BCG Vaccination Program mitigates COVID19 Related Mortality: A Reality check

2021 ◽  
Vol 22 ◽  
Author(s):  
Archana Pandita ◽  
Audesh Bhat ◽  
Anita Koul ◽  
Shashank K Singh
Keyword(s):  
Potential Role ◽  
Respiratory Infections ◽  
Cross Protection ◽  
Childhood Vaccination ◽  
Vaccination Program ◽  
Vaccination Policy ◽  
Bcg Vaccination ◽  
Reality Check ◽  
The World ◽  
Related Mortality

: Since its origin in the Wuhan province of China in December 2019, Coronavirus disease 19 (COVID-19) has spread to most parts of the world and has infected millions of people. However, the significant variability in the mortality rate across the world indicates some underlying factors, especially the immunity factors that may have a potential role in this variability. One such factor that is being discussed and tested is the Bacillus Calmette-Guerin (BCG) vaccine. The available evidence suggests that BCG vaccination provides broad protection against respiratory infections as well as other infections. Therefore, BCG may prove to be a barrier for COVID-19 infection and may offer a ray of hope. In this review, we contrasted BCG vaccination program with COVID-19 mortality and analyzed trained immunity and cross protection against unrelated pathogens due to BCG vaccination. On analyzing the available data, we observed that countries without universal BCG vaccination policy are severely affected, while countries having universal BCG policies are less affected. Based on these data, we propose that the SARS-CoV-2 related qualified immunity, cross protection against unrelated pathogens and COVID-19 impact variations could be partly explained by the different national policies regarding BCG childhood vaccination. The combination of reduced morbidity and mortality may make BCG vaccination a potential new tool in the fight against COVID-19.

scholarly journals Correlation between universal BCG vaccination policy and reduced morbidity and mortality for COVID-19: an epidemiological study

2020 ◽  
Author(s):  
Aaron Miller ◽  
Mac Josh Reandelar ◽  
Kimberly Fasciglione ◽  
Violeta Roumenova ◽  
Yan Li ◽  
...  
Keyword(s):  
Elderly Population ◽  
Respiratory Infections ◽  
Morbidity And Mortality ◽  
Childhood Vaccination ◽  
Cultural Norms ◽  
Vaccination Policy ◽  
Bcg Vaccination ◽  
National Differences ◽  
Late Start ◽  
The Impact

AbstractCOVID-19 has spread to most countries in the world. Puzzlingly, the impact of the disease is different in different countries. These differences are attributed to differences in cultural norms, mitigation efforts, and health infrastructure. Here we propose that national differences in COVID- 19 impact could be partially explained by the different national policies respect to Bacillus Calmette-Guérin (BCG) childhood vaccination. BCG vaccination has been reported to offer broad protection to respiratory infections. We compared large number of countries BCG vaccination policies with the morbidity and mortality for COVID-19. We found that countries without universal policies of BCG vaccination (Italy, Nederland, USA) have been more severely affected compared to countries with universal and long-standing BCG policies. Countries that have a late start of universal BCG policy (Iran, 1984) had high mortality, consistent with the idea that BCG protects the vaccinated elderly population. We also found that BCG vaccination also reduced the number of reported COVID-19 cases in a country. The combination of reduced morbidity and mortality makes BCG vaccination a potential new tool in the fight against COVID-19.

Explore the Possible Impact of BCG Vaccination Policy on the Morbidity, Mortality, and Recovery Rates due to COVID-19 Infection. (Preprint)

2020 ◽  
Author(s):  
Yue-Cune Chang
Keyword(s):  
Odds Ratio ◽  
Randomized Clinical Trials ◽  
Vaccination Policy ◽  
Bacille Calmette Guerin ◽  
Recovery Rates ◽  
Bcg Vaccination ◽  
The World ◽  
New Form ◽  
The Relationship ◽  
Disease Specific

BACKGROUND The Coronavirus Disease-19 (COVID-19) is the new form of an acute infectious respiratory disease and has quickly spread over most continents in the world. Recently, it has been shown that Bacille Calmette-Guerin (BCG) might protect against COVID-19. This study aims to investigate the possible correlation between BCG vaccination and morbidity/mortality/recovery rate associated with COVID-19 infection. OBJECTIVE Our findings confirm that the BCG vaccination might protect against COVID-19 virus infection. METHODS Data of COVID-19 confirmed cases, deaths, recoveries, and population were obtained from https://www.worldometers.info/coronavirus/ (Accessed on 12 June, 2020). To have meaningful comparisons among countries’ mortality and recovery rates, we only choose those countries with COVID-19 infected cases at least 200. The Poisson regression and logistic regression were used to explore the relationship between BCG vaccination and morbidity, mortality and recovery rates. RESULTS Among those 158 countries with at least 200 COVID-19 infected cases, there were 141 countries with BCG vaccination information available. The adjusted rates ratio of COVID-19 confirmed cases for Current BCG vaccination vs. non-Current BCG vaccination was 0.339 (with 95% CI= (0.338,0.340)). Moreover, the adjusted odds ratio (OR) of death and recovery after coronavirus infected for Current BCG vaccination vs. non-Current BCG vaccination were 0.258 (with 95% CI= (0.254,0.261)) and 2.151 (with 95% CI= (2.140,2.163)), respectively. CONCLUSIONS That data in this study show the BCG might provide the protection against COVID-19, with consequent less COVID-19 infection and deaths and more rapid recovery. BCG vaccine might bridge the gap before the disease-specific vaccine is developed, but this hypothesis needs to be further tested in rigorous randomized clinical trials. INTERNATIONAL REGISTERED REPORT RR2-https://doi.org/10.1101/2020.06.14.20131268

scholarly journals BCG vaccine protection from severe coronavirus disease 2019 (COVID-19)

2020 ◽  
Vol 117 (30) ◽  
pp. 17720-17726 ◽  
Author(s):  
Luis E. Escobar ◽  
Alvaro Molina-Cruz ◽  
Carolina Barillas-Mury
Keyword(s):  
Control Strategies ◽  
Cross Protection ◽  
Time Of Arrival ◽  
Vaccination Policy ◽  
Coarse Scale ◽  
Vaccine Protection ◽  
Epidemiological Analysis ◽  
Bcg Vaccination ◽  
Epidemic Development ◽  
National Control

A series of epidemiological explorations has suggested a negative association between national bacillus Calmette–Guérin (BCG) vaccination policy and the prevalence and mortality of coronavirus disease 2019 (COVID-19). However, these comparisons are difficult to validate due to broad differences between countries such as socioeconomic status, demographic structure, rural vs. urban settings, time of arrival of the pandemic, number of diagnostic tests and criteria for testing, and national control strategies to limit the spread of COVID-19. We review evidence for a potential biological basis of BCG cross-protection from severe COVID-19, and refine the epidemiological analysis to mitigate effects of potentially confounding factors (e.g., stage of the COVID-19 epidemic, development, rurality, population density, and age structure). A strong correlation between the BCG index, an estimation of the degree of universal BCG vaccination deployment in a country, and COVID-19 mortality in different socially similar European countries was observed (r2= 0.88;P= 8 × 10−7), indicating that every 10% increase in the BCG index was associated with a 10.4% reduction in COVID-19 mortality. Results fail to confirm the null hypothesis of no association between BCG vaccination and COVID-19 mortality, and suggest that BCG could have a protective effect. Nevertheless, the analyses are restricted to coarse-scale signals and should be considered with caution. BCG vaccination clinical trials are required to corroborate the patterns detected here, and to establish causality between BCG vaccination and protection from severe COVID-19. Public health implications of a plausible BCG cross-protection from severe COVID-19 are discussed.

scholarly journals Explore the Possible Impact of BCG Vaccination Policy on the Morbidity, Mortality, and Recovery Rates due to COVID-19 Infection

2020 ◽  
Author(s):  
Chuan-Hsin Chang ◽  
Yue-Cune Chang
Keyword(s):  
Odds Ratio ◽  
Randomized Clinical Trials ◽  
Vaccination Policy ◽  
Bacille Calmette Guerin ◽  
Recovery Rates ◽  
Bcg Vaccination ◽  
The World ◽  
New Form ◽  
The Relationship ◽  
Disease Specific

ABSTRACTBACKGROUNDThe Coronavirus Disease-19 (COVID-19) is the new form of an acute infectious respiratory disease and has quickly spread over most continents in the world. Recently, it has been shown that Bacille Calmette-Guerin (BCG) might protect against COVID-19. This study aims to investigate the possible correlation between BCG vaccination and morbidity/mortality/recovery rate associated with COVID-19 infection.METHODSData of COVID-19 confirmed cases, deaths, recoveries, and population were obtained from https://www.worldometers.info/coronavirus/ (Accessed on 12 June, 2020). To have meaningful comparisons among countries’ mortality and recovery rates, we only choose those countries with COVID-19 infected cases at least 200. The Poisson regression and logistic regression were used to explore the relationship between BCG vaccination and morbidity, mortality and recovery rates.RESULTSAmong those 158 countries with at least 200 COVID-19 infected cases, there were 141 countries with BCG vaccination information available. The adjusted rates ratio of COVID-19 confirmed cases for Current BCG vaccination vs. non-Current BCG vaccination was 0.339 (with 95% CI= (0.338,0.340)). Moreover, the adjusted odds ratio (OR) of death and recovery after coronavirus infected for Current BCG vaccination vs. non-Current BCG vaccination were 0.258 (with 95% CI= (0.254,0.261)) and 2.151 (with 95% CI= (2.140,2.163)), respectively.CONCLUSIONSThat data in this study show the BCG might provide the protection against COVID-19, with consequent less COVID-19 infection and deaths and more rapid recovery. BCG vaccine might bridge the gap before the disease-specific vaccine is developed, but this hypothesis needs to be further tested in rigorous randomized clinical trials.

scholarly journals Bacille Calmette-Guérin Vaccination in Infancy Does Not Protect Against Coronavirus Disease 2019 (COVID-19): Evidence From a Natural Experiment in Sweden

2020 ◽  
Author(s):  
Clément de Chaisemartin ◽  
Luc de Chaisemartin
Keyword(s):  
Protective Effect ◽  
Natural Experiment ◽  
Respiratory Infections ◽  
Controlled Trial ◽  
Large Population ◽  
Childhood Vaccination ◽  
Birth Cohorts ◽  
Bacille Calmette Guerin ◽  
Bcg Vaccination ◽  
Cross Country

Abstract Background The bacille Calmette-Guérin (BCG) tuberculosis vaccine has immunity benefits against respiratory infections. Accordingly, it has been hypothesized to have a protective effect against coronavirus disease 2019 (COVID-19). Recent research found that countries with universal BCG childhood vaccination policies tend to be less affected by the COVID-19 pandemic. However, such ecological studies are biased by numerous confounders. Instead, this paper reports on a rare nationwide natural experiment that occurred in Sweden in 1975, where discontinuation of newborns’ BCG vaccination led to a dramatic decrease in BCG coverage rate, thus allowing us to estimate BCG’s effect without the biases associated with cross-country comparisons. Methods Numbers of COVID-19 cases and hospitalizations were recorded for birth cohorts born just before and just after 1975, representing 1 026 304 and 1 018 544 individuals, respectively. We used regression discontinuity to assess the effect of BCG vaccination on COVID-19–related outcomes. On such a large population, this method allows for a precision that would be hard to achieve using a randomized controlled trial. Results The odds ratios (95% CI) for COVID-19 cases and COVID-19–related hospitalizations were 1.0005 (.8130–1.1881) and 1.2046 (.7532–1.6560), allowing us to reject fairly modest effects of universal BCG vaccination. We can reject with 95% confidence that universal BCG vaccination reduces the number of cases by 19% and the number of hospitalizations by 25%. Conclusions While the effect of a recent vaccination must be evaluated, we provide strong evidence that receiving the BCG vaccine at birth does not have a protective effect against COVID-19 among middle-aged individuals.

Explore the Possible Impact of BCG Vaccination Policy on the Morbidity, Mortality, and Recovery Rates due to COVID-19 Infection. (Preprint)

2020 ◽  
Author(s):  
Chuan-Hsin Chang ◽  
Yue-Cune Chang
Keyword(s):  
Odds Ratio ◽  
Randomized Clinical Trials ◽  
Vaccination Policy ◽  
Bacille Calmette Guerin ◽  
Recovery Rates ◽  
Bcg Vaccination ◽  
The World ◽  
New Form ◽  
The Relationship ◽  
Disease Specific

UNSTRUCTURED BACKGROUND The Coronavirus Disease-19 (COVID-19) is the new form of an acute infectious respiratory disease and has quickly spread over most continents in the world. Recently, it has been shown that Bacille Calmette-Guerin (BCG) might protect against COVID-19. This study aims to investigate the possible correlation between BCG vaccination and morbidity/mortality/recovery rate associated with COVID-19 infection. METHODS Data of COVID-19 confirmed cases, deaths, recoveries, and population were obtained from https://www.worldometers.info/coronavirus/ (Accessed on 12 June, 2020). To have meaningful comparisons among countries mortality and recovery rates, we only choose those countries with COVID-19 infected cases at least 200. The Poisson regression and logistic regression were used to explore the relationship between BCG vaccination and morbidity, mortality and recovery rates. RESULTS Among those 158 countries with at least 200 COVID-19 infected cases, there were 141 countries with BCG vaccination information available. The adjusted rates ratio of COVID-19 confirmed cases for Current BCG vaccination vs. non-Current BCG vaccination was 0.339 (with 95% CI= (0.338,0.340)). Moreover, the adjusted odds ratio (OR) of death and recovery after coronavirus infected for Current BCG vaccination vs. non-Current BCG vaccination were 0.258 (with 95% CI= (0.254,0.261)) and 2.151 (with 95% CI= (2.140,2.163)), respectively. CONCLUSIONS That data in this study show the BCG might provide the protection against COVID-19, with consequent less COVID-19 infection and deaths and more rapid recovery. BCG vaccine might bridge the gap before the disease-specific vaccine is developed, but this hypothesis needs to be further tested in rigorous randomized clinical trials. INTERNATIONAL REGISTERED REPORT RR2-https://doi.org/10.1101/2020.06.14.20131268

scholarly journals Impact of Environmental Contamination on Immunity: Implications for Childhood Vaccination Policy

2011 ◽  
Vol 1 (1) ◽  
pp. 5-7
Author(s):  
Bruce D. Forrest
Keyword(s):  
Environmental Contamination ◽  
Childhood Vaccination ◽  
Immune Functions ◽  
Vaccination Policy ◽  
Industrial Growth ◽  
Barriers To Access ◽  
The World ◽  
Vaccines For Children ◽  
Community Access ◽  
New Vaccines

As the barriers to access to routine vaccines for children in the poorest countries in the world are eroded by the contributions of a range of donors, these successes expose other factors that can impact the value of these interventions. This is especially so in those communities that are concurrently experiencing rapid industrial growth. Such growth is frequently associated with escalating environmental contamination that even the lowest levels is known to significantly impair fundamental immune functions. Maximizing the value of this new access to vaccines also must address the effects of existing and future environmental contamination. However, there remains a gap between science, public health policy and community access in understanding how this might impact a community and how best to deliver on creating an environment that optimizes the value of this improved access to new vaccines for children.

scholarly journals BCG vaccination in infancy does not protect against COVID-19. Evidence from a natural experiment in Sweden

2020 ◽  
Author(s):  
Clément de Chaisemartin ◽  
Luc de Chaisemartin
Keyword(s):  
Protective Effect ◽  
Natural Experiment ◽  
Respiratory Infections ◽  
Controlled Trial ◽  
Large Population ◽  
Childhood Vaccination ◽  
Birth Cohorts ◽  
Bcg Vaccination ◽  
Cross Country ◽  
Dramatic Fall

AbstractBackgroundThe Bacille Calmette-Guérin (BCG) tuberculosis vaccine has immunity benefits against respiratory infections. Accordingly, it has been hypothesized that it may have a protective effect against COVID-19. Recent research found that countries with universal Bacillus Calmette-Guérin (BCG) childhood vaccination policies tend to be less affected by the COVID-19 pandemic. However, such ecological studies are biased by numerous confounders. Instead, this paper takes advantage of a rare nationwide natural experiment that took place in Sweden in 1975, where discontinuation of newborns BCG vaccination led to a dramatic fall of the BCG coverage rate from 92% to 2%, thus allowing us to estimate the BCG’s effect without all the biases associated with cross-country comparisons.MethodsNumbers of COVID-19 cases and hospitalizations were recorded for birth cohorts born just before and just after that change, representing 1,026,304 and 1,018,544 individuals, respectively. We used regression discontinuity to assess the effect of BCG vaccination on Covid-19 related outcomes. This method used on such a large population allows for a high precision that would be hard to achieve using a classical randomized controlled trial.ResultsThe odds ratio for Covid-19 cases and Covid-19 related hospitalizations were 0·9997 (CI95: [0·8002-1·1992]) and 1·1931 (CI95: [0·7558-1·6304]), respectively. We can thus reject with 95% confidence that universal BCG vaccination reduces the number of cases by more than 20% and the number of hospitalizations by more than 24%ConclusionsWhile the effect of a recent vaccination must be evaluated, we provide strong evidence that receiving the BCG vaccine at birth does not have a protective effect against COVID-19.

scholarly journals COVID-19 Related Mortality: Is the BCG Vaccine Truly Effective?

2020 ◽  
Author(s):  
Jan A. Paredes ◽  
Valeria Garduño ◽  
Julian Torres
Keyword(s):  
Bcg Vaccine ◽  
Vaccination Policy ◽  
Demographic Differences ◽  
Bacille Calmette Guerin ◽  
Bcg Vaccination ◽  
Prophylactic Measures ◽  
Significant Difference ◽  
Gathering Data ◽  
A Current ◽  
Related Mortality

AbstractThe coronavirus disease 2019 (COVID-19) pandemic has become a worldwide emergency. In the attempt to search for interventions that would improve outcomes, some studies have looked at the potential benefit of BCG vaccination. These past studies have found a statistically significant reduction in COVID-19 related mortality in countries with a current universal bacille Calmette-Guérin (BCG) vaccination policy. However, just as the authors themselves noted, the nature of ecological studies make them very prone to the presence of several confounders. This paper took into account demographic differences, economic differences and the different stages of the pandemic in each country; gathering data from publicly available sources. It was found that no statistically significant difference exists in mortality rates between countries with a current or prior BCG vaccination policy when compared to those that never had such a program. Nevertheless, the immunostimulatory potential of the BCG vaccine might still prove useful in the development of future vaccines or other prophylactic measures.

THE 2019 NOVEL PANDEMIC OF CORONAVIRUS DISEASE (COVID-19): A STUDY OF EXISTING EVIDENCE IN THE INDIAN POPULATION

2020 ◽  
Vol 7 (2) ◽  
pp. 199-204
Author(s):  
Shrikant Verma ◽  
Mohammad Abbas ◽  
Sushma Verma ◽  
Syed Tasleem Raza ◽  
Farzana Mahdi
Keyword(s):  
Disease Transmission ◽  
Indian Population ◽  
Respiratory Infections ◽  
Clinical Signs ◽  
Case Fatality ◽  
Public Health Emergency ◽  
The World ◽  
And Control ◽  
General Wellbeing ◽  
Different Parts

A novel spillover coronavirus (nCoV), with its epicenter in Wuhan, China's People's Republic, has emerged as an international public health emergency. This began as an outbreak in December 2019, and till November eighth, 2020, there have been 8.5 million affirmed instances of novel Covid disease2019 (COVID-19) in India, with 1,26,611 deaths, resulting in an overall case fatality rate of 1.48 percent. Coronavirus clinical signs are fundamentally the same as those of other respiratory infections. In different parts of the world, the quantity of research center affirmed cases and related passings are rising consistently. The COVID- 19 is an arising pandemic-responsible viral infection. Coronavirus has influenced huge parts of the total populace, which has prompted a global general wellbeing crisis, setting all health associations on high attentive. This review sums up the overall landmass, virology, pathogenesis, the study of disease transmission, clinical introduction, determination, treatment, and control of COVID-19 with the reference to India.

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