, pneumonitis, arthritis and skin rashes.

The handling instructions reveal what the manufacturer knows about this organism: “OncoTICE contains viable attenuated mycobacteria and should be handled as potentially infectious. All equipment and material used during reconstitution and instillation should be handled and disposed of as biohazardous material.”

Biohazardous. The infant vaccine contains the same organism, yet handling instructions for paediatric vaccination lack this explicit warning about biohazard protocols.

“BCG infections have been reported in health care workers preparing BCG for administration.”

Healthcare workers infected while preparing the vaccine. The organism remains capable of causing disease in those who handle it, even attenuated.

The carcinogenicity section for the bladder cancer product states: “TICE BCG has not been evaluated for its carcinogenic, mutagenic potentials or impairment of fertility.”

The same admission as the infant vaccine, but more striking in context – a cancer treatment that has never been evaluated for carcinogenic potential. The irony apparently troubled no one in the regulatory process.

The Contrast

The same bacterium. The same fundamental biology. Two different presentations depending on audience and indication.

For infants, the language is reassuring: variable protection, unclear relationships, no preclinical data available. Adverse events are listed clinically without emotional weight.

For cancer patients (adults with legal standing and physicians paying close attention), the language is explicit: deaths have been reported, fatal infections occur, handle as biohazardous material, mechanism unknown.

The disclosures differ systematically by audience and legal exposure. The infant product assumes parents won’t read carefully or ask questions. The cancer product assumes physicians will read carefully and require comprehensive risk information.

What the cancer insert acknowledges, the manufacturer knows. What the infant insert omits, the manufacturer chooses not to emphasise.

What’s Being Injected

The BCG vaccine is not simply attenuated mycobacteria. It is a formulation containing multiple chemical compounds, delivered by injection, with no preclinical toxicological evaluation of the combination.

BCG Vaccine AJV contains:

Powder:

• Sodium glutamate

Solvent:

• Magnesium sulphate heptahydrate
• Dipotassium phosphate
• Citric acid, monohydrate
• L-asparagine monohydrate
• Ferric ammonium citrate
• Glycerol 85%
• Water for injections

TICE BCG growth medium contains:

• Glycerin
• Asparagine
• Citric acid
• Potassium phosphate
• Magnesium sulfate
• Iron ammonium citrate
• Lactose

These compounds are classified as “excipients” – a regulatory term implying inactive status. The classification obscures a fundamental problem: the complete injected formulation has never undergone standard preclinical toxicology as a unit.

“No preclinical safety data information is available” means:

• No acute toxicity studies of the complete formulation.
• No repeat-dose toxicity studies examining cumulative effects.
• No reproductive toxicity studies.
• No developmental toxicity studies.
• No genotoxicity assessment.
• No carcinogenicity studies.
• No studies of interactions between excipients and the live organism.

The regulatory assumption is that each ingredient has a history of use and is individually acceptable. This standard was developed for oral consumption and topical application, not injection. The routes are biologically distinct. Injection bypasses every protective barrier – skin, mucous membranes, digestive acids, gut wall, liver first-pass metabolism – that the body uses to manage foreign substances.

The aggregate effect of multiple compounds injected simultaneously has never been studied for any vaccine formulation. Each excipient is evaluated in isolation, if at all. The formulation as administered – live attenuated mycobacteria combined with salts, amino acids, iron compounds and buffering agents – has no toxicological profile.

Longstanding use is offered as a substitute for evidence. But historical use only substitutes for prospective study when adverse outcome surveillance is capable of detecting slow, rare or developmental harms. It is not. A century of BCG vaccination, over four billion doses administered, and no preclinical safety data on the formulation itself.

The Deeper Problem: What Is Tuberculosis?

Even if BCG worked perfectly against tuberculosis – which it manifestly does not – a question would remain: what is tuberculosis, and does the germ theory model that justifies vaccination adequately explain it?

