Why Infants Rarely Die of COVID-19 and Morbidity and Mortality Rates Vary by Location: Pneumococcal and Hib Vaccinations as Possible Means to Mitigate Future Pandemics

Abstract

Two conundrums have puzzled COVID-19 investigators: 1) morbidity and mortality is rare among Infants and young children and 2) rates of morbidity and mortality exhibit very large variances across nations, locals and even within cities. These differences correlate with rates of Haemophilus influenzae type B (Hib) and pneumococcal vaccination, which are almost universal among infants and vary widely by geography among adults and the elderly. The higher the rate of vaccination, the lower the COVID-19 morbidity and mortality. Vaccination rates with other vaccines, including BCG and poliovirus, do not correlate with COVID-19 risks. Notably, both Hib and pneumoccoci are common co-infections with influenza and coronaviruses and are associated with more severe disease and risk of death. Whether the vaccines simply protect against COVID-19 complications, directly protect against COVID-19 infection by inducing cross-reactive immunity, or are markers for some other types of protection such as availability of better healthcare, is not yet known. What is known is that improving coverage rates of Hib and pneumococcal vaccination has significantly lowered severe morbidity and mortality in influenza epidemics and might have similar efficacy for mitigating coronavirus outbreaks. If infants and children are valid indicators, the beneficial effects might be very significant. The possibility that anti-viral proteins in milk (e.g., lactoferrin) protect against COVID-19 is also explored.

Possible Cross-Reactivity Between SARS-CoV-2 Proteins, CRM197 and Proteins in Pneumococcal Vaccines May Protect Against Symptomatic SARS-CoV-2 Disease and Death

“…Various studies have indicated that some vaccines may protect against symptomatic SARS-CoV-2 infection and death. A very significant inverse correlation has been found between rates of pneumococcal vaccination at both national and local population levels and rates of SARS-CoV-2 infections and death (Root-Bernstein, 2020). No such correlations were found in that study to the tuberculosis vaccine BCG (Bacillus Calmette Guerin), Haemophilus influenzae type B (Hib), diphtheriatetanus-pertussis, measles-mumps-rubella, or poliovirus vaccinations.…”

“…To conclude, there are many reasons to investigate whether pneumococcal, Hib, meningitis and rubella vaccination may protect against SARS-CoV-2 infection or complications. Epidemiologically, a strong inverse association of pneumococcal vaccinations with rates of SARS-CoV-2 rates of disease and death has been documented by two studies (Root-Bernstein, 2020;Pawlowski, et al, 2020). The epidemiological association makes sense in terms of the particular proteins found in pneumococcal vaccines that are identified in this study as being potentially protective.…”

“…Tuberculosis (BCG) vaccination has also been proposed to protect against SARS-CoV-2 (Netea, et al, 2020). While BCG vaccination was purported to be associated with SARS-CoV-2 protection in several epidemiological studies (reviewed in Riccò, et al, 2020) that result was not replicated in others (e.g., Hamiel, et al, 2020;Root-Bernstein, 2020) and serious concerns about methodologies have called into question the association (Riccò, et al, 2020;Periera, et al 2020). The current study leads to the conclusion that BCG protection against SARS-CoV-2 is unlikely.…”

“…Because pneumococcal vaccination has the highest degree of protection in both studies that have compared it with other vaccines (Root-Bernstein, 2020;Pawlowski, et al, 2020), it seems logical to focus current efforts on this type of vaccination. Regardless of the efficacy of such pneumococcal vaccines in protecting against serious SARS-CoV-2 infection, increased use of pneumococcal vaccination should be urged because the world will be facing dual epidemic/pandemics this coming Fall and Winter and perhaps for many years hereafter, involving concurrent influenza and SARS-CoV-2 epidemic/pandemics.…”