Vaccination After Mycobacterium tuberculosis Infection: Post-Exposure, Therapeutic and Revaccination Strategies

Tuberculosis caused an estimated 1.23 million deaths and 10.7 million new illnesses worldwide in 2024, making it the leading cause of death from a single infectious agent (WHO, Global Tuberculosis Report 2025). Approximately one-quarter of the world’s population is estimated to have been infected with Mycobacterium tuberculosis, although most infected individuals remain asymptomatic. Preventing progression to disease in this population is therefore an important priority for TB control.BCG has been used for more than a century and provides good protection to infants and young children against severe forms of TB, including miliary TB and TB meningitis. Its protection against pulmonary TB in adolescents and adults, however, varies considerably between populations and settings. Factors such as previous exposure to environmental mycobacteria, BCG strain, age at vaccination and host characteristics may contribute to this variation.The effects of BCG and other vaccines in people with established M. tuberculosis infection are less well understood. Evidence that BCG prevents progression, reactivation or recurrence remains limited and mixed, and recent revaccination studies have not yet resolved these questions. This highlights the need for vaccination strategies specifically designed for people who have already been exposed to or infected with M. tuberculosis.Several TB vaccine candidates and revaccination strategies are now being evaluated in clinical studies. As the field develops, important questions concern not only whether a candidate can induce an immune response, but also which strategy is most appropriate for different groups, when it should be administered, and which immune responses are associated with protection.This Research Topic will focus on vaccination in people who are already infected, recently exposed or recently treated for TB. Areas of interest will include post-exposure and therapeutic vaccination, BCG revaccination, prevention of recurrence after treatment, and the use of vaccines alongside preventive or curative drug regimens.A related challenge is the lack of consistent approaches for measuring vaccine-induced protection. Studies often use different assays, populations and clinical endpoints, making it difficult to compare findings across trials. We therefore also welcome research on immune correlates associated with sustained infection, progression to disease, relapse and reinfection, as well as the development and standardisation of immune assays, reference reagents and translational models.We welcome submissions addressing, but not limited to:- Post-exposure and therapeutic vaccination, including immunology, candidate evaluation and clinical trial design- BCG revaccination and the prevention of sustained infection, disease progression or recurrence- Vaccination to prevent relapse or reinfection after TB treatment- Vaccine and drug combinations for TB prevention and treatment- Latency-associated, resuscitation-promoting and stage-specific antigens- Mucosal and tissue-resident immunity in people with established infection- Immune responses associated with progression, protection and recurrence- Standardisation of immune assays and reference reagents across preclinical and clinical studies- Controlled human infection and other challenge models relevant to TB vaccine development- Correlates of protection in people living with HIV, adolescents, older adults, and people with diabetes or undernutrition- Factors contributing to variation in BCG responses between populations and settings- Implications of these findings for the design of next-generation TB vaccine regimensWe welcome original research, systematic reviews, mini-reviews, perspectives, hypothesis and theory articles, clinical trial reports, brief research reports and methods papers.If you are interested in submitting or have any questions please contact the journal email: tuberculosis@frontiersin.org Topic editors: Mehak Zahoor Khan, Owais Rashid Hakiem, Samreen Fatima, Ananya Gupta, Kirtimaan Syal Source: https://www.frontiersin.org/research-topics/83560/vaccination-after-mycobacterium-tuberculosis-infection-post-exposure-therapeutic-and-revaccination-strategies