This article deals with the tuberculosis policy in Communist Bulgaria from the 1940s to the end of the 1950s. The focus is on the BCG vaccination as the major preventive tool. The article’s reconstruction of decision-making draws on evidence from archive records produced by the Bulgarian Ministry of Health. The main question guiding the research is how past Bulgarian experiences on the one hand, and international traditions, on the other, influence medical opinion and state policy towards tuberculosis and patients with tuberculosis. How did the Cold War context shape BCG vaccination policy? The author presents the story of the ‘Bulgarian’ BCG strain, which was made possible by the international research networks and travels of the Bulgarian scientist Srebra Rodopska (1913–2006). Her story has recently been rediscovered and made popular in Bulgaria, in the context of debates about COVID-19. This article aims to correct the public history narrative, which has thus emerged by placing the story of the BCG vaccine within its Cold War context. The author pays attention to dependencies between medicine and politics, and to the role of the state. Despite the popular story of Rodopska as the inventor of a ‘Bulgarian’ BCG strain and vaccine, what actually happened was that in Bulgaria of the 1950s and 1960s, the Soviet strain and vaccine production technique were used. This was also due to Soviet pressure to follow the Soviet model of public health infrastructure.