Vaccine innovations in an age of uncertainty: BCG in France

The Bacille Calmette-Guérin vaccine (BCG) remains one of the most widely used vaccines against infectious disease since it first appeared in the early 1900s. The development of BCG and its adoption into the vaccination schedule was, however, controversial. This paper reviews the history of BCG innovations, including its development in France, its worldwide diffusion, and its connection with public health policy. The research finds that, while knowledge-centered scientific activities played an important role in vaccine innovations, decision making vis-a-vis public acceptance of the vaccine relies more on the characteristics of the vaccine and is shaped by collective actions taken by diverse social actors. This article provides a community-based framework to explain the collective actions that overcame the uncertainty caused by limitations in technology and knowledge.