New hope for tuberculosis vaccines

• Published in: The Lancet infectious diseases Vol. 19; no. 7; pp. 687 - 688
• Main Authors: Olesen, Ole F, Abdullah, Fareed, Coppens, Rene, Gardner, Peter J, Ginsberg, Ann M, Hanekom, Willem A, Laang, Hannu, Lewinsohn, David M, Loots, Glaudina, Schmidt, Alexander, Vekemans, Johan, Voss, Gerald H
• Format: Journal Article
• Language: English
• Published: United States Elsevier Ltd 01.07.2019; Elsevier Limited
• Subjects: Acquired immune deficiency syndrome; Adolescents; Adults; AIDS; Animals; Antigens; BCG Vaccine - immunology; Candidates; Disease control; Economic models; Effectiveness; Epidemics; Funding; Gold; Humans; Impact analysis; Infections; Infectious diseases; Latent infection; Low income areas; Modelling; Mycobacterium tuberculosis - immunology; Mycobacterium tuberculosis - pathogenicity; Older people; Public health; R&D; Research & development; Teenagers; Tuberculosis; Tuberculosis - immunology; Tuberculosis - microbiology; Tuberculosis - prevention & control; Tuberculosis Vaccines - administration & dosage; Tuberculosis Vaccines - immunology; Vaccination - trends; Vaccines; Vaccines, Subunit - administration & dosage; Vaccines, Subunit - immunology; South Africa; Zambia; Kenya; United States > US
• ISSN: 1473-3099; 1474-4457
• DOI: 10.1016/S1473-3099(19)30280-4

An efficacy of 45·4% (95% CI 6·4–68·1; p=0·03) was shown against a secondary endpoint: sustained conversion of the QuantiFERON-TB gold in-tube test, which measures the host response to infection.1 Second, an experimental subunit tuberculosis vaccine, M72/AS01E, comprising only two antigens, Rv1196 and Rv0125, formulated with a potent adjuvant, showed 54·0% (90% CI 13·9–75·4; p=0 efficacy in protecting against development of pulmonary tuberculosis in adults with latent infection.2 This vaccine was tested in a phase 2b efficacy trial in South Africa, Kenya, and Zambia over a 2-year follow-up period.2 Both results represent major scientific breakthroughs in tuberculosis vaccine research and strongly indicate that it could be feasible to develop a tuberculosis vaccine to impact the global tuberculosis epidemic. Economic modelling has suggested that a new, effective tuberculosis vaccine can have a large impact; a tuberculosis vaccine targeting adolescents and adults in low-income countries with 60% efficacy against pulmonary tuberculosis over a 10-year duration could prevent 17 million cases of tuberculosis disease (range 11–24 million) by 2050.4 The same modelling also showed extraordinary cost savings to health systems. [...]only about 12–13% of tuberculosis investments are currently allocated to vaccine research and development, despite the recognised benefits of vaccines in controlling infectious diseases.