Evidence mapPaperPMID 42453283Full record

ArticleBMJ public health2026

'Prevention is better than cure': a mixed methods study of communities' and healthcare workers' perspectives on new adult and adolescent TB vaccines and their implementation in Zambia.

Andrew D Kerkhoff, Jake M Pry, Mwiza Haambokoma, Noelle Le Tourneau, Sandra S Simbeza, Bertha Shamoya, Nelly Zulu, Herbert Nyirenda, Evelyn Kunda-Ng'andu, Kombatende Sikombe and 3 more

Abstract read
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Article in BMJ public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

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No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Andrew D KerkhoffDivision of HIV, Infectious Diseases and Global Medicine, San Francisco General Hospital and Trauma Center, University of California San Francisco, San Francisco, California, USA.ORCID https://orcid.org/0000-0002-5023-6658
Jake M PryDivision of Epidemiology, School of Medicine, University of California, Davis, Davis, California, USA.ORCID https://orcid.org/0000-0001-6312-4420
Mwiza HaambokomaCentre for Infectious Disease Research in Zambia, Lusaka, Zambia.
Noelle Le TourneauDivision of Infectious Diseases, School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA.
Sandra S SimbezaCentre for Infectious Disease Research in Zambia, Lusaka, Zambia.
Bertha ShamoyaCentre for Infectious Disease Research in Zambia, Lusaka, Zambia.
Nelly ZuluCentre for Infectious Disease Research in Zambia, Lusaka, Zambia.
Herbert NyirendaCentre for Infectious Disease Research in Zambia, Lusaka, Zambia.
Evelyn Kunda-Ng'anduCentre for Infectious Disease Research in Zambia, Lusaka, Zambia.ORCID https://orcid.org/0000-0003-1178-2362
Kombatende SikombeCentre for Infectious Disease Research in Zambia, Lusaka, Zambia.ORCID https://orcid.org/0000-0002-8187-8661
Elvin H GengDivision of Infectious Diseases, School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA.
Rupali J LimayeCollege of Public Health, Department of Global and Community Health, George Mason University, Fairfax, Virginia, USA.
Anjali SharmaCentre for Infectious Disease Research in Zambia, Lusaka, Zambia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: New tuberculosis (TB) vaccines for adults and adolescents are crucial for achieving global control targets, and several candidates may be ready for introduction within 5 years. We conducted a convergent mixed-methods study in Lusaka, Zambia, among community members and healthcare workers (HCWs) to understand preliminary TB vaccine acceptance and potential factors influencing uptake to inform readiness activities critical for successful implementation. Methods: Adult community members were enrolled from randomly selected households within four communities with historically low COVID-19 vaccine coverage, and HCWs from 10 public healthcare facilities representing different care levels. Structured surveys evaluated participants' perspectives on new vaccines and mixed-effects Poisson regression was used to estimate the marginal probability of participants' intention to get a new TB vaccine. Qualitative in-depth interviews (IDIs; n=24) and focus group discussions (FGDs; n=9) were conducted and analysed using a hybrid approach to explore acceptable vaccine attributes, preferences and determinants of TB vaccine uptake and recommendations for rollout. Results: Overall, 499 participants completed surveys (395 community members and 104 HCWs) with 62 additional participants across IDIs and FGDs. 77% of community members and 83% of HCWs expressed intention to get a TB vaccine. Perceived TB risk and severity concerns were the only significant drivers of vaccine intention. Participants pragmatically accepted the WHO's preferred vaccine specifications (50% efficacy, two-dose schedule, transient, mild side effects, at least 2 years' duration) though HCWs preferred higher efficacy thresholds due to occupational risk. Implementation preferences emphasised early community engagement (at least 3-6 months pre-rollout), diverse delivery approaches, including facility-based and community venues for adults, schools for adolescents and door-to-door campaigns, while addressing COVID-19-related scepticism through transparent, clear communication using trusted sources. Conclusions: This study reveals strong potential for a successful TB vaccine rollout in Zambia through proactive implementation strategies, including early community engagement, transparent communication and person-centred delivery approaches.

Indexed as

Communicable Disease ControlCommunity HealthVaccination

Identifiers

PMID42453283
PMCPMC13365775

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.