Fig. 1: TB health outcomes, resource use and costs for the baseline and 4 vaccination strategies.

Mass&Routine18–50—mass campaign for people aged 18–50 and routine vaccination for 18-year olds; 2xMass18–50—two mass campaigns for people aged 18–50; Mass&RoutineAdultsHIV+—mass campaign for all adults living with HIV and routine vaccination of 18-year olds living with HIV; 2xMassAdultsHIV+—two mass campaigns for all adults living with HIV. Lines represent median annual values. Number of total TB notifications from 2025 to 2050 estimated by transmission model. Number of people tested was calculated using an estimated Test-to-Diagnosis (TDR) ratio for South Africa in 2025. A TDR value of 12.8 was used based on Xpert test (primary diagnostic tool used in South Africa) results data from the South Africa National Health Laboratory Services. This value was adjusted for subsequent years by the prevalence of active tuberculosis. A vaccine course was assumed to comprise two vaccine doses. Number of vaccinators estimated assuming that the vaccinations will be delivered throughout the year and 5 minutes of vaccinator time per dose.