Will lessons from COVID-19 and TB vaccine rollout improve pandemic preparedness and health security?
ODE UDUU, SHOBHA SHUKLA, BOBBY RAMAKANT
Lessons from past vaccine rollouts must help in improving readiness for future vaccine rollouts
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TB high burden countries India and Nigeria both have had decades of experience in rolling out the TB vaccine. Both nations were successful (even if not ideal) in reaching out to a large part of their populations with COVID-19 vaccination. Are there any lessons that we can learn from this experience of rolling out vaccines against TB and COVID-19, which might pave the way for improving preparedness for the rollout of future vaccines?
We spoke with experts in both these nations - as a new TB vaccine, which is currently in Phase-3 study in India (and elsewhere too), if proven safe and effective, would need readiness and preparedness to ensure that it reaches everyone who needs it, timely. As promised by governments, only 32 months are left for India to end TB (by 2025) and 92 months are left for Nigeria and other countries globally to do so by 2030.
Century-old TB vaccine and still not 100% coverage in hard-hit nations
The only vaccine against TB, the 102-year-old BCG (Bacille Calmette Guerin), has a protective effect against meningitis and disseminated TB in children. It does not prevent primary infection and does not prevent reactivation of latent pulmonary infection. It is hard to fathom that why for a disease that was the deadliest infectious disease in the world before COVID-19 hit us, why better vaccines to prevent and control TB are not around yet? More importantly, despite 102 years of BCG vaccine being around, its coverage is still not 100% in TB hard-hit nations like India and Nigeria - as per WHO data, BCG vaccine coverage in 2021 was 84% in India and 75% in Nigeria.
Science first: "While the neonatal BCG vaccination is partially effective in reducing the risk and severity of serious forms of TB, like miliary TB and TB meningitis in infants and young children, it is poorly protective against pulmonary disease in adolescents and adults. There is a critical need for new TB vaccines that are more effective than the existing BCG vaccine in preventing pulmonary as well as extra-pulmonary forms of TB in all age groups," said Prof Surya Kant, scientific Chairperson of 77th National Conference of Tuberculosis and Chest Diseases held in Agra, India.
BCG vaccine is contraindicated in those with cell-mediated immune deficiency. While HIV infected, non-symptomatic infants should be immunized with BCG vaccine according to standard schedules, infants with clinical (symptomatic) AIDS should not receive it.
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