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The potential impact of BCG vaccine supply shortages on global paediatric tuberculosis mortality

Rebecca C Harris1, Peter J Dodd2, Richard G White3

  • 1TB Modelling Group, TB Centre and Centre for the Mathematical Modelling of Infectious Diseases, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK. rebecca.harris@lshtm.ac.uk.

BMC Medicine
|September 17, 2016
PubMed

Insights

Global Bacillus Calmette-Guérin (BCG) vaccine shortages significantly increase childhood tuberculosis (TB) deaths. Ensuring continuous BCG supply is critical to prevent widespread pediatric TB mortality.

Area of Science:

  • Immunization
  • Global Health
  • Epidemiology

Background:

  • The Bacillus Calmette-Guérin (BCG) vaccine is crucial for preventing childhood tuberculosis (TB), administered to over 100 million neonates annually.
  • Recent interruptions in BCG manufacturing have exposed vulnerabilities in the global supply chain.

Purpose of the Study:

  • To estimate the impact of BCG vaccine supply shortfalls on global pediatric TB mortality.
  • To quantify potential excess TB deaths in children under 15 years due to BCG supply disruptions.

Main Methods:

  • A static mathematical model was utilized to assess TB deaths.
  • The model estimated deaths avoided by normal BCG coverage and additional deaths from supply shortfalls (6.3% to 27.6%).

Main Results:

  • Normal BCG coverage (90%) is estimated to prevent 117,132 pediatric TB deaths per birth cohort.
  • A 10% BCG supply shortfall could lead to an additional 11,713 pediatric TB deaths.
  • A 6.3% shortfall in 2015 was associated with 7,433 excess TB deaths, but prompt actions avoided 24,914 potential deaths.

Conclusions:

  • BCG vaccine shortages pose a substantial risk to global pediatric TB mortality.
  • The 2015 events underscore the necessity of maintaining secure manufacturing capacity and consistent global BCG supply.
  • Proactive measures can mitigate the impact of shortfalls, but long-term supply chain resilience is paramount.
Abstract

Keywords:
Bacillus Calmette-Guérin vaccineChildMathematical modelMortalityMycobacterium tuberculosisPaediatricShortageShortfallTuberculosis

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