The orthodox account holds that Mycobacterium tuberculosis causes tuberculosis through airborne transmission. Infected people cough bacteria into the air; susceptible people inhale them; infection follows; disease develops. The BCG vaccine, containing attenuated Mycobacterium bovis, trains the immune system to recognise and control the bacteria before disease progresses.

This model has problems that predate modern vaccine scepticism.

The Transmission Paradox

At Brompton Hospital in London during the late 19th century, approximately 500 staff members – doctors, nurses, maids, porters – worked in constant close contact with consumptive patients. Dr. C. Theodore Williams documented the outcomes: only four contracted the disease. Of four resident medical men, including one who worked there for twenty-five years, none developed any lung disease. Of six matrons, none contracted consumption. Of 150 resident clinical assistants, eight became consumptive, but in only one case did the disease develop during residence at the hospital.

Victoria Park Hospital showed identical patterns. Rush Hospital in Philadelphia reported no cases of infection among attendants. The only hospital for consumptives in New York reported no staff infections.

Dr. Arthur Ransome, Professor of Public Health at Owens College, Manchester, summarised: “The universal testimony of physicians of these institutions is that no such conveyance of the disease can be traced in any such institution.” Consumption wards, he concluded, appeared to be “the safest places in which susceptible persons could take up their abode.”

At health resorts where consumptives congregated freely with other residents – Colorado Springs, Davos-Platz – transmission was essentially non-existent despite unrestricted mingling and complete absence of isolation measures.

If tuberculosis spread readily through airborne particles, these patterns would be inexplicable. Hospital staff breathing the air of consumption wards daily for decades should have experienced devastating infection rates. They did not.

Koch’s Postulates

Robert Koch established criteria for proving microbial causation:

1. The microorganism must be found in abundance in all hosts suffering from the disease but should not be found in healthy hosts.
2. The microorganism must be isolated from a diseased host and grown in pure culture.
3. The cultured microorganism should cause the same symptoms when introduced into a healthy host.
4. The microorganism must be re-isolated from the inoculated, diseased host.

Tuberculosis fails the first postulate. Koch himself found the bacterium in healthy individuals. The WHO currently states that “about one-quarter of the world’s population has a TB infection.” The CDC confirms: “About 90% of those infected with M. tuberculosis have asymptomatic, latent TB infections, with only a 10% lifetime chance that the latent infection will progress to overt, active tuberculous disease.”

Two billion people carry the bacterium. Ninety percent never develop disease.

The mainstream explanation – that the immune system “controls” the infection in most people – effectively concedes the terrain theory point. Bacterial presence does not determine illness. Something else does: nutritional status, toxic burden, living conditions, immune function. If bacterial presence alone caused tuberculosis, the progression rate would be far higher, especially among impoverished populations where “latent infection” is most prevalent.

The Decline Before Medicine

Tuberculosis mortality in Massachusetts fell from 375 per 100,000 in 1874 to 2.4 per 100,000 by 1970 – a 99.4% decline. Epidemiologist Thomas McKeown calculated that approximately 96.8% of this decline occurred before the introduction of antibiotics (streptomycin, 1947) or BCG vaccination (1954 in most countries).

The treatments credited with conquering tuberculosis arrived after the disease had already declined by more than 90%.

Edward Kass, founding member and first president of the Infectious Disease Society of America, stated: “The overall decline in deaths from tuberculosis was not altered measurably by the discovery of the tuberculosis bacillus, the advent of the tuberculin test, the appearance of BCG vaccination, the widespread use of mass screening, the intensive anti-tuberculosis campaigns, or the discovery of streptomycin.”

If the vaccine and antibiotics were not responsible for tuberculosis decline, what was? The historical consensus points to improved living standards, nutrition, housing and reduced crowding. A 19th-century editorial in the New York Medical Journal recognised what mattered: “With the progress of civilisation all classes of people live more hygienically. There is less bad water drunk and drainage conditions have been improved … there is less crowding, less exposure to cold and men in general eat better food than formerly.”

