Preparing Indonesia for New TB Vaccines

Tuberculosis (TB) remains a major health challenge, and new adult TB vaccines are already in clinical trials and may be licensed as soon as 2028. Recognising that licensing is only the first step, a team led by Ahmad Fuady set out to understand what it would take to actually introduce a new TB vaccine in Indonesia. The researchers convened a stakeholder consultation in Jakarta (13/03/2025) with 28 participants from diverse backgrounds and followed up with interviews with two of those participants. Participants completed a structured questionnaire via Slido®, which had been adapted into Bahasa, and answered both closed- and open-ended questions about who should get the vaccine, how it should be delivered, what regulatory steps would be needed, and what lessons could be learned from past vaccine programmes. The goal was practical: to gather on-the-ground perspectives from people who would be involved in making vaccine rollout work, from clinicians and public health officials to programme managers and other experts. By focusing on local views, the study aimed to highlight real-world barriers and enablers that go beyond clinical trial results.

The study used a mixed-methods approach combining a single stakeholder consultation and follow-up interviews. Participants completed the structured Slido® questionnaire with closed- and open-ended questions; quantitative data were analysed descriptively, and qualitative responses underwent thematic analysis. Results showed unanimous agreement on the importance of introducing a new TB vaccine, but participants raised important conditions and concerns. Many said a minimum efficacy of 50% would be needed and stressed the need to compare vaccine impact with other interventions, such as TB preventive treatment. Most participants agreed that introduction should not hinge on local manufacturing capacity, the route of administration, or the number of doses. Key enablers identified were adequate funding, strong political commitment, and demand generation through public acceptance. Priority target groups listed included people living with HIV/AIDS, individuals with diabetes, household contacts of TB patients, adolescents, and healthcare workers. Major challenges highlighted were vaccine hesitancy, halal issues, misinformation, and limited healthcare worker knowledge. Opinions diverged on whether rollout was feasible without IGRA testing, and participants also pointed to regulatory and budgeting processes as additional barriers.

The findings make clear that introducing a new TB vaccine in Indonesia will be more complicated than simply having a licensed product. Stakeholders emphasised that concerns extend well beyond vaccine efficacy to include social, cultural, regulatory, and financial factors. For policymakers and programme planners, the study suggests that success will depend on coordinated strategies: defining and prioritising target populations, designing delivery approaches tailored to those groups, and investing in communication to build public trust and demand. Operational issues such as whether IGRA testing is needed, how to address halal certification questions, how to counter misinformation, and how to strengthen healthcare worker knowledge will also need clear plans. Financial and regulatory pathways must be smoothed so that budgeting and approvals do not become bottlenecks. In short, the path from a licensed vaccine to population protection will require political will, money, smart planning, and community engagement to translate scientific progress into real reductions in TB disease.