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SARS-CoV-2 Rates in BCG-Vaccinated and Unvaccinated Young Adults

Educational Objective
To understand the indistinguishable SARS-CoV-2 infection rates between those BCG Vaccinated and those Unvaccinated
1 Credit CME

Confirmed cases of coronavirus disease 2019 (COVID-19) and case-fatality rates vary among countries. One reason could be national policies regarding childhood BCG vaccination, with fewer confirmed cases and a lower death toll reported in countries with vs without universal BCG vaccine coverage.1,2 Comparing outbreak characteristics between countries is influenced by potential confounders such as different phases of outbreak, mean age of affected population, management of the pandemic, amount of tests being administered, definitions of COVID-19–related deaths, or underreporting.

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Article Information

Corresponding Author: Ilan Youngster, MD, MMSc, Pediatric Infectious Diseases Unit, Center for Microbiome Research, Shamir Medical Center, Zerifin 70300, Israel (youngsteri@shamir.gov.il).

Accepted for Publication: April 30, 2020.

Published Online: May 13, 2020. doi:10.1001/jama.2020.8189

Author Contributions: Dr Youngster had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Hamiel, Youngster.

Acquisition, analysis, or interpretation of data: Kozer, Youngster.

Drafting of the manuscript: Hamiel, Youngster.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Youngster.

Supervision: Youngster.

Conflict of Interest Disclosures: None reported.

References
1.
Miller  A , Reandelar  MJ , Fasciglione  K ,  et al. Correlation between universal BCG vaccination policy and reduced morbidity and mortality for COVID-19: an epidemiological study. medRxiv. Preