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
- BCG turns 100: its nontraditional uses against viruses, cancer, and immunologic diseases. Singh AK, Netea MG, Bishai WR. J Clin Invest. 2021 June 1. doi: 10.1172/JCI148291.
- Eosinophils are an integral component of the pulmonary granulocyte response in Tuberculosis and promote host resistance in mice. Bohrer AC, Castro E, Hu Z, Queiroz AT, Tocheny CE, Assmann M, Sakai S, Nelson C, Baker PJ, Ma H, Wang, L. bioRxiv. 2021 June 1. doi: 10.1101/2021.05.29.446277.
- Type I interferon decreases macrophage energy metabolism during mycobacterial infection. Olson GS, Murray TA, Jahn AN, Mai D, Diercks AH, Gold ES, Aderem A. Cell Rep. 2021 June 1. doi: 10.1016/j.celrep.2021.109195.
- In-vivo expressed Mycobacterium tuberculosis antigens recognised in three mouse strains after infection and BCG vaccination. Coppola M, Jurion F, van den Eeden SJ, Tima HG, Franken KL, Geluk A, Romano M, Ottenhoff, T.H. NPJ Vaccines. 2021 Jun 3. doi: 10.1038/s41541-021-00343-2.
- Lung epithelial signaling mediates early vaccine-induced CD4+ T cell activation and Mtb control. Das S, Marin ND, Esaulova E, Ahmed M, Swain A, Rosa BA, Mitreva M, Rangel-Moreno J, Netea MG, Barreiro LB, Divangahi M. bioRxiv. 2021 June 3. doi: 10.1101/2021.06.03.446981.
- In-vivo expressed Mycobacterium tuberculosis antigens recognised in three mouse strains after infection and BCG vaccination. Coppola M, Jurion F, van den Eeden SJ, Tima HG, Franken KL, Geluk A, Romano M, Ottenhoff TH. NPJ Vaccines. 2021 June 3. doi: 10.1038/s41541-021-00343-2.
- High-dose Mycobacterium tuberculosis aerosol challenge cannot overcome BCG-induced protection in Chinese origin cynomolgus macaques; implications of natural resistance for vaccine evaluation. Sibley L, White AD, Gooch KE, Stevens LM, Tanner R, Jacobs A, Daykin-Pont O, Gleeson F, McIntyre A, Basaraba R, Clark S. Sci Rep. 2021 June 10. doi: 10.1038/s41598-021-90913-0.
- Monocyte metabolic transcriptional programs associate with resistance to tuberculin skin test/interferon-γ release assay conversion. Simmons JD, Van PT, Stein CM, Chihota V, Ntshiqa T, Maenetje P, Peterson GJ, Reynolds A, Benchek P, Velen K, Fielding KL. J Clin Invest. 2021 June 10. doi: 10.1172/JCI140073.
- A 2-Dose AERAS-402 Regimen Boosts CD8+ Polyfunctionality in HIV-Negative, BCG-Vaccinated Recipients. Sivakumaran D, Blatner G, Bakken R, Hokey D, Ritz C, Jenum S, Grewal HMS. Front Immunol. 2021 Jun 11. doi: 10.3389/fimmu.2021.673532.
- Vaccination with BCGΔBCG1419c protects against pulmonary and extrapulmonary TB and is safer than BCG. Aceves-Sánchez MJ, Flores-Valdez MA, Pedroza-Roldán C, Creissen E, Izzo L, Silva-Angulo F, Dawson C, Izzo A, Bielefeldt-Ohmann H, Segura-Cerda CA, López-Romero W, Bravo-Madrigal J, Barrios-Payán JA, de la Cruz MÁ, Ares M, Jorge-Espinoza MG. Sci Rep. 2021 Jun 14. doi: 10.1038/s41598-021-91993-8.
- Integrated transcriptomic analysis of human tuberculosis granulomas and a biomimetic model identifies therapeutic targets. Reichmann MT, Tezera LB, Vallejo AF, Vukmirovic M, Xiao R, Reynolds J, Jogai S, Wilson S, Marshall B, Jones MG, Leslie A, D’Armiento JM, Kaminski N, Polak ME, Elkington P. J Clin Invest. 2021 Jun 15. doi: 10.1172/JCI148136.
- Neonatal BCG vaccination and infections in the first year of life: the MIS BAIR randomised controlled trial. Messina NL, Pittet LF, Gardiner K, Freyne B, Francis KL, Zufferey C, Abruzzo V, Morrison C, Allen KJ, Flanagan KL, Ponsonby AL, Robins-Browne R, Shann F, South M, Vuillermin P, Donath S, Casalaz D, Curtis N. J Infect Dis. 2021 Jun 19. doi: 10.1093/infdis/jiab306.
- Production of antibiotic resistance gene-free urease-deficient recombinant BCG that secretes antigenic protein applicable for practical use in tuberculosis vaccination. Miyamoto Y, Tsukamoto Y, Maeda Y, Tamura T, Mukai T, Ato M, Makino M. Tuberculosis (Edinb). 2021 Jun 19. doi: 10.1016/j.tube.2021.102105.
- Prevalence of Latent TB and effectiveness of BCG vaccination against Latent Tuberculosis. An Observational Study. Trollfors B, Sigurdsson V, Dahlgren-Aronsson A. Int J Infec Dis. 2021 Jun 23. doi: 10.1016/j.ijid.2021.06.045.