evidence: Now, there is only one rBCG vaccine in clinical trials, the VPM1002 vaccine. The clinical trial evaluations are in phases II and III for tuberculosis (ClinicalTrials.gov Identifier: NCT03152903, NCT04351685), in phases I and II for recurrent non-muscle invasive bladder cancer (ClinicalTrials.gov Identifier: NCT02371447), and in phase III for SARS-CoV-2 infectionFootnote 4 (ClinicalTrials.gov Identifier: NCT04439045, NCT04387409). The VPM1002 vaccine has not been evaluated as a vaccine candidate for leprosy. The VPM1002 is a genetically modified BCG that has the urease C encoding gene replaced by the listeriolysin O encoding gene from Listeria monocytogenes [115,116,117]. Urease C neutralises phagosomes that contribute to mycobacteria survival, whereas listeriolysin O forms transmembrane β-barrel pores in the phagolysosome membrane. Therefore, VPM1002 can effectively release mycobacterial antigens into the cytosol to trigger immunogenic responses. The VPM1002 system can potentially be used and further modified as a leprosy vaccine. Now that BCG is more widely recognised as a vaccine for leprosy, this offers promise for rBCGs such as VPM1002, rBCG/85A, rBCG-SM, rBCG::PGL-b, and rBCG::PGL-1 and the tuberculosis rBCGs as leprosy vaccine candidates in clinical studies.