BCG and New Preventive Tuberculosis Vaccines: Implications for Healthcare Workers.
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.
South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, South Africa.
Mark
M
Hatherill
South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, South Africa.
Thomas J
TJ
Scriba
Department of Respiratory Medicine, P. D. Hinduja National Hospital, Mumbai, India.
Zarir F
ZF
Udwadia
Department of Respiratory Medicine, P. D. Hinduja National Hospital, Mumbai, India.
Jai B
JB
Mullerpattan
Directorate of Health Impact Assessment, Western Cape Government Department of Health, Cape Town.
Anthony
A
Hawkridge
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.
Hassan
H
Mahomed
Office of the Director General, World Health Organization, Geneva, Switzerland.
Christopher
C
Dye
D001500:BCG Vaccine; D006282:Health Personnel; D006801:Humans; D009784:Occupational Diseases / Q000276:immunology / Q000517:prevention & control; D016273:Occupational Exposure; D013019:South Africa; D014376:Tuberculosis / Q000276:immunology / Q000517:prevention & control; D032581:Tuberculosis Vaccines
D001500:BCG Vaccine; D032581:Tuberculosis Vaccines
healthcare workers; prevention; tuberculosis; vaccine