BCG vaccine 400 per 100,000 in that higher risk context). The age of the person and the frequency with which BCG is given has always varied from country to country. BCG is prepared from a strain of the attenuated (virulence-reduced) live bovine tuberculosis bacillus, "Mycobacterium bovis", that has lost its ability to cause disease in humans. Because the living bacilli evolve to make the best use of available nutrients, they become less well-adapted to human blood and can no longer induce disease when introduced into a human host. Still, they are similar enough to their wild ancestors to provide some degree of
BCG vaccine to fall the closer one gets to the equator. A 1994 systematic review found that BCG reduces the risk of getting TB by about 50%. There are differences in effectiveness, depending on region, due to factors such as genetic differences in the populations, changes in environment, exposure to other bacterial infections, and conditions in the lab where the vaccine is grown, including genetic differences between the strains being cultured and the choice of growth medium. A systematic review and meta analysis conducted in 2014 demonstrated that the BCG vaccine reduced infections by 19–27% and reduced progression to active TB by