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
- MAIT cell-directed therapy of Mycobacterium tuberculosis infection. Sakai S, Kauffman KD, Oh S, Nelson CE, Barry CE 3rd, Barber DL. Mucosal Immunol. 2021 Jan. doi: 10.1038/s41385-020-0332-4. Epub 2020 Aug 18.
- Clinical features of tuberculosis and Bacillus Calmette-Guerin (BCG) -associated adverse effects in children: A 12-year study. Yang TL, Lee CM, Lee KL, Yen TY, Lu CY, Lee PI, Chen CM, Huang LM, Chang LY. J Formos Med Assoc. 2021 Jan. doi: 10.1016/j.jfma.2020.06.012. Epub 2020 Jun 15.
- Cell Envelope Proteomics of Mycobacteria. Hermann C, Karamchand L, Blackburn JM, Soares NC. J Proteome Res. 2021 Jan 1. doi: 10.1021/acs.jproteome.0c00650. Epub 2020 Nov 3.
- MTBVAC vaccination protects rhesus macaques against aerosol challenge with M. tuberculosis and induces immune signatures analogous to those observed in clinical studies.White AD, Sibley L, Sarfas C, Morrison A, Gullick J, Clark S, Gleeson F, McIntyre A, Arlehamn CL, Sette A, Salguero FJ, Rayner E, Rodriguez E, Puentes E, Laddy D, Williams A, Dennis M, Martin C, Sharpe S. NPJ Vaccines. 2021 Jan 4. doi: 10.1038/s41541-020-00262-8.
- A non-human primate in vitro functional assay for the early evaluation of TB vaccine candidates. Tanner R, White AD, Boot C, Sombroek CC, O’Shea MK, Wright D, Hoogkamer E, Bitencourt J, Harris SA, Sarfas C, Wittenberg R, Satti I, Fletcher HA, Verreck FAW, Sharpe SA, McShane H. NPJ Vaccines. 2021 Jan 4. doi: 10.1038/s41541-020-00263-7.
- Composition and Clinical Significance of Exosomes in Tuberculosis: A Systematic Literature Review. Biadglegne F, König B, Rodloff AC, Dorhoi A, Sack U. J Clin Med. 2021 Jan 4. doi: 10.3390/jcm10010145.
- Developing New Anti-Tuberculosis Vaccines: Focus on Adjuvants. Franco AR, Peri F. Cells. 2021 Jan 5. doi: 10.3390/cells10010078.
- Identification of CTL Epitopes on Efflux Pumps of the ATP-Binding Cassette and the Major Facilitator Superfamily of Mycobacterium tuberculosis.Lin Y, Dong Y, Gao Y, Shi R, Li Y, Zhou X, Liu W, Li G, Qi Y, Wu Y. J Immunol Res. 2021 Jan 5. doi: 10.1155/2021/8899674. eCollection 2021.
- Immunological Characterization of Proteins Expressed by Genes Located in Mycobacterium tuberculosis-Specific Genomic Regions Encoding the ESAT6-like Proteins. Mustafa AS. Vaccines (Basel). 2021 Jan 7. doi: 10.3390/vaccines9010027.
- Design of Trehalose-based Amide/Sulfonamide C-type Lectin Receptor Ligands. Ryter KT, Rasheed OK, Buhl C, Evans JT. ChemMedChem. 2021 Jan 7. doi: 10.1002/cmdc.202000775. Online ahead of print.
- Preclinical evaluation of tuberculosis vaccine candidates: Is it time to harmonize study design and readouts for prioritizing their development? Flores-Valdez MA, Segura-Cerda CA. Vaccine. 2021 Jan 8. doi: 10.1016/j.vaccine.2020.11.073. Epub 2020 Dec 14.
- Predicted Structural Variability of Mycobacterium tuberculosis PPE18 Protein With Immunological Implications Among Clinical Strains.Hakim JMC, Yang Z. Front Microbiol. 2021 Jan 8. doi: 10.3389/fmicb.2020.595312. eCollection 2020.
- Ultra-low Dose Aerosol Infection of Mice with Mycobacterium tuberculosis More Closely Models Human Tuberculosis.Plumlee CR, Duffy FJ, Gern BH, Delahaye JL, Cohen SB, Stoltzfus CR, Rustad TR, Hansen SG, Axthelm MK, Picker LJ, Aitchison JD, Sherman DR, Ganusov VV, Gerner MY, Zak DE, Urdahl KB. Cell Host Microbe. 2021 Jan 13. doi: 10.1016/j.chom.2020.10.003. Epub 2020 Nov 2.
- In silico analysis of epitope-based vaccine candidate against tuberculosis using reverse vaccinology. Bibi S, Ullah I, Zhu B, Adnan M, Liaqat R, Kong WB, Niu S.Sci Rep. 2021 Jan 13. doi: 10.1038/s41598-020-80899-6.
- Intranasal Immunization with Peptide-based Immunogenic Complex Enhances BCG Vaccine Efficacy in murine model of Tuberculosis. Kumar S, Bhaskar A, Patnaik G, Sharma C, Singh DK, Kaushik S, Chaturvedi S, Das G, Dwivedi VP. JCI Insight. 2021 Jan 14. doi: 10.1172/jci.insight.145228. Online ahead of print.
- PE_PGRS33, an Important Virulence Factor of Mycobacterium tuberculosis and Potential Target of Host Humoral Immune Response. Kramarska E, Squeglia F, De Maio F, Delogu G, Berisio R. Cells. 2021 Jan 15. doi: 10.3390/cells10010161.
- Proteomic characterization of a second-generation version of the BCGdeltaBCG1419c vaccine candidate by means of electrospray-ionization quadrupole time-of-flight mass spectrometry. Velázquez-Fernández JB, Ferreira-Souza GHM, Rodríguez-Campos J, Aceves-Sánchez MJ, Bravo-Madrigal J, Vallejo-Cardona AA, Flores-Valdez MA.Pathog Dis. 2021 Jan 16. doi: 10.1093/femspd/ftaa070.
- Modelling the global burden of drug-resistant tuberculosis avertable by a post-exposure vaccine.Fu H, Lewnard JA, Frost I, Laxminarayan R, Arinaminpathy N. Nat Commun. 2021 Jan 18. doi: 10.1038/s41467-020-20731-x.
- Stronger induction of trained immunity by mucosal BCG or MTBVAC vaccination compared to standard intradermal vaccination. Vierboom, MPM, Dijkman K, Sombroek CC, Hofman SO, Boot C, Vervenne RAW, Haanstra KG, van der Sande M, van Emst L, Dominguez-Andres J, Moorlag SJCFM, Kocken CHM, Thole J, Rodriguez E, Puentes E, Martens JHA, van Crevel R, Netea MG, Aguilo N, Marin C, Verreck FAW. Cell Rep Med. 2021 Jan 19. doi: 10.1016/j.xcrm.2020.100185
- Sterilization by Adaptive Immunity of a Conditionally Persistent Mutant of Mycobacterium tuberculosis. Vilchèze C, Porcelli SA, Chan J, Jacobs WR Jr.mBio. 2021 Jan 19. doi: 10.1128/mBio.02391-20.
- A structured Markov chain model to investigate the effects of pre-exposure vaccines in tuberculosis control.Fernández-Peralta R, Gómez-Corral A. J Theor Biol. 2021 Jan 21. doi: 10.1016/j.jtbi.2020.110490. Epub 2020 Sep 16.
- Perspectives and Advances in the Understanding of Tuberculosis. Kinsella RL, Zhu DX, Harrison GA, Mayer Bridwell AE, Prusa J, Chavez SM, Stallings CL. Annu Rev Pathol. 2021 Jan 24. doi: 10.1146/annurev-pathol-042120-032916.
- Development of a formulation platform for a spray-dried, inhalable tuberculosis vaccine candidate. Gomez M, McCollum J, Wang H, Ordoubadi M, Jar C, Carrigy NB, Barona D, Tetreau I, Archer M, Gerhardt A, Press C, Fox CB, Kramer RM, Vehring R. Int J Pharm. 2021 Jan 25. doi: 10.1016/j.ijpharm.2020.120121. Epub 2020 Dec 2.
- Co-adsorption of synthetic Mincle agonists and antigen to silica nanoparticles for enhanced vaccine activity: A formulation approach to co-delivery. Abdelwahab WM, Riffey A, Buhl C, Johnson C, Ryter K, Evans JT, Burkhart DJ. Int J Pharm. 2021 Jan 25. doi: 10.1016/j.ijpharm.2020.120119. Epub 2020 Nov 27.
- The double-sided effects of Mycobacterium Bovis bacillus Calmette-Guerin vaccine. Li J, Zhan L, Qin C. NPJ Vaccines. 2021 Jan 25. doi: 10.1038/s41541-020-00278-0.
- Synthetic protein conjugate vaccines provide protection against Mycobacterium tuberculosis in mice. Hanna CC, Ashhurst AS, Quan D, Maxwell JWC, Britton WJ, Payne RJ. Proc Natl Acad Sci U S A. 2021 Jan 26. doi: 10.1073/pnas.2013730118
- Self-clearance of Mycobacterium tuberculosis infection: implications for lifetime risk and population at-risk of tuberculosis disease. Emery JC, Richards AS, Dale KD, McQuaid CF, White RG, Denholm JT, Houben RMGJ. Proc Biol Sci. 2021 Jan 27. doi: 10.1098/rspb.2020.1635. Epub 2021 Jan 20.
- CD8 T Cells Show Protection against Highly Pathogenic Simian Immunodeficiency Virus (SIV) after Vaccination with SIV Gene-Expressing BCG Prime and Vaccinia Virus/Sendai Virus Vector Boosts. Kato S, Shida H, Okamura T, Zhang X, Miura T, Mukai T, Inoue M, Shu T, Naruse TK, Kimura A, Yasutomi Y, Matsuo K. J Virol. 2021 Jan 28. doi: 10.1128/JVI.01718-20. Print 2021 Jan 28.