New adult and adolescent tuberculosis vaccines and Indonesia: policy planning and evidence, November 2024

This report summarizes the proceedings of a policy and planning meeting convened in Indonesia, by the Ministry of Health and the World Health Organization, on potential new tuberculosis (TB) vaccines intended for adults and adolescents. Given that Indonesia bears the second highest TB burden globally, and that it is participating in the phase III efficacy study for one of the leading vaccine candidates that could be approved for use by 2028, the meeting aimed to discuss strategies and evidence needs that could accelerate vaccine introduction. The meeting, held in November 2024, was attended by Indonesian policymakers, researchers, health advocates and community representatives, alongside observers from immunization and TB programmes working at the global level, as well as donors. This report offers several key recommendations to ensure new TB vaccines for adults and adolescents are available, accessible and acceptable in Indonesia, as soon as possible after regulatory approval.

The vaccine implementation strategy is expected to be through a stratified, geographical approach, initiating in provinces with the highest disease and socio-economic burden. As such, improved data on disease, infection prevalence and acceptability within different age cohorts and populations are needed to inform national and sub-national (e.g., province or district level) health and economic impact modelling. Early studies on knowledge, attitudes and practices of new TB vaccines for adults and adolescents will help to engage community leaders and advocates and ensure effective, culturally acceptable communication to improve acceptability. Of greatest urgency, a national strategic plan for new TB vaccine introduction, including a roadmap of critical activities, responsible entities and a stakeholder engagement plan are needed.