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New tuberculosis vaccines: advances in clinical development and modelling
C K Weerasuriya1, R A Clark1, R G White1
1From the, TB Modelling Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
Journal of Internal Medicine
|October 31, 2020
Summary
A new tuberculosis vaccine is crucial to meet the 2035 End TB goals. Mathematical modeling and ongoing trials for candidates like M72/AS01E and BCG revaccination are essential for understanding their population impact and guiding deployment strategies.
Area of Science:
- Vaccinology
- Epidemiology
- Mathematical Biology
Background:
- Tuberculosis (TB) causes significant global morbidity and mortality, necessitating novel prevention strategies.
- The 'End TB' strategy by 2035 likely requires a new TB vaccine, as current control measures are insufficient.
- The TB vaccine development pipeline shows promise, but questions regarding population impact and implementation persist.
Purpose of the Study:
- To update on the current TB vaccine development pipeline.
- To systematically review mathematical modeling studies on the epidemiological impact of new TB vaccines.
- To identify research and modeling priorities for effective TB vaccine deployment.
Main Methods:
- Systematic literature review of mathematical modeling studies.
- Analysis of data from clinical trials of TB vaccine candidates.
- Synthesis of findings to inform vaccine development and implementation strategies.
Main Results:
- Fourteen prophylactic TB vaccine candidates are in clinical trials.
- M72/AS01E showed 49.7% protection against TB disease; BCG revaccination showed 45.4% protection against M. tuberculosis infection in Phase II trials.
- Recent modeling studies have explored vaccine characteristics, age, and risk group targeting.
Conclusions:
- Further trials are critical for M72/AS01E and BCG revaccination to confirm efficacy and safety, especially in vulnerable populations.
- Gaps in modeling remain regarding the full value proposition, comparative effectiveness, and realistic implementation strategies.
- Coordinated efforts in clinical trials and mathematical modeling are essential to ensure timely and effective deployment of new TB vaccines.
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