Cited by 164Tuberculosis Research and EpidemiologyImmune responses and vaccinationsInfectious Diseases and Tuberculosis

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Tuberculosis Vaccines and Prevention of Infection

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Hawn, Thomas R., Day, Tracey A., Scriba, Thomas J., Hatherill, Mark, Hanekom, Willem A., Evans, Thomas G., Churchyard, Gavin J., Kublin, James G., Bekker, Linda-Gail, Self, Steven G.·2014·Microbiology and Molecular Biology Reviews

DOI 10.1128/mmbr.00021-14PMC PMC4248657

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Abstract

SUMMARY: Tuberculosis (TB) is a leading cause of death worldwide despite the availability of effective chemotherapy for over 60 years. Although Mycobacterium bovis bacillus Calmette-Guérin (BCG) vaccination protects against active TB disease in some populations, its efficacy is suboptimal. Development of an effective TB vaccine is a top global priority that has been hampered by an incomplete understanding of protective immunity to TB. Thus far, preventing TB disease, rather than infection, has been the primary target for vaccine development. Several areas of research highlight the importance of including preinfection vaccines in the development pipeline. First, epidemiology and mathematical modeling studies indicate that a preinfection vaccine would have a high population-level impact for control of TB disease. Second, immunology studies support the rationale for targeting prevention of infection, with evidence that host responses may be more effective during acute infection than during chronic infection. Third, natural history studies indicate that resistance to TB infection occurs in a small percentage of the population. Fourth, case-control studies of BCG indicate that it may provide protection from infection. Fifth, prevention-of-infection trials would have smaller sample sizes and a shorter duration than disease prevention trials and would enable opportunities to search for correlates of immunity as well as serve as a criterion for selecting a vaccine product for testing in a larger TB disease prevention trial. Together, these points support expanding the focus of TB vaccine development efforts to include prevention of infection as a primary goal along with vaccines or other interventions that reduce the rate of transmission and reactivation.

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Authors: Hawn, T. R., Day, T. A., Scriba, T. J., Hatherill, M., Hanekom, W. A., Evans, T. G., Churchyard, G. J., Kublin, J. G., Bekker, L.-G., & Self, S. G.
Affiliations: University of Washington (US)
Fred Hutch Cancer Center (US)
University of Cape Town (ZA)
Gates Foundation (US)
Aeras (US)
University of the Witwatersrand (ZA)
ORCID: Hawn, Thomas R.
Day, Tracey A.
Scriba, Thomas J.
Hatherill, Mark
Hanekom, Willem A.
Evans, Thomas G.
Churchyard, Gavin J.
Kublin, James G.
Bekker, Linda-Gail
Venue: Microbiology and Molecular Biology Reviews
Publisher: American Society for Microbiology
Published: 2014-12
Volume: 78
Issue: 4
Pages: 650-671
ISSN: 1092-2172 (ISSN-L)
1098-5557
DOI: 10.1128/mmbr.00021-14
PMC: PMC4248657
OpenAlex: W2137780892
Cited by: 164
References: 209
Citations by year: 2026: 3 · 2025: 8 · 2024: 8 · 2023: 8 · 2022: 16 · 2021: 14 · 2020: 15 · 2019: 21 · 2018: 22 · 2017: 23 · 2016: 20 · 2015: 6
FWCI: 2.27
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: journals.asm.org/non-commercial-tdm-license (tdm)
Locations: Microbiology and Molecular Biology Reviews (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: Wellcome Trust (84323)
National Institute of Allergy and Infectious Diseases (UM1AI068614, UM1AI068635)
Topics: Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
Life Sciences › Immunology and Microbiology › Immunology › Immune responses and vaccinations
Health Sciences › Medicine › Infectious Diseases › Infectious Diseases and Tuberculosis
Keywords: tuberculosis vaccine development, BCG vaccine, protective immunity, natural resistance to infection, correlates of immunity, tuberculosis transmission, tuberculosis reactivation, tuberculosis epidemiology
MeSH terms: Animals, Clinical Trials as Topic, Humans, Models, Theoretical, Mycobacterium bovis, Mycobacterium tuberculosis, Tuberculosis, Vaccination, HIV Infections, Models, Animal, Tuberculosis Vaccines, Coinfection

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Tuberculosis Vaccines and Prevention of Infection

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