How Do Live Bacterial Vaccines Work?

Live bacterial vaccines are biological products that provide immunity against certain bacterial infections. Live bacterial vaccines stimulate the body’s immune system to produce antibodies against specific types of bacteria and protect a vaccinated individual from diseases caused by these bacteria.

Live bacterial vaccines are weakened (attenuated) forms of disease-causing bacteria. Live bacterial vaccines produce a strong and often life-long immunity similar to the acquired immunity from a natural infection, but without causing serious disease, because they only contain a small amount of the weakened bacteria. 

Live bacterial vaccines are derived by weakening the disease-causing bacteria in laboratories, usually with repeated culturing. Live bacterial vaccines must be stored and handled with care because they are fragile and can be damaged by heat and light.

Live bacterial vaccines may not be safe for individuals with compromised immunity. People with weakened immune systems should consult with their health care providers before receiving live bacterial vaccines, because they may cause severe infections that their immune systems may be unable to control.

BCG (bacillus Calmette-Guérin) live bacterial vaccine that protects against tuberculosis (TB) is also used as immunotherapy in treating bladder cancer. The vaccine stimulates the immune system to attack the cancer cells. BCG vaccine is derived from Mycobacterium bovis which is similar to Mycobacterium tuberculosis that causes TB.

The FDA-approved live bacterial vaccines provide immunity against the following bacterial infectious diseases:

• Tuberculosis, caused by Mycobacterium tuberculosis
• Cholera, caused by Vibrio cholerae serogroup 01
• Typhoid fever, caused by Salmonella typhi

Live bacterial vaccines are mostly administered as single or a series of doses through the following routes:

• Oral suspensions or capsules
• Intramuscular (IM) injections into the muscle
• Percutaneous injections into the skin
• Instillation into the bladder with a catheter

Live bacterial vaccines approved by the FDA include:

• BCG vaccine for immunization against tuberculosis for:
  • Adults and children in developing countries, primarily.
  • TB exposed health care workers in high-risk settings.
• BCG vaccine as immunotherapy in bladder cancer in adults.
• Cholera vaccine for immunization in persons of ages 2-64 traveling to cholera-affected areas.
• Typhoid vaccine for selective immunization against typhoid fever in adults and children traveling to typhoid-endemic areas.

Side effects of live bacterial vaccines may include the following:

• Malaise
• Fever
• Headache
• Pain and soreness
• Induration (hardening of the tissue) at the injection site
• General aches
• Chills
• Nausea
• Vomiting
• Loose stools/diarrhea
• Abdominal pain
• Decreased appetite
• Perforated jejunum (part of the small intestine)
• Dysuria (painful urination)
• Hematuria (blood in the urine)
• Urinary urgency
• Nocturia (frequent night urination)
• Urinary incontinence
• Infection
• Flu-like syndrome
• Tiredness
• Skin rash
• Pruritus (itching)
• Anemia (low red blood cell count)
• Leukopenia (low count of leucocytes, type of immune cells in the blood)
• Genital inflammation/abscess
• Renal toxicity (toxicity to kidneys)
• Hemorrhagic cystitis (bladder inflammation with bleeding)
• Arthralgia (joint pain)
• Myalgia (muscle pain)
• Cervical pain (neck pain)
• Pulmonary infection
• Weakness
• Loss of consciousness
• Increase in blood urea nitrogen (BUN)
• Increased creatinine in the blood
• Disseminated sepsis
• Hepatitis (liver inflammation)
• Coagulopathy (bleeding disorder)
• Myoglobinuria (excess myoglobin in urine, resulting from damage to muscle cell)
• Nephritis (kidney inflammation)
• Uveitis (inflammation of the uvea, the middle layer of the eye)

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand names of live bacterial vaccines include:

• BCG Vaccine (Tice strain)
• BCG vaccine live
• cholera vaccine
• Typhim Vi
• typhoid polysaccharide vaccine
• typhoid vaccine live
• Vaxchora
• Vivotif