How New Vaccines Could Revolutionise Our Relationship With TB
13 May 2025
Hopes are high for a new TB vaccine now in the last stages of development, but other candidates aren’t far behind it.
Tuberculosis (TB) has scourged humanity for millennia and remains the deadliest infectious disease worldwide. Although a cheap and partially effective vaccine has long been available, new ones are urgently needed.
News that a potential breakthrough vaccine – one that many hope could be the first new TB vaccine for a century – has reached its clinical trial recruitment target ahead of time is understandably stirring optimism. It’s not alone, either: several other contenders are close on its heels.
So what might these next-generation vaccines mean for the way we live with, and defend against, TB in the years to come?
Ancient killer
Every three minutes, tuberculosis silently claims another three lives, making it the world’s biggest infectious killer.
In 2021 alone, 10.6 million people were diagnosed with TB and 1.6 million died. Even though the disease is curable with antibiotics, millions still slip through the cracks, undiagnosed, untreated or facing forms of TB that no longer respond to standard antibiotics.
The only vaccine currently in widespread use, BCG, offers moderate protection against severe forms of TB in infants and young children, including TB disease of the brain (meningitis), and miliary TB – where the bacterium spreads through the bloodstream and affects multiple organs.
But for adolescents and adults, who are responsible for the lion’s share of transmission, its effectiveness wanes. The BCG vaccine also doesn’t prevent the transmission of pulmonary TB, a type that affects the lungs. New vaccines could be a game-changer.
“There is hope that a new tuberculosis vaccine targeting adolescents and adults could bring the numbers significantly down,” says Marta Tufet Bayona, head of policy at Gavi, the Vaccine Alliance.
When Gavi recently assessed the potential impact that such vaccines could have in the countries it supports, it estimated that delivering a TB vaccine through routine immunisation of 15-year-olds could avert 201,000–230,000 deaths and 64–73 million years of healthy lives lost between 2026 and 2040.
Researchers at the Harvard T.H. Chan School of Public Health in Boston, US, have also suggested that an effective TB vaccine for adolescents and adults could produce up to US$ 474 billion in economic benefits by 2050.
Vaccine frontrunner
While there are at least 20 TB vaccine candidates for adults and adolescents in the clinical pipeline, the current frontrunner is the M72/AS01E (M72) vaccine.
It is built around a fusion protein called M72, which combines fragments from two proteins found in Mycobacterium tuberculosis, the bacterium that causes TB. To boost the body’s immune response, the vaccine also contains an adjuvant called AS01E, which is also used to boost immune responses to the RTS,S malaria vaccine, respiratory syncytial virus (RSV) vaccine for adults and the Shingrix shingles vaccine.