Is there a vaccine for Tuberculosis (TB)?

From the Guidelines

Yes, there is a tuberculosis (TB) vaccine called Bacille Calmette-Guérin (BCG), which is most effective at preventing severe forms of TB in children, particularly TB meningitis and miliary TB, with effectiveness rates of 70-80% for these conditions. The BCG vaccine has been in use since the 1920s and is primarily given to infants and young children in countries where TB is common [ 1 ]. BCG is made from a weakened strain of Mycobacterium bovis, which is related to the bacterium that causes human TB. However, its effectiveness in preventing pulmonary TB in adults is variable, ranging from 0-80% depending on the population and geographic location [ 1 ].

Key Points to Consider

• The vaccine is typically administered as a single intradermal injection, usually in the upper arm, and may cause a small scar at the injection site [ 1 ].
• In the United States and many other low-TB-incidence countries, BCG is not routinely recommended due to the low risk of infection and because the vaccine can interfere with tuberculin skin test results, making it harder to detect latent TB infection [ 1 ].
• Despite its limitations, BCG remains an important tool in global TB control efforts, especially in high-burden countries [ 1 ].
• The primary strategy for controlling TB in the United States is to minimize the risk for transmission by the early identification and treatment of patients who have active infectious TB, and the use of preventive therapy with isoniazid to prevent the latent infection from progressing to active TB disease [ 1 ].

Recommendations for Use

• BCG vaccination should be considered for infants and children who reside in settings in which the likelihood of M. tuberculosis transmission and subsequent infection is high [ 1 ].
• BCG vaccination may be considered for health-care workers (HCWs) who are employed in settings in which the likelihood of transmission and subsequent infection with M. tuberculosis strains resistant to isoniazid and rifampin is high [ 1 ].

From the Research

Current Vaccines for Tuberculosis (TB)

• There is currently only one licensed vaccine against tuberculosis (TB), which is the Bacillus Calmette-Guérin (BCG) vaccine 2, 3, 4, 5, 6.
• The BCG vaccine has protective efficacy against TB in children, but its efficacy in adults is variable and it lacks therapeutic value 2, 3, 4, 5, 6.

Limitations of the BCG Vaccine

• The BCG vaccine has several limitations, including its inability to completely prevent TB infection and transmission 3.
• It also compromises the use of antigens present in the purified protein derivative of Mycobacterium tuberculosis in the diagnosis of TB 2.
• The BCG vaccine can cause complications in immunocompromised individuals 2.

Development of New TB Vaccines

• Many approaches are being explored to develop safer and more efficacious TB vaccines than BCG, including whole-cell organisms, subunit, and recombinant vaccines 2, 5, 6.
• There are currently several TB vaccine candidates in different stages of clinical trials, including subunit vaccines, whole-cell vaccines, and viral vector-delivered subunit vaccines 5, 6.
• Researchers are working to identify correlates of protection and evaluate new TB biomarkers to aid in the development of effective TB vaccines 6.