BCG vaccine nesting birds and rusted electrical conduits. The resulting closure of the plant for over two years resulting in shortages of bladder cancer and tuberculosis vaccines. On October 29, 2014 Health Canada gave the permission for Sanofi to resume production of BCG. The global supply situation was analyzed in 2017 and concluded that the global supply is sufficient to meet forecasted BCG vaccine demand but risks for shortages remain mainly due to supply concentration. A weakened strain of bovine tuberculosis bacillus, "Mycobacterium bovis" is specially subcultured in a culture medium, usually Middlebrook 7H9. Some BCG vaccines are freeze dried and become
BCG vaccine bladder cancer (NMIBC)" since 1977. By 2014 there were more than eight different considered biosimilar agents or strains used for the treatment of non–muscle-invasive bladder cancer (NMIBC). Except in neonates, a tuberculin skin test should always be done before administering BCG. A reactive tuberculin skin test is a contraindication to BCG. Someone with a positive tuberculin reaction is not given BCG, because the risk of severe local inflammation and scarring is high, not because of the common misconception that tuberculin reactors "are already immune" and therefore do not need BCG. People found to have reactive tuberculin skin tests should be