Key stakeholders’ perspectives on introducing a new TB vaccine for adolescents and adults in Mozambique: a qualitative study

Tuberculosis (TB) remains a major global health challenge, particularly in low- and middle-income countries such as Mozambique. To address this burden, promising new TB vaccines targeting adolescents and adults are currently in phase III efficacy trials. This study aimed to assess stakeholders’ perspectives on priority high-risk groups, the challenges in reaching them, and potential strategies for delivering a new TB vaccine. We conducted an interpretative qualitative study, using semi-structured interviews with 22 TB and EPI experts, particularly members of the National TB Program, the National Immunization Program, and the National Immunization Technical Advisory Group. Data were collected between March and July 2024. The analysis combined quantitative summaries of respondents’ views, including expected vaccination coverage in key population groups, with qualitative analysis incorporating illustrative participant quotes. Stakeholders most frequently identified PLHIV and healthcare workers as priority groups, while TB contacts, people with other comorbidities, miners, and incarcerated populations were also considered important. Although uptake is expected to vary across groups, higher coverage was anticipated among healthcare workers, incarcerated individuals, formal miners, and in-school adolescents; moderate coverage among people living with HIV, TB contacts, and older adults; and lower coverage among informal miners and people with other comorbidities such as hypertension and hepatitis B. To improve uptake, particularly among groups expected to have lower coverage, campaign-based strategies using mobile brigades were considered promising approaches to expand coverage. Stakeholder perspectives highlight the importance of prioritizing high-risk groups and adopting context-specific delivery strategies to support the effective introduction of a new TB vaccine in Mozambique. Not applicable.