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The London School of Hygiene & Tropical Medicine | LSHTM

Facing up to reality? What to do if M72/AS01E doses are limited

M72/AS01e
Ongoing
The Ph3 trial for the vaccine candidate M72/AS01E is underway, and, assuming a positive result, could be licensed by 2030. Modelling suggested a large potential impact from introducing M72/AS01E but assumed an unconstrained dose supply. However, at least initially, it is likely that M72/AS01E will be supply-constrained. We estimated the effect of decisions surrounding the allocation of constrained doses on the potential global impact of M72/AS01E

New tuberculosis vaccines are in late-stage trials, but how confident is the public in high burden countries in vaccines?

Ongoing
With tuberculosis (TB) vaccine candidates in late-stage trials, it is important to prepare for implementation to avoid delays upon licensure. General confidence in vaccines has been identified as an anticipated barrier to introducing new TB vaccines. In the absence of detailed TB specific vaccine acceptability and confidence data, we analysed currently available vaccine confidence data in countries appearing on one of the World Health Organization (WHO) high burden lists to investigate vaccine confidence in countries with a high TB burden

Preparing the landscape for TB vaccines: South Africa’s strategic planning

Ongoing
The South African TB Think Tank is a national collaboration of TB stakeholders, including researchers, policymakers, clinicians, and civil society. Chaired by the Chief Director of the National TB Programme (NTP), members consolidate TB research through several technical task teams, providing evidenced-based policy recommendations to the Department of Health. To support the national TB vaccine initiative, the TB Think Tank provided recommendations for the recently released NTP Strategic Plan, 2023-28

Forecasting TB vaccine demand to support supply and procurement planning

Ongoing
We present insights from two workshops with global health funders, academics, and in country TB and vaccine decision-makers and estimates of potential global demand for TB vaccines using a bottom-up, constrained demand forecasting model. The model was informed by the workshops, publicly available target product profile, landscape assessment of vaccines in development, information from proxy vaccines sourced from the WHO databases and peer reviewed literature, and interviews with TB and vaccine experts

Modelling to estimate the health impact of novel tuberculosis vaccines on TB burden in people living with HIV

2023-2024
Hypothetical vaccine
Ongoing
This project will inform tuberculosis (TB) prevention efforts by estimating the health impact of novel tuberculosis vaccines on TB burden in people living with HIV (PLHIV) using a novel Mycobacterium tuberculosis transmission model. HIV confers the largest relative risk of TB, and new TB vaccines could be an important tool to prevent TB; however, modelling studies have not systematically investigated how new vaccines will affect TB burden in PLHIV. In stage 1 of this project, we aim to investigate TB vaccine impact in PLHIV where vaccine product characteristics and delivery vary by recipient HIV status. In stage 2, we aim to quantify how complex vaccine targeting strategies and incorporating additional granularity in HIV/AIDS natural history might affect vaccine impact estimates in PLHIV

FAST-TB MOD

2023-2026
Hypothetical vaccine
Ongoing
FAST-TB population and cost-effectiveness modelling core: This project will accelerate tuberculosis (TB) research translation by using mathematical modelling to address key priority questions as part of FAST TB, linking an expanded state-of-the-art modelling framework with country level data and cross consortium communication around new TB treatment regimens, diagnostics and other interventions.

Creating evidence to support tuberculosis (TB) national and global decision-makers in reducing the global burden of TB

2024-2028
Hypothetical vaccine
Ongoing
In strong collaboration, we (India, South Africa, Brazil, Indonesia, UK) will create evidence to strengthen capacity and sustainably support high tuberculosis (TB) burden countries (HBC) and global decision-makers in reducing the global burden of TB, by using modelling tools to address key questions on drug-resistant (DR-)TB, new TB vaccines and other interventions, and extend and apply a state-of-the-art TB model, to estimate the relative health, cost-effectiveness, and budget impact, of new and existing interventions, as well as their optimal combination.

Potential implications of reduced tuberculosis vaccine efficacy in those with undernutrition on overall vaccine impact in India

Hypothetical vaccine
Ongoing
Nutritional status is a leading risk factor for tuberculosis (TB). In India up to half of all TB episodes are attributed to undernutrition. Given the impact of nutrition on the immune system, vaccine characteristics such as efficacy and duration of protection could vary depending on nutritional status. Therefore, previous vaccine impact estimates may be overestimated. We re estimated vaccine impact in India with reduced efficacy with undernutrition
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