Terrain Theory Framework

An alternative model understands tuberculosis as a condition arising when the body, overwhelmed by accumulated toxicity and nutritional deficiency, recruits the lungs as an emergency elimination pathway. The coughing, sputum production and respiratory distress represent the body’s attempt to discharge poisons through tissue that evolved primarily for gas exchange.

Dr. Henry Bieler described this mechanism: “Toxic blood must discharge its toxins or the person dies, so nature uses substitutes. The lungs and skin help the kidneys and liver respectively. From the irritation caused by the elimination of poison through this vicarious channel, we get bronchitis, pneumonia or tuberculosis, as is determined by the particular chemistry of the poison being eliminated.”

Weston A. Price documented patterns that germ theory could not explain. Swiss villagers on traditional diets had no tuberculosis while it was the leading killer in their country. Outer Hebrides islanders living in smoke-filled houses remained free of disease until processed foods arrived. Price noted that every patient in a Hawaiian paediatric TB ward had dental deformities – signs of the same nutritional deficiencies that prevented optimal lung formation.

The bacterium Mycobacterium tuberculosis is present in diseased tissue. But firefighters appearing at fires does not make firefighters the cause of fires. The bacterium may be responding to damaged tissue rather than creating it.

If this model is correct, a vaccine against the bacterium addresses a consequence rather than a cause. BCG cannot improve nutrition, reduce toxic exposure, enhance living conditions or support the body’s elimination pathways. It can only attempt to modify immune response to an organism that may be present as effect rather than cause.

The Pressure Valve

Why does BCG maintain its reputation when the evidence is so weak?

In any system under sustained criticism, there is selective pressure for at least one product to emerge as the respectable exception. That product absorbs scepticism and demonstrates, on the surface, that the system can produce something genuinely beneficial. BCG serves this function.

It is old – over a century of use creates an aura of established safety. It is used worldwide – billions of doses suggest success. It is not given in the United States – American critics cannot point to personal harm. It is associated with benefits beyond its stated purpose – trained immunity claims give it an almost magical quality. It is promoted by researchers who publish in respected journals with appropriately hedged conclusions – the appearance of rigorous science legitimises the claims.

De Becker, applying his sceptical framework to the vaccine enterprise, identified the pattern of institutional failure and captured science across product after product. Then he encountered BCG, with its century of use, its non-specific benefits, its absence from the American schedule, and its cadre of sincere researchers. It looked different. It felt different. He accepted the exception.

Once a critic accepts a single “good” vaccine, the debate shifts from fundamentals (”Does this paradigm work?”) to details (”Which products live up to it?”). BCG plays that role for many.

The MIS BAIR researchers are not corrupt. They design rigorous trials, report null findings honestly, hedge their conclusions appropriately. But they operate within a framework that treats BCG’s benefits as plausible and worth investigating – a framework that has absorbed a century of institutional momentum. Their careful conclusions (”insufficient evidence to support use,” “wide uncertainty around the estimates”) enter a promotional ecosystem that transforms uncertainty into confidence.

The trained immunity researchers are not fabricating data. They measure real changes in cytokine production and epigenetic markers. But they operate within a paradigm that assumes laboratory changes predict clinical protection – an assumption repeatedly contradicted when actual disease outcomes are measured. Surrogate endpoints serve institutional needs even when pursued by sincere scientists.

BCG persists because the structure sustains it. One apparently “good” vaccine validates the paradigm even as other vaccines fail their scrutiny.

Conclusion

De Becker asked why the vaccine with “far and away the most beneficial health results” is not given in the United States.

The answer is simpler than policy irrationality: BCG’s benefits are not established, its efficacy against tuberculosis is variable to non-existent, its non-specific effects fail to replicate in rigorous trials, its mechanism remains unknown after a century of use, its safety profile includes deaths and disseminated infection, and its formulation has never undergone preclinical toxicological evaluation.

The United States does not give BCG because, in a low-tuberculosis setting, the poor and unpredictable efficacy does not justify even the modest risks. This is one instance where American policy may be less wrong than the global consensus – not because US regulators are more honest, but because the risk-benefit calculation happens to point toward omission.

BCG fails on its own terms. The Chingleput trial showed more tuberculosis in the vaccinated group. The efficacy range of 0-80% means the vaccine sometimes does nothing. The duration of protection is unknown. The trained immunity claims collapse under clinical trial scrutiny – eczema, asthma, respiratory infections, covid-19, none protected to statistical significance in the largest trials. The product inserts admit unknown mechanisms, absent preclinical data and deaths from disseminated infection.

And beneath these failures lies the deeper question: if tuberculosis is not primarily a bacterial infection but a condition arising from toxicity, malnutrition and the body’s elimination processes, then a vaccine against the associated bacterium addresses the wrong target entirely. The 96.8% decline before medical intervention, the hospital staff who never contracted the disease, the two billion carriers who never become ill – these patterns suggest that BCG is attempting to solve a problem that does not exist in the form claimed.

The pattern holds. BCG is not the exception; it is another instance. The same tricks apply: surrogate endpoints substituted for clinical outcomes, variable efficacy explained away rather than explained, safety data absent where it should exist, mechanism unknown but benefits asserted anyway.

De Becker saw through the other vaccines because he applied consistent scepticism to the evidence. BCG’s reputation survived because he did not apply the same scrutiny to the one vaccine positioned as different. The enterprise needs its exceptions. It needs critics to find the “good” vaccine and accept it, thereby validating the framework even while questioning individual products.

There is no good vaccine in a paradigm built on flawed premises. BCG is not the exception that proves the enterprise sound. It is the pressure valve that protects the enterprise from total scrutiny – and under examination, it fails on every count.

References

Product Information Documents

1. BCG Vaccine AJV Product Information. Seqirus (NZ) Ltd. Revised 8 June 2023.
2. TICE BCG (BCG LIVE for Intravesical Use) Prescribing Information. Organon USA Inc. February 2009.
3. OncoTICE Product Information. Organon Australia Pty Ltd. Australian Therapeutic Goods Administration.

Clinical Trials and Research Papers

• Pittet LF, Messina NL, Gardiner K, et al. Prevention of infant eczema by neonatal Bacillus Calmette-Guérin vaccination: The MIS BAIR randomised controlled trial. Allergy. 2022;77(3):956-965.
• Pittet LF, Messina NL, Gardiner K, et al. Neonatal Bacillus Calmette-Guérin Vaccination Decreases Eczema Incidence at 5 years: The MIS BAIR randomised controlled trial. Allergy. 2025.
• Pittet LF, Forbes EK, Donath S, et al. Neonatal BCG vaccination to prevent asthma: Results from the MIS BAIR randomised controlled trial. Paediatric Allergy and Immunology. 2025;36:e70110.
• Messina NL, Gardiner K, Pittet LF, et al. Neonatal BCG Vaccination for Prevention of Allergy in Infants: The MIS BAIR Randomised Controlled Trial. Clinical & Experimental Allergy. 2024;54:682-693.
• Messina NL, Pittet LF, Gardiner K, et al. Neonatal Bacille Calmette-Guérin Vaccination and Infections in the First Year of Life: The MIS BAIR Randomized Controlled Trial. Journal of Infectious Diseases. 2021;224(7):1115-1127.
• Freyne B, Messina NL, Donath S, et al. Neonatal BCG Vaccination Reduces Interferon-γ Responsiveness to Heterologous Pathogens in Infants From a Randomized Controlled Trial. Journal of Infectious Diseases. 2020;221(12):1999-2009.
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Historical and Terrain Theory Sources

1. Dulles CW. Consumption Not Contagious. Philadelphia, 1897.
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Regulatory and Institutional Sources

• World Health Organization. Global Tuberculosis Report 2022.
• World Health Organization. Tuberculosis Fact Sheet.
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• UK National Health Service. BCG tuberculosis vaccine overview.
• De Becker G. Forbidden Facts. Chapter Eleven: Vaccines Are the Greatest Idea Ever Conceived, for Real.