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 a tool that provides a structured development path and gating criteria for TB vaccine candidates. It also describes the different functions and capabilities required to advance a candidate TB vaccine to its next stage of development.
- 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
- The Urgent Need for New TB Vaccines is a fact sheet developed by WGNV that highlights the importance of new TB vaccines, and the strategy and funding needed to develop them.
- Vital Role for of Research for TB Elimination is a briefing document from TAG, WGNV and several other partners that provides information on TB R&D and its centrality to universal health coverage in preparation for the United National High Level Meeting on TB.
- 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
- The subunit vaccine H65+ CAF01 increased the BCG-protection against Mycobacterium bovis infection in a mouse model of bovine tuberculosis. Blanco FC, García EA, Aagaard C, Bigi F. Res Vet Sci. 2021 May. doi: 10.1016/j.rvsc.2021.04.014. Epub 2021 Apr 14.
- HLA-DR-Positive NK Cells Expand in Response to Mycobacterium Tuberculosis Antigens and Mediate Mycobacteria-Induced T Cell Activation. Kust SA, Streltsova MA, Panteleev AV, Karpina NL, Lyadova IV, Sapozhnikov AM, Kovalenko EI. Front Immunol. 2021 May 3. doi: 10.3389/fimmu.2021.662128.
- Exaggerated IL-17A activity in human in vivo recall responses discriminates active tuberculosis from latent infection and cured disease. Pollara G, Turner CT, Rosenheim J, Chandran A, Bell LC, Khan A, Patel A, Peralta LF, Folino A, Akarca A, Venturini C. Sci Transl Med. 2021 May 5. doi: 10.1126/scitranslmed.abg7673.
- BCG Cell Wall Skeleton As a Vaccine Adjuvant Protects Both Infant and Old-Aged Mice from Influenza Virus Infection. Kim KH, Lee YT, Park Y, Ko EJ, Jung YJ, Kim YJ, Jo EK, Kang SM. Biomedicines. 2021 May 5. doi: 10.3390/biomedicines9050516.
- IL-1R1-Dependent Signals Improve Control of Cytosolic Virulent Mycobacteria In Vivo. van der Niet S, van Zon M, de Punder K, Grootemaat A, Rutten S, Moorlag SJ, Houben D, van der Sar AM, Bitter W, Brosch R, Pando RH. Msphere. 2021 May 5. doi: 10.1128/mSphere.00153-21.
- Robust IgM responses following vaccination are associated with prevention of Mycobacterium tuberculosis infection in macaques. Irvine EB, O’Neil A, Darrah PA, Shin S, Choudhary A, Li W, Honnen W, Mehra S, Kaushal D, Gideon HP, Flynn JL. bioRxiv. 2021 May 06. doi: 10.1101/2021.05.06.442979.
- A century of BCG: Impact on tuberculosis control and beyond. Ahmed A, Rakshit S, Adiga V, Dias M, Dwarkanath P, D’Souza G, Vyakarnam A. Immunol Rev. 2021 May 06. doi: 10.1111/imr.12968.
- Monkeying around with MAIT Cells: Studying the Role of MAIT Cells in SIV and Mtb Co-Infection. Moriarty RV, Ellis AL, O’Connor SL. Viruses. 2021 May 8. doi: 10.3390/v13050863.
- Balance between Protection and Pathogenic Response to Aerosol Challenge with Mycobacterium tuberculosis (Mtb) in Mice Vaccinated with TriFu64, a Fusion Consisting of Three Mtb Antigens. Sulman S, Savidge BO, Alqaseer K, Das MK, Nezam Abadi N, Pearl JE, Turapov O, Mukamolova, GV, Akhtar MW, Cooper AM. Vaccines (Basel). 2021 May 18. doi: 10.3390/vaccines9050519.
- Discovering mycobacterial lectins as potential drug targets and vaccine candidates for tuberculosis treatment: a theoretical approach. Sundar S, Thangamani L, Piramanayagam S, Natarajan J. J Proteins Proteom. 2021 May 18. doi: 10.1007/s42485-021-00065-y.
- Mining the Mycobacterium tuberculosis proteome for identification of potential T-cell epitope based vaccine candidates. Madan R, Pandit K, Bhati L, Kumar H, Kumari N, Singh S. Microb Pathog. 2021 May 24. doi: 10.1016/j.micpath.2021.104996.
- Sterilizing immunity: New opportunities for rational TB vaccine design. Sher A, Flynn JL. J Exp Med. 2021 jul 5. doi: 10.1084/jem.20210454. Epub 2021 May 26.
- Will there be a RNA vaccine for TB? Fan XY, Lowrie DB. Emerg Microbes Infect. 2021 May 26. doi: 10.1080/22221751.2021.1935328.
- Comparing cytokine production and clinical response following vaccination with BCG Moreau and BCG Russia strains in a Brazilian infant population. Bitencourt J, Sarno A, Oliveira C, de Souza RA, Lima CC, Takenami I, Pereira SM, Arruda S. Vaccine. 2021 May 27. doi: 10.1016/j.vaccine.2021.04.028. Epub 2021 May 5.