COVID-19 Death and BCG Vaccination Programs Worldwide = COVID-19 Death and BCG Vaccination Programs Worldwide

다국어 초록 (Multilingual Abstract)

Several clinical trials are being conducted worldwide to investigate the protective effect of the bacillus Calmette-Guerin (BCG) vaccine against death in healthcare providers who are working directly with coronavirus disease 2019 (COVID-19) patients. Clinical studies suggested that certain live vaccines, particularly the BCG vaccine, could reduce the mortality due to other diseases caused by non-targeted pathogens, most probably through the nonspecific effects (heterologous effects). By the end of May 2020, the available information on the COVID-19 pandemic indicated the great effect of the BCG vaccine in reducing the number of COVID-19 death cases. The occurrence of death due to COVID-19 was found to be 21-fold lower in countries with a national BCG vaccination policy than in countries without such a policy, based on the medians of COVID-19 death case per 1 million of the population in these two groups of countries (p<0.001, Mann- Whitney test). Therefore, it can be concluded that the early establishment of a BCG vaccination policy in any country is a key element in reducing the number of COVID-19 and tuberculosis death cases.

참고문헌 (Reference)

1 "WHO vaccine-preventable diseases: monitoring system. 2019 global summary" World Health Organization

2 "WHO timeline - COVID-19" World Health Organization

3 Fine PE, "Variation in protection by BCG : implications of and for heterologous immunity" 346 : 1339-1345, 1995

4 Rieckmann A, "Vaccinations against smallpox and tuberculosis are associated with better long-term survival : a Danish casecohort study 1971-2010" 46 : 695-705, 2017

5 British Lung Foundation, "Tuberculosis" British Lung Foundation

6 Tanner R, "The humoral immune response to BCG vaccination" 10 : 1317-, 2019

7 Abubakar I, "Systematic review and meta-analysis of the current evidence on the duration of protection by bacillus CalmetteGuerin vaccination against tuberculosis" 17 : 1-372, 2013

8 Ricco M, "Stop playing with data : there is no sound evidence that Bacille CalmetteGuerin may avoid SARS-CoV-2 infection(for now)" 91 : 207-213, 2020

9 The SAGE Working Group on BCG Vaccines and WHO Secretariat, "Report on BCG vaccine use for protection against mycobacterial infections including tuberculosis, leprosy, and other nontuberculous mycobacteria (NTM) infections" World Health Organization

10 "People with certain medical conditions" Centers for Disease Control and Prevention

11 Mangtani P, "Observational study to estimate the changes in the effectiveness of bacillus Calmette-Guerin(BCG)vaccination with time since vaccination for preventing tuberculosis in the UK" 21 : 1-54, 2017

12 de Castro MJ, "Nonspecific(heterologous)protection of neonatal BCG vaccination against hospitalization due to respiratory infection and sepsis" 60 : 1611-1619, 2015

13 Spencer JC, "Nonspecific protection of mice against influenza virus infection by local or systemic immunization with Bacille Calmette-Guerin" 136 : 171-175, 1977

14 Aronson NE, "Long-term efficacy of BCG vaccine in American Indians and Alaska Natives : a 60-year follow-up study" 291 : 2086-2091, 2004

15 Gruber C, "Is early BCG vaccination associated with less atopic disease? An epidemiological study in German preschool children with different ethnic backgrounds" 13 : 177-181, 2002

16 Bosteels C, "Inflammatory type 2 cDCs acquire features of cDC1s and macrophages to orchestrate immunity to respiratory virus infection" 52 : 1039-1056, 2020

17 Zhao X, "Incidence, clinical characteristics and prognostic factor of patients with COVID-19: a systematic review and meta-analysis" 2020

18 Venkataswamy MM, "In vitro culture medium influences the vaccine efficacy of Mycobacterium bovis BCG" 30 : 1038-1049, 2012

19 Prompetchara E, "Immune responses in COVID-19 and potential vaccines: Lessons learned from SARS and MERS epidemic" 38 : 1-9, 2020

20 Luca S, "History of BCG vaccine" 8 : 53-58, 2013

21 "Global tuberculosis report 2019 (WHO/CDS/TB/2019.15)" World Health Organization

22 Colditz GA, "Efficacy of BCG vaccine in the prevention of tuberculosis: meta-analysis of the published literature" 271 : 698-702, 1994

23 Rahman M, "Economic evaluation of universal BCG vaccination of Japanese infants" 30 : 380-385, 2001

24 Sterne JA, "Does the efficacy of BCG decline with time since vaccination?" 2 : 200-207, 1998

25 Kumar J, "Demystifying BCG vaccine and COVID-19relationship" 57 : 588-589, 2020

26 Miller A, "Correlation between universal BCG vaccination policy and reduced mortality for COVID-19" 2020

27 Li H, "Coronavirus disease 2019(COVID-19) : current status and future perspectives" 55 : 105951-, 2020

28 World Health Organization, "Coronavirus disease (COVID-19): situation report - 130" World Health Organization

29 "ClinicalTrials.gov" U.S National Library of Medicine

30 "Clinical management of COVID-19" World Health Organization

31 Huang C, "Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China" 395 : 497-506, 2020

32 Onder G, "Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy" 323 : 1775-1776, 2020

33 Covian C, "BCG-induced cross-protection and development of trained immunity : implication for vaccine design" 10 : 2806-, 2019

34 Escobar LE, "BCG vaccine protection from severe coronavirus disease 2019(COVID-19)" 117 : 17720-17726, 2020

35 Arts RJ, "BCG vaccination protects against experimental viral infection in humans through the induction of cytokines associated with trained immunity" 23 : 89-100, 2018

36 Sharma A, "BCG vaccination policy and preventive chloroquine usage: do they have an impact on COVID-19 pandemic?" 11 : 516-, 2020

37 Hegarty PK, "BCG vaccination may be protective against Covid-19" 2020

38 Leentjens J, "BCG vaccination enhances the immunogenicity of subsequent influenza vaccination in healthy volunteers: a randomized, placebo-controlled pilot study" 212 : 1930-1938, 2015

39 Briassoulis G, "BCG vaccination at three different age groups : response and effectiveness" 3 : 1-, 2005

40 Sharma AR, "BCG as a game-changer to prevent the infection and severity of COVID-19 pandemic?" 48 : 507-517, 2020

41 Wang C, "A novel coronavirus outbreak of global health concern" 395 : 470-473, 2020

42 Lahariya C, "A brief history of vaccines and vaccination in India" 139 : 491-511, 2014