title: Beyond BCG: the potential for a more effective TB vaccine.
abstract: The 'Bacille Calmette-Guerin' (BCG) vaccine has been used throughout most parts of the world for the majority of the century. It is safe to use and cheap to produce, but there have been increasing doubts about its effectiveness. These doubts could not come at a worse time, as tuberculosis (TB) rates continue to rise, compounded by the AIDS epidemic, and outbreaks of tuberculosis caused by multidrug-resistant strains are more common even in advanced countries. As a result, there is now a concerted research effort to produce new TB vaccine candidates. These include DNA vaccines, recombinant and auxotrophic vaccines and subunit vaccines, all of which hold promise. The real difficulty will probably arise at the clinical trial level, when a decision must be made either to replace BCG or to boost existing BCG-induced immunity using these new-generation vaccines.
authors.affiliation: Mycobacteria Research Laboratories, Department of Microbiology, Colorado State University, Fort Collins, CO 80523, USA. iorme@lamar.colostate.edu
authors.forename: I M
authors.initials: IM
authors.lastname: Orme
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000517:prevention & control; D000818:Animals; D001500:BCG Vaccine; D001428:Bacterial Vaccines / Q000276:immunology; D002648:Child; D002986:Clinical Trials as Topic; D005544:Forecasting; D005822:Genetic Vectors; D006168:Guinea Pigs; D006291:Health Policy; D006801:Humans; D051379:Mice; D009169:Mycobacterium tuberculosis / Q000276:immunology*; D015995:Prevalence; D016176:T-Lymphocyte Subsets / Q000276:immunology; D014376:Tuberculosis / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control*; D018088:Tuberculosis, Multidrug-Resistant / Q000517:prevention & control; D014611:Vaccination; D019444:Vaccines, DNA; D014614:Vaccines, Synthetic
chemical_list: D001500:BCG Vaccine; D001428:Bacterial Vaccines; D019444:Vaccines, DNA; D014614:Vaccines, Synthetic