The Spread of COVID-19 and the BCG Vaccine: A Natural Experiment in Reunified Germany

Bluhm, Richard; Pinkovskiy, Maxim L.

doi:10.2139/ssrn.3604314

Cited by 16 publications

(15 citation statements)

References 20 publications

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“…There are several limitations that need to be addressed in supporting our main findings and the conclusions from this study. The first difficulty stems from the fact that countries vary greatly by their area, population density and age structure that can mask the apparent BCG protective effect [ 44 ]. Moreover, difference in culture and habits (e.g., religious gathering, social distancing, smoking), economy, demography and the capacity of the health system often cannot be easily generalized.…”

Section: Discussionmentioning

confidence: 99%

Significantly Improved COVID-19 Outcomes in Countries with Higher BCG Vaccination Coverage: A Multivariable Analysis

et al. 2020

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The COVID-19 pandemic that started in China has spread within 3 months to the entire globe. We tested the hypothesis that the vaccination against tuberculosis by Bacille Calmette–Guérin vaccine (BCG) correlates with a better outcome for COVID-19 patients. Our analysis covers 55 countries complying with predetermined thresholds on the population size and number of deaths per million (DPM). We found a strong negative correlation between the years of BCG administration and the DPM along with the progress of the pandemic, corroborated by permutation tests. The results from multivariable regression tests with 23 economic, demographic, health-related, and pandemic restriction-related quantitative properties, substantiate the dominant contribution of BCG years to the COVID-19 outcomes. The analysis of countries according to an age-group partition reveals that the strongest correlation is attributed to the coverage in BCG vaccination of the young population (0–24 years). Furthermore, a strong correlation and statistical significance are associated with the degree of BCG coverage for the most recent 15 years, but no association was observed in these years for other broadly used vaccination protocols for measles and rubella. We propose that BCG immunization coverage, especially among the most recently vaccinated population, contribute to attenuation of the spread and severity of the COVID-19 pandemic.

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Section: Discussionmentioning

confidence: 99%

Significantly Improved COVID-19 Outcomes in Countries with Higher BCG Vaccination Coverage: A Multivariable Analysis

et al. 2020

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“…Two within-country studies from Israel and Germany failed to demonstrate the relevance of BCG vaccination to COVID-19 prevention; however, those studies do not contradict our study findings considering that universal immunization was discontinued in these countries in 1982 and 1990, respectively, and that the number of asymptomatic silent spreaders could not be evaluated. 24 , 25 …”

Section: Discussionmentioning

confidence: 99%

Impact of Routine Infant BCG Vaccination on COVID-19

Kinoshita

Tanaka

2020

Journal of Infection

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In Japan, the first case of coronavirus disease 2019 (COVID-19) was diagnosed on January 15, 2020 and subsequent infections rapidly increased. The Bacillus Calmette-Guérin (BCG) vaccination program is the principal element of tuberculosis control in Japan. We investigated the impact of routine infant BCG vaccination on prevention of local COVID-19 spread. Methods: Data on the prevalence of SARS-CoV-2 infection, annual routine infant BCG vaccine coverage (represented by the number of BCG vaccinations per live births), and other candidate factors in each prefecture were obtained from the official notifications database in Japan. We analysed the association of vaccine coverage with the prevalence of SARS-CoV-2 infection. Results: The BCG vaccine coverage in 1999-20 02, 20 04, and 2012 in five prefectures with no COVID-19 infections was significantly higher than that in five prefectures with a high prevalence of infections (Mann-Whitney U test, p < 0.05). The prevalence of SARS-CoV-2 infection was significantly negatively correlated with BCG vaccine coverage in 2004 and was significantly positively correlated with age groups 20-34 and 40-54 years (Spearman's rank correlation, p < 0.01). Conclusions: Our findings suggest that routine infant BCG vaccination coverage in young generation had a significant impact on prevention of local COVID-19 spread in Japan.

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“…There are several limitations that need to be addressed for fully supporting our main findings and the conclusions from this study. The first difficulty stems from the fact that countries vary greatly by their area, population density and age structure that can mask the apparent BCG protective effect when high resolution analysis is sought [35]. Moreover, difference in culture and habits (e.g.…”

Section: Discussionmentioning

confidence: 99%

Significantly Improved COVID-19 Outcomes in Countries with Higher BCG Vaccination Coverage: A Multivariable Analysis

Klinger

Blass

Rappoport

et al. 2020

Preprint

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COVID-19 pandemic that started in China has spread within 3 months to the entire globe. We tested the hypothesis that the vaccination against tuberculosis by BCG correlates with a better outcome for COVID-19 patients. Our analysis covers 55 countries complying with predetermined thresholds on the population size and number of deaths per million (DPM). We found a strong negative correlation between the years of BCG administration and the DPM along with the progress of the pandemic, corroborated by permutation tests. The results from multivariable regression tests with 23 economic, demographic, health-related, and pandemic restriction quantitative properties, substantiate the dominant contribution of BCG years to the COVID-19 outcomes. The analysis of countries according to an age-group partition reveals that the strongest correlation is attributed to the coverage in BCG vaccination of the young population (0-24 years). Furthermore, a strong correlation and statistical significance are associated with the degree of BCG coverage for the most recent 15 years, but no association was observed in these years for other broadly used vaccination protocols for measles and rubella. We propose that BCG immunization coverage, especially among the most recently vaccinated contributes to attenuation of the spread and severity of the COVID-19 pandemic.

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The Spread of COVID-19 and the BCG Vaccine: A Natural Experiment in Reunified Germany

Cited by 16 publications

References 20 publications

Significantly Improved COVID-19 Outcomes in Countries with Higher BCG Vaccination Coverage: A Multivariable Analysis

Significantly Improved COVID-19 Outcomes in Countries with Higher BCG Vaccination Coverage: A Multivariable Analysis

Impact of Routine Infant BCG Vaccination on COVID-19

Significantly Improved COVID-19 Outcomes in Countries with Higher BCG Vaccination Coverage: A Multivariable Analysis

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