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Peer reviewedOpen accessTuberculosis

Inclusion of young adolescents in policy development for new tuberculosis vaccines.

The Lancet. Global health·

Hatherill M, Clark RA, Martinez L, Fiore-Gartland AL, Garcia-Basteiro AL, Churchyard GJ, Rangaka MX, Behr MA, Evans T, Mave V, Hill PC, Hanekom WA, Cobelens F, White RG

DOI
10.1016/s2214-109x(26)00017-3
PMID
42259345
PMCID
OpenAlex
W7163919376
Study type
Journal article
Publisher
Publisher unavailable
Article type
journal-article
Integrity
current

Why this research matters now

Policymakers must integrate these operational hurdles into immunization planning to prevent systematic exclusion of younger demographics from emerging therapeutic protections.

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Structured evidence summary

Research question

Should current immunization frameworks formally incorporate children aged nine to fourteen into tuberculosis vaccine planning, and what methodological modifications are necessary?

Study design

The manuscript operates as a policy commentary and methodological proposal, synthesizing epidemiological observations with proposed clinical trial architectures rather than presenting primary empirical data.

Population and setting

The analysis focuses on preteen and early adolescent cohorts between nine and fourteen years old, while referencing adult populations primarily for comparative licensure benchmarks.

Main findings

Early immunization provides preventive advantages before age-dependent susceptibility rises and aligns with routine school-based health initiatives. Conducting trials in this demographic presents obstacles such as sparse disease occurrence, limited prior infection markers, and diluted projected community-wide effects. The authors recommend utilizing recent household contact tracing to accelerate case identification and validate immunological markers.

Public-health relevance

Policymakers must integrate these operational hurdles into immunization planning to prevent systematic exclusion of younger demographics from emerging therapeutic protections.

Important limitations

Trial execution faces inherent constraints due to infrequent disease manifestation within the target age bracket and insufficient prior pathogen exposure to facilitate immune marker translation from adult studies. Additionally, population-level benefit projections appear comparatively subdued relative to broader adult outreach efforts, with potential multi-year delays in detecting impact if interventions target only previously infected individuals.

GIDS interpretation

This publication situates adolescent immunization strategy within broader health system planning, emphasizing how trial architecture directly influences policy adoption speed and demographic coverage metrics.

02

Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

03

Evidence relationships

This article has 10 auditable classifier relationships to diseases, places, topics, and study design.

about diseaseaddresses topicaddresses topicaddresses topicevaluates interventioninforms policy domainstudied population settingstudies populationstudies populationuses study design