If you were born in the United States, chances are you don't have that tiny, circular scar on your upper arm. You know the one. It looks like a shallow crater or a permanent imprint of a cigarette burn. That mark is the "signature" of the BCG vaccine, the primary defense against tuberculosis (TB). But here’s the kicker: for most Americans, that vaccine was never a standard part of the childhood routine. If you’re asking when did they stop giving tb vaccine, the answer is actually a bit more complicated than a single date on a calendar.
In the U.S., they didn't really "stop" giving it because they never truly started—at least not on a mass scale.
TB is a nasty business. It's caused by Mycobacterium tuberculosis. It usually attacks the lungs, but it can settle in your spine or kidneys if it gets ambitious. Back in the early 20th century, it was the "White Plague." It killed everyone from poets to paupers. When Albert Calmette and Camille Guérin developed the Bacillus Calmette-Guérin (BCG) vaccine in 1921, much of the world jumped on it. Europe, Asia, and South America eventually made it mandatory for newborns.
The U.S. took a different path. We decided to play the long game of "test and treat" rather than "vaccinate everyone."
The Pivot Point: Why the US Bailed on BCG
By the mid-1940s and 50s, while other countries were rolling out mass BCG campaigns, American health officials were looking at the data and feeling skeptical. The vaccine isn't perfect. It's actually kind of a coin flip when it comes to preventing adult pulmonary TB. It’s great at stopping kids from getting TB meningitis or miliary TB, which are lethal, but its effectiveness in adults ranges anywhere from 0% to 80% depending on which study you read and where the study was conducted.
The big reason the U.S. never adopted it? It messes up the test.
If you get the BCG vaccine, you will likely test positive on a standard Tuberculin Skin Test (the PPD shot in the forearm that swells up). In a country like the U.S., where TB rates were falling due to better housing and nutrition, doctors wanted to know exactly who was actually infected. If everyone was vaccinated, the skin test became useless. You couldn't tell the difference between a protected person and a sick person.
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Honestly, the U.S. strategy was about surveillance. By keeping the population "unvaccinated," public health officials could use the skin test as a high-precision radar. If someone popped positive, they knew it was a fresh infection and could jump on it with antibiotics like Isoniazid.
What About the Rest of the World?
If you go to the UK, the story is different. They actually had a universal program. If you're wondering when did they stop giving tb vaccine in Britain, the year was 2005. For decades, every 13-year-old in a British school lined up for their jab. But by 2005, the infection rates had dropped so low that it was no longer "cost-effective" or medically necessary to jab every teenager. They switched to a targeted system, focusing only on high-risk groups, like babies born into families from high-prevalence countries.
Australia did something similar. They ditched widespread BCG in the mid-80s. Each country had its own "tipping point" where the risk of the vaccine (which is very low, but not zero) outweighed the benefit of protecting a population where the disease had almost vanished.
The Mystery of the Scar and the Modern Reality
It’s weird to think that a tiny puncture in the arm could be a geopolitical marker. If you see someone with that scar today, they likely grew up in a place where TB is still a major threat. Or perhaps they were part of a very specific U.S. subgroup.
Even though the U.S. didn't do universal shots, they did give them to certain people. High-risk healthcare workers sometimes got them. Some indigenous communities with high infection rates received them. But for the average person in the suburbs? Never happened.
There's also a massive misconception that TB is a "thing of the past." It isn't.
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While we stopped worrying about it in the West, TB remains one of the world’s top infectious killers globally. In 2026, we are still seeing cases of Multi-Drug Resistant TB (MDR-TB) that are terrifyingly hard to treat. The BCG vaccine, for all its flaws, is still the only tool many countries have.
Why You Can't Just Go Get One Now
You might think, "Hey, I'm traveling to a high-risk area, can I just get the shot?"
Probably not. In the U.S., the BCG vaccine is mostly used for something entirely different now: bladder cancer. Seriously. Doctors instill the BCG bacteria directly into the bladder to trigger an immune response that attacks cancer cells. Because of this, and because of low demand for the actual TB prevention version, there are frequent "real world" shortages of the vaccine.
Also, most doctors will tell you it's not worth it for an adult. Since the vaccine’s efficacy in adults is so spotty, they'd rather you just get tested when you get back from your trip.
The Complicated Legacy of the 1970s and 80s
By the late 1970s, the World Health Organization (WHO) had basically streamlined the Expanded Program on Immunization. They pushed BCG hard in developing nations. Meanwhile, the "Western" world was moving in the opposite direction.
In Canada, for instance, they mostly stopped routine BCG in the 1970s, except for in many First Nations and Inuit communities where the risk remained high. This created a weird health dichotomy. You had two different standards of care based on your zip code or your heritage.
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It’s also worth noting that the vaccine itself hasn't changed much in a century. We are still using a weakened version of a cow-based TB strain (Mycobacterium bovis). Imagine using 100-year-old software to protect a modern computer. That’s essentially what BCG is. Scientists are currently working on mRNA versions of a TB vaccine—the same tech used for COVID-19—but we aren't there yet.
What Should You Do if You're Worried?
If you're spiraling because you realized you're unvaccinated and you just spent a week coughing in a crowded metro, take a breath. TB doesn't usually spread through a casual "hello" in the hallway. It usually requires prolonged, close contact in poorly ventilated spaces.
Here is the actual, actionable reality for 2026:
- Check your status if you're traveling: If you're headed to sub-Saharan Africa, Southeast Asia, or parts of Eastern Europe for an extended stay (more than a few months), talk to a travel clinic. They won't give you a BCG, but they will establish a "baseline" skin or blood test (like the QuantiFERON-TB Gold) so they can tell if you've been exposed when you return.
- Don't rely on the scar: If you do have the scar, don't assume you're a superhero. The protection from a childhood BCG jab often wanes by the time you're an adult. You can still get sick.
- The IGRA Test is your friend: If you were vaccinated as a kid and you need a TB test for a job (like in healthcare or teaching), ask for the IGRA blood test instead of the skin prick. The blood test is smart enough to ignore the vaccine and only look for the actual human TB infection. No more "false positives" just because you got a shot in 1992.
- Symptoms matter more than history: If you have a cough that lasts more than three weeks, unexplained weight loss, and night sweats that soak your sheets, go to a doctor. I don't care if you were vaccinated yesterday or never—those are the red flags.
The reason they stopped (or never started) the TB vaccine in many places wasn't because the disease disappeared. It was a tactical decision to keep our "diagnostic tools" sharp. We traded a mediocre vaccine for the ability to see the enemy more clearly. In a world of evolving bacteria, that trade-off still mostly makes sense, even if it feels a bit counterintuitive when you're looking at your scarless arm.
To stay safe in the modern age, focus on your environment and your symptoms. If you live in a low-prevalence country, your best defense isn't a 100-year-old vaccine; it's a quick diagnosis and a rigorous course of modern antibiotics. Keep an eye on your respiratory health and ensure that any persistent cough is evaluated by a professional who can run an IGRA test to give you a definitive answer.