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Clin Infect Dis. 2016 May 15;62 Suppl 3:S262-7. doi: 10.1093/cid/ciw025.

BCG and New Preventive Tuberculosis Vaccines: Implications for Healthcare Workers.

Author information

South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, South Africa.
Department of Respiratory Medicine, P. D. Hinduja National Hospital, Mumbai, India.
Directorate of Health Impact Assessment, Western Cape Government Department of Health, Cape Town.
Division of Community Health, Faculty of Medicine and Health Sciences, Stellenbosch University Metro District Health Services, Western Cape Government Department of Health, Cape Town, South Africa.
Office of the Director General, World Health Organization, Geneva, Switzerland.


Healthcare workers (HCWs) are at high risk of Mycobacterium tuberculosis (Mtb) infection and tuberculosis disease, but also play a crucial role in implementing healthcare. Preexposure tuberculosis vaccination, including revaccination with BCG, might benefit Mtb-uninfected HCWs, but most HCWs in tuberculosis-endemic countries are already sensitized to mycobacteria. A new postexposure tuberculosis vaccine offers greatest potential for protection, in the setting of repeated occupational Mtb exposure. Novel strategies for induction of mycobacteria-specific resident memory T cells in the lung by aerosol administration, or induction of T cells with inherent propensity for residing in mucosal sites, such as CD1-restricted T cells and mucosa-associated innate T cells, should be explored. The need for improved protection of HCWs against tuberculosis disease is clear. However, health systems in tuberculosis-endemic countries would need significantly improved occupational health structures to implement a screening and vaccination strategy for HCWs.


healthcare workers; prevention; tuberculosis; vaccine

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