BCG and COVID-19
The BCG vaccine is a crucial tool for protecting babies and young children in high burden countries from TB, which killed 1.5 million people in 2019 and caused 10 million people to fall sick. Recent media reports indicating that BCG, the only licensed vaccine to protect again TB, may be protective against COVID-19 have led to new interest in this century-old vaccine. However, BCG’s ability to protect against COVID-19 infection or disease has not yet been tested in rigorous, prospective, randomized, controlled clinical trials. Such trials are now underway to study the effects of BCG in healthcare workers and others at high risk of COVID-19. Decisions on use of BCG to protect against COVID-19 should await these results and adequate supplies of BCG should be preserved to protect infants and children in high burden countries from TB.
For more information on this issue, please refer to the following resources:
- WHO Scientific Brief on Bacille Calmette-Guérin (BCG) vaccination and COVID-19
- Treatment Action Group Statement and Information Note on BCG Vaccine and COVID-19
- Bacille Calmette-Guérin (BCG) vaccine and the COVID-19 pandemic: responsible stewardship is needed, HS Schaaf et al., International Journal of Tuberculosis and Lung Disease
Resources about TB
and TB Vaccine R&D
- Meeting Report: 5th Global Forum on TB Vaccines, 21-24 February 2018, New Delhi, India, published open access in Tuberculosis (Dec 2018)
- TB Vaccines Pipeline Report is a report from Treatment Action Group (TAG) that reviews progress in the clinical development of TB vaccines. The report is updated annually.
- End TB Strategy from the World Health Organization’s Global TB Programme provides a 20-year strategy toward the goal of ending the TB epidemic, including research, development, and implementation of new tools.
- Global Plan to End TB 2018-2022 is a costed plan and roadmap for a concerted response to tuberculosis (TB) aligned with the United Nations (UN) Political Declaration on TB, including a strategic framework for TB vaccine R&D.
- WHO Preferred Product Characteristics for New Tuberculosis Vaccine presents WHO preferences for new tuberculosis vaccines, driven by the high medical need for contribution to the fight against TB, in alignment with the End TB strategy.
- Global Tuberculosis Report, published by the WHO, provides a comprehensive and up-to-date assessment of the TB epidemic, and of progress in prevention, diagnosis and treatment of the disease at global, regional and country levels. The report is updated annually.
- TB Vaccine Development Pathway, developed by IAVI and TBVI, is an online tool that provides a structured development path and gating criteria for TB vaccine candidates. It includes considerations for target populations, vaccine platforms, and market, access and implementation, as well as guidance for planning and operating community engagement activities.
- Global Investments in Tuberculosis Research and Development: Past, Present, and Future is a policy paper developed by WHO in collaboration with civil society groups, academia, and product development partnerships to articulate the research and funding needs to end TB.
- TB Research Investments Provide Returns in Combating Both TB and COVID-19 is a policy brief published by Treatment Action Group (TAG) that explores the impact of COVID-19 on TB research and development (R&D), and how tools, concepts, capacity, and infrastructure established through years of public and donor investments in TB R&D have informed and jump-started COVID-19 research and responses.
- The impact of COVID-19 on the TB epidemic: a community perspective, provides the results of a civil society and affected community led survey to better understand how COVID-19 is impacting key stakeholder groups.
- BCG World Atlas is an interactive map that provides detailed information on current and past BCG vaccination policies and practices for over 180 countries.
Resources for Advocacy and Community Engagement
- Video - The challenges of TB, a vision of a TB free world, and the importance of new TB vaccines from a variety of perspectives.
- Video - Phumeza Tisile talk about her challenges in facing extensively drug-resistant TB, her vision of a TB free world, and how we can achieve it with new TB vaccines.
- Report on Tuberculosis Research Funding Trends, published annually by TAG, tracks how much public, private, philanthropic, and multilateral institutions spend on TB research and development (R&D) across six areas of research: basic science, diagnostics, drugs vaccines, operational research, and infrastructure/unspecified projects.
- Good Participatory Practice Guidelines for TB Vaccine Research, published by Aeras, is a user- friendly framework that defines specific standards and key elements needed for creating effective partnerships with stakeholders throughout the entire research process. Contact us if you are interested in obtaining copies of the GPP guidelines for TB vaccine research.
- Frequently Asked Questions on TB Vaccine Research, published by IAVI, is a fact sheet that provides information and answers to commonly asked questions about TB vaccine research.
- Myths and Facts about TB Vaccine Research, by IAVI, is a fact sheet that responds to some common misconceptions about vaccine research.
- Tuberculosis Vaccines and Clinical Trials, published by IAVI, provides information about TB, vaccines, and clinical trials in an illustrative and easy to understand booklet.
- Being Part of Tuberculosis Vaccine Clinical Trials is a speaking book published by Books of Hope in collaboration with Aeras, that provides potential clinical trial participants with information about tuberculosis and what is involved in participating in a clinical trial. The information is in both English and Afrikaans. Hard copies of the speaking book are available on request. Contact us if you are interested in obtaining copies of the speaking book.
Recent Scientific Publications
- Engineering a new vaccine platform for heterologous antigen delivery in live-attenuated Mycobacterium tuberculosis. Broset E, Seral JC, Arnal C, Uranga S, Kanno AI, Leite LC, Martín, C, Gonzalo-Asensio J. Comput Struct Biotechnol J. 2021 Jul 30. doi: 10.1016/j.csbj.2021.07.035.
- Effect of BCG vaccination on proinflammatory responses in elderly individuals. Kumar, NP, Padmapriyadarsini C, Rajamanickam A, Marinaik SB, Nancy A, Padmanaban S, Akbar N, Murhekar M, Babu S. Science Advances. 2021 Aug 4. doi: 10.1126/sciadv.abg7181.
- Controlling inflammation in the elderly with BCG vaccination. Koeken VA. Science Advances. 2021 Aug 4. doi: 10.1126/sciadv.abk1668.
- Epidemiology of childhood tuberculosis after ceasing universal Bacillus Calmette-Guérin vaccination. Kobayashi S, Yoshiyama T, Uchimura K, Hamaguchi Y, Kato S. Sci Rep. 2021 Aug 5. doi:10.1038/s41598-021-95294-y.
- Interleukin-23 instructs protective multifunctional CD4 T cell responses after immunization with the Mycobacterium tuberculosis subunit vaccine H1 DDA/TDB independently of interleukin-17A. Ritter K, Behrends J, Erdmann H, Rousseau J, Hölscher A, Volz J, Prinz I, Lindenstrøm, T, Hölscher C. J Mol Med (Berl). 2021 Aug 5. doi: 10.1007/s00109-021-02100-3.
- Parental Bacillus Calmette-Guérin vaccine scars decrease infant mortality in the first six weeks of life: A retrospective cohort study. Berendsen MLT, Schaltz-Buchholzer F, Bles P, Biering-Sørensen S, Jensen KJ, Monteiro I, Silva I, Aaby P, Benn CS. EClinicalMedicine. 2021 Aug 12. doi: 10.1016/j.eclinm.2021.101049.
- Particulate Mycobacterial Vaccines Induce Protective Immunity against Tuberculosis in Mice. Chen S, Quan DH, Wang XT, Sandford S, Kirman JR, Britton WJ, Rehm BHA. Nanomaterials (Basel). 2021 Aug 13. doi: 10.3390/nano11082060.
- A recombinant bovine adenoviral mucosal vaccine expressing mycobacterial antigen-85B generates robust protection against tuberculosis in mice. Khan A, Sayedahmed EE, Singh VK, Mishra A, Dorta-Estremera S, Nookala S, Canaday DH, Chen M, Wang J, Sastry KJ, Mittal SK, Jagannath C. Cell Reports Medicine. 2021 Aug 17. doi: 10.1016/j.xcrm.2021.100372.
- Characterizing Early T Cell Responses in Nonhuman Primate Model of Tuberculosis. Sharan R, Singh DK, Rengarajan J, Kaushal, D. Front Immunol. 2021 Aug 17. doi: 10.3389/fimmu.2021.706723.
- CD4+CCR6+ T cells dominate the BCG-induced transcriptional signature. Singhania A, Dubelko P, Kuan R, Chronister WD, Muskat K, Das J, Phillips EJ, Mallal SA, Seumois G, Vijayanand P, Sette A, Lerm M, Peters B, Lindestam Arlehamn CS. Biorxiv. 20 Aug 2021. doi: 10.1101/2021.08.20.457054.
- ESX-5-targeted export of ESAT-6 in BCG combines enhanced immunogenicity & efficacy against murine tuberculosis with low virulence and reduced persistence. Heijmenberg I, Husain A, Sathkumara HD, Muruganandah V, Seifert J, Miranda-Hernandez S, Kashyap RS, Field, MA, Krishnamoorthy G, Kupz A. Vaccine. 2021 Aug 19. doi: 10.1016/j.vaccine.2021.08.030.
- A recombinant selective drug-resistant M. bovis BCG enhances the bactericidal activity of a second-line anti-tuberculosis regimen. Chiwala G, Liu Z, Mugweru JN, Wang B, Khan SA, Bate PNN, Yusuf B, Hameed HMA, Fang C, Tan Y, Guan P, Hu J, Tan S, Liu J, Zhong N, Zhang T. Biomed Pharmacother. 2021 Aug 21. doi: 10.1016/j.biopha.2021.112047.
- Immunogenicity of HspX/EsxS fusion protein of Mycobacterium tuberculosis along with ISCOMATRIX and PLUSCOM nano-adjuvants after subcutaneous administration in animal model. Avarvand AY, Meshkat Z, Khademi F, Tafaghodi M. Microbial Pathogenesis. 2021 Aug 27. doi.org/10.1101/2021.08.27.458002.
- Comparison TLR2 and TLR4 serum levels in children with pulmonary and extrapulmonary tuberculosis with and without a Bacillus Calmette-Guerin (BCG) scar. Shabariah R, Hatta M, Idris I, Santoso A, Patellongi I, Permatasari TAE, Farsida, Islam AA, Natzir R, Wahyudin B, Warsinggih, Emilda.J Clin Tuberc Other Mycobact Dis. 2021 Aug 31. doi: 10.1016/j.jctube.2021.100272. eCollection 2021 Dec.