The TB Vaccines Pipeline

Since the 2012 Pipeline Report, results from phase II trials and advances in preclinical development have brought the pipeline for new TB vaccines into sharper focus, even as correlates of protective immunity against TB remain elusive. Nearly empty in 2000, the current pipeline includes 14 vaccine candidates in clinical trials and over 35 candidates in discovery or preclinical development. Compared to where the TB community stood just 10 years ago, the present pipeline attests to the reinvigorated investment in TB vaccine research and development over the last decade. Yet disappointing results from the phase IIb efficacy trial of vaccine candidate MVA85A in infants as a boost to neonatal BCG announced in February 2013 require that we reevaluate the strategies that have brought us this far, paying critical attention to gaps in our knowledge of how Mycobacterium tuberculosis (MTB) interacts with the immune system and to the metrics we use to advance vaccine candidates through the pipeline.