The TBVaxRepository: A living database of projects supporting the preparedness for adult and adolescent TB vaccine rollout

BackgroundTuberculosis (TB) continues to cause substantial morbidity and mortality, with adults and adolescents carrying the largest burden of disease. Multiple promising novel vaccine candidates are in clinical trials, and their eventual impact will depend on effective implementation strategies. Information on TB vaccine preparedness efforts that could inform coordination remains fragmented. MethodsWe developed the first living and interactive online repository (https://tbvaxrepository.org/) collating completed, ongoing, and planned adult and adolescent TB vaccine preparedness initiatives. Data were obtained through a prior scoping review, direct stakeholder engagement, international conferences, and open calls via social media and partner networks between March 2023-November 2024. Projects were categorized using the World Health Organizations (WHO) framework for TB vaccine preparedness across three thematic areas: availability, accessibility, and acceptability. FindingsBy December 2024, the repository included 90 projects from 119 countries. Most projects focused on health- (47%) and economic modelling (21%), demand and acceptability studies (19%) or implementation feasibility (14%). Most of the projects were situated in India (n=36), South Africa (n=34), China (n=19), Indonesia, (n=17), Kenya (n=17), Brazil (n=14), and Pakistan (n=14). Few initiatives targeted key populations such as people living with HIV, pregnant or lactating individuals, or socially marginalized and occupational high-risk groups. Research on communication strategies for facilitating uptake as part of rollout were absent. ConclusionsThe repository reveals both progress and gaps in global TB vaccine preparedness across WHOs three thematic areas, with particular attention to geographic coverage, and the inclusion of key populations. As novel vaccines for adults and adolescents approach potential licensure, coordinated and inclusive preparedness efforts will be critical to ensure equitable and effective rollout. This repository offers a transparent platform to strengthen collaboration, reduce duplication, and guide strategic planning in a historically underfunded field.