A Leukapheresis Study for Immune Responses in Healthy US Adults Who Receive BCG Vaccination Followed by Boosting With AERAS-402 (C-021-402)

Inclusion Criteria:

1. Is male or female
2. Provided written informed consent prior to any study related procedures
3. Is age ≥18 years and ≤45 years on Study Day -84.
4. Has Body Mass Index (BMI) ≥19 and <33 by nomogram (see appendices)
5. Has general good health, confirmed by medical history and physical examination
6. Females physically capable of pregnancy (not sterilized and still menstruating or within 1 year of the last menses if menopausal) in sexual relationships with men must avoid pregnancy with an acceptable method of avoiding pregnancy from 28 days prior to Study Day -84 through the end of the study.
7. Females physically capable of pregnancy must have a negative serum pregnancy test within 7 days prior to Study Day -84 AND a negative urine pregnancy test on Study Day -84, Study Day 0, and Study Day 28.
8. Has committed to avoid elective surgery for the duration of the study
9. Has ability to complete all study visits as required per the protocol and is able to be contacted by telephone

Exclusion Criteria:

1. Acute illness, oral temperature ≥37.5°C, or axillary lymphadenopathy on Study Day -84, Study Day 0, or Study Day 28.

2. Any of the following laboratory results from blood and urine collected within 7 days prior to Study Day -84 (evaluated per local laboratory parameters):

   • Abnormal hemoglobin or hematocrit
   • Abnormal white blood cell count, absolute neutrophil count, or absolute lymphocyte count
   • Elevated creatinine, total bilirubin, AST, ALT, or alkaline phosphatase (ALP)
3. Evidence of chronic hepatitis (e.g., hepatitis B core antibody, or hepatitis C antibody, or other)
4. Laboratory test (e.g., QuantiFERON®-TB) evidence of Mycobacterium tuberculosis (Mtb) infection
5. History of residence in a tuberculosis-endemic country, per WHO 2008 "high-burden" definition
6. History of treatment for active or latent tuberculosis infection
7. History or evidence (including chest X-ray) of active tuberculosis
8. Shared a residence within the last year with an individual on anti-tuberculosis treatment or with culture or smear positive tuberculosis
9. History of allergic disease or reactions likely to be exacerbated by any component of the BCG or study vaccines
10. History of autoimmune disease or immunosuppression
11. Current household contact or occupational exposure to an individual with known significant immunosuppression
12. History or evidence on physical examination of any systemic disease, or acute or chronic illness that, in the opinion of the investigator, may interfere with the evaluation of the safety or immunogenicity of the vaccine, including axillary lymphadenopathy
13. History or laboratory evidence of any past, present or future possible immunodeficiency state which will include (but is not limited to) any laboratory indication of HIV infection
14. History of alcohol or drug abuse within the past 2 years
15. History of cheloid formation
16. Previous medical history that may compromise the safety of the subject in the study
17. Any current medical, psychiatric, occupational, or substance abuse problems which, in the opinion of the investigator, will make it unlikely the subject will comply with the protocol

18. Inability to discontinue daily medications during the study period except the following:

    • Contraceptives
    • Multivitamins
    • Inhaled or topical corticosteroids
19. Tobacco smoking of a pack or more of cigarettes a day, or cannabis smoking three or more days per week
20. Received immunosuppressive medication within 45 days prior to Study Day -84 (inhaled and topical corticosteroids are permitted)
21. Received investigational drugs or vaccine products within 182 days prior to Study Day -84 or planned participation in any other investigational study during the study period
22. Received investigational Mtb vaccine at any time prior to Study Day -84
23. Received vaccination or immunotherapy with a BCG product at any time prior to Study Day -84.
24. Received immunoglobulin or blood products within 45 days prior to Study Day -84.
25. Received any standard vaccine within 45 days prior to Study Day -84 except inactivated influenza vaccine which may have been received within 2 weeks prior to Study Day -84.
26. History of high risk sexual behaviors since 1977.