title: The present and future of tuberculosis vaccinations.
abstract: The clinical, social, and economic burden of tuberculosis (TB) remains high worldwide, thereby highlighting the importance of TB prevention. The bacilli Calmette-Guérin (BCG) vaccine that is currently available can protect younger children but is less effective in adults, the major source of TB transmission. In addition, the emergence of drug-resistant Mycobacterium tuberculosis (Mtb) strains and the high prevalence of HIV infection have significantly complicated TB prognosis and treatment. Together, these data highlight the need for new and more effective vaccines. Recently, several vaccines containing multiple antigens, including some of those specific for dormant Mtb strains, have been developed. These vaccines appear to be the best approach for satisfactory Mtb prevention. However, until a new vaccine is proven more effective and safe than BCG, BCG should remain part of the immunization schedules for neonates and children at risk for TB as a fundamental prophylactic measure.
authors.affiliation: Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Principi
authors.affiliation: Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy. Electronic address: susanna.esposito@unimi.it.
authors.forename: Susanna
authors.initials: S
authors.lastname: Esposito
mesh_terms: D000276:Adjuvants, Immunologic; D000818:Animals; D001500:BCG Vaccine; D004195:Disease Models, Animal; D055808:Drug Discovery / Q000639:trends; D014943:Global Health / Q000639:trends; D006801:Humans; D007117:Immunization, Secondary / Q000639:trends; D051379:Mice; D011994:Recombinant Proteins; D014376:Tuberculosis / Q000517:prevention & control*; D032581:Tuberculosis Vaccines; D014611:Vaccination / Q000639:trends*
chemical_list: D000276:Adjuvants, Immunologic; D001500:BCG Vaccine; D011994:Recombinant Proteins; D032581:Tuberculosis Vaccines
keywords: BCG vaccine; Mycobacterium tuberculosis; Prevention; TB; Tuberculosis; Vaccine