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While efficacy has been strong against severe TB in children and against pulmonary TB in low-endemicity regions, there is low protection against pulmonary TB in TB endemic countries

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medical emergency requiring bone marrow transplant Common variable immunodeficiency (CVID) — low B cells and immunoglobulins with variable T-cell involvement Other causes: Severe malnutrition and protein-calorie deficiency — lymphocytes require protein for synthesis Bone marrow failure (aplastic anemia, MDS) — global cytopenias including lymphocytes Severe critical illness and sepsis — lymphocyte apoptosis from inflammatory mediators Normal Lymphocyte Levels When to See Your Care Team Book a 1:1 consultation with a licensed care team lead for any lymphocyte count below 1,000/µL that persists on repeat testing after ruling out recent viral illness or corticosteroid use