Infectious Disease

Why are there efficient vaccines towards COVID-19 however not towards TB?

December 23, 2020

2 min read

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Several vaccines against COVID-19 have been shown to be extremely effective and appear close to approval – a development that has been completed in less than a year.

However, after 140 years there is still no widely used, highly effective vaccine against tuberculosis. We asked Aaron E. Glatt, MD, MACP, FIDSA, FSHEA, Chairman of the Medical Department and Chief of Infectious Diseases at Mount Sinai South Nassau in New York and Professor of Medicine at the Icahn School of Medicine on Mount Sinai, why.

Aaron E. Glatt, MD, MACP, FIDSA, FSHEA
Aaron E. Glatt

When people think of TB, they don’t think of a vaccine-preventable disease. However, there is a vaccine against TB named after French scientists Calmette and Guérin. It is not recommended for use in the US to prevent TB. However, in many other parts of the world, especially in other countries where TB is very common, it is routinely used to prevent the acquisition of TB in young children with varying degrees of success.

Given the rapid progress we’ve seen in developing a vaccine against COVID-19, a disease entity that is not yet 1 year old, one might wonder why we haven’t been able to develop a better vaccine against TB. The question becomes even bigger when you consider that there are well over 1 billion people worldwide with latent TB infection. Some estimates suggest that one in four people worldwide has latent TB, which begs the question, “Why hasn’t a successful vaccine been found?”

The answer is simple: despite the many success stories we have so far, vaccines are not easy to develop. Many diseases such as TB, malaria and Staphylococcus aureus – all major pathogens in the world – have failed in vaccine development, especially due to a lack of effort. We have had relatively little success with influenza, but it remains difficult to find great vaccine therapy. Still other diseases, like many of the childhood viral rashes, have been almost completely eradicated – think polio or measles.

Every infectious agent is different. Some mutate easily and thwart vaccination efforts, while others simply pose technical problems and make an effective vaccine nearly impossible.

However, there is new hope based on some of the COVID-19 efforts. New vaccine modalities such as messenger RNA vaccines may open up an entirely new, comprehensive technology for vaccine development. Perhaps the silver lining in this terrible COVID-19 pandemic is developing prevention for TB.

Click here to read the cover story: “In the shadow of COVID-19, TB vaccine research enters a new era.”

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