Tuberculosis Vaccines in Indonesia: Importance and Future Directions

Abstract

Background: Tuberculosis (TB) remains a major public health burden globally and in Indonesia, despite the availability of established control strategies such as case detection,treatment, TB preventive therapy, and Bacillus Calmette-Guerin (BCG) vaccination. Indonesia continues to carry one of the highest TB burdens worldwide, and ongoing transmission highlights the need for stronger preventive approaches, particularly vaccines.

Methods: A narrative review was conducted using literature retrieved from PubMed, Scopus, and Google Scholar. Search terms included "Tuberculosis, “Novel Tuberculosis Vaccine," "BCG Limitations," and “Vaccine Implementation.”

Results: Current strategies remain essential but have important limitations. Diagnosis and treatment are often initiated only after disease has developed, treatment duration can affect adherence, and BCG provides limited and variable protection against pulmonary TB in adolescents and adults, the groups most responsible for transmission. In this context, new TB Vaccines may become an important complement to existing TB control efforts. For Indonesia, an ideal TB vaccine should provide durable protection against pulmonary TB in adolescents and adults, have an acceptable safety profile for broad and high-risk populations, require a feasible dosing schedule, and be suitable for integration into existing health system platforms. Successful vaccine introduction will require careful target population selection, health system readiness, public acceptance, sustainable financing, and strong policy support.

Conclusion: Strengthening preparedness for future TB vaccine implementation may help Indonesia accelerate progress toward national and global TB elimination targets.