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Targeted Tuberculosis (TB) Vaccination Strategies in the United States: A Modeling Study

2026

Tuberculosis (TB) incidence in the United States has remained elevated above pre-pandemic levels since 2021, with over 85% of cases resulting from reactivation of Mycobacterium tuberculosis (Mtb) infection. New vaccines that would prevent TB in adults are under development, but the potential health impact of a program prioritizing non-U.S.-born persons and persons with medical comorbidities, including persons living with HIV (PLWH), has not been evaluated.

Target Tuberculosis vaccination strategies in the United States

2026

Hypothetical vaccines

Uses a mathematical model to evaluate targeted TB vaccination strategies in the United States. The study examines which high-risk groups should be prioritised for a future adult TB vaccine, including people living with HIV, people with medical comorbidities, and people born outside the United States

Preparing for Tuberculosis Vaccine M72/AS01E Implementation

2026

M72/AS01e

This correction relates to the global demand forecast for the potential implementation of the M72/AS01E TB vaccine

Estimating the population impact of new tuberculosis vaccines depending on efficacy against infectious asymptomatic tuberculosis:

2026

Hypothetical vaccines, M72/AS01e

Uses a dynamic TB transmission model to estimate how the population impact of future TB vaccines changes depending on whether vaccines prevent progression to infectious symptomatic TB only, all infectious TB, or all TB disease.

Tuberculosis policy should shift focus to population-level interventions for greatest impact

2026

Hypothetical vaccines

Uses mathematical modelling to compare the population-level health and economic impacts of TB interventions in Brazil, India and South Africa. It highlights mass vaccination and community-wide screening as interventions with the potential for substantial epidemiological impact.

ZAMSA-TB: Advancing epidemiological methods for surveillance of Mycobacterium tuberculosis infection

2024-2028

Hypothetical vaccines, M72/AS01e

Multi-country study developing and validating clinic-based convenience sampling of Mtb immunoreactivity (IGRA) in children aged 1-5 as a sentinel measure of recent TB transmission. Outputs include geospatial identification of high-transmission neighbourhoods to target adult/adolescent vaccine delivery, and Monte Carlo simulations to size convenience-sampling surveys able to detect population-level vaccine effectiveness during roll-out.

Tuberculosis Integrated Model-Based Evidence and Recommendations (TIMBER) for robust TB vaccine decision-making by National Immunization Technical Advisory Groups (NITAGs) in Africa.

2025 - 2028

Hypothetical vaccines

The TIMBER study is a multi-country research study aimed at strengthening the use of model-based evidence to support national decision-making on the introduction of new TB vaccines in Africa. The study brings together National Immunization Technical Advisory Groups (NITAGs), policymakers, researchers, modellers and other stakeholders in South Africa, Kenya and The Gambia to co-create models and explore how modelling can be used effectively within the WHO Evidence-to-Recommendation process. TIMBER will generate country-specific evidence, strengthen capacity for using modelling in vaccine policy decisions, and develop practical approaches to support timely, evidence-informed introduction of new TB vaccines.

New Tuberculosis vaccines for people with HIV

2025

Hypothetical vaccines

Mathematical modelling study assessing how different strategies for vaccinating people with and without HIV could reduce TB cases among people with HIV in high HIV/TB burden countries

A model for the epidemiological impact of tuberculosis policy options

2026

Hypothetical vaccines

Develops a new TB transmission model to help decision-makers comapre the epidemiological impact of different TB interventions and allocate resources. The model incorporates diagnosis, treatment, drug resistance, HIV status, age, and vaccination status, and was calibrated using data from 29 high burden countries. It demonstrates the potential impact of comprehensive TB interventions in Indonesia and Nigeria, including the possible use of a post-exposure TB vaccine

Global impact and cost-effectiveness of tuberculosis interventions

2026

Hypothetical vaccines

The modelling study compares the population-level impact and cost-effectiveness of TB vaccination with other TB interventions. It models vaccination scale-up in Brazil, India, and South Africa and estimates that vaccination could prevent 15-28% of symptomatic TB episodes by 2050. It provides evidence to inform investment, policy, and planning for future TB vaccine introduction and scale-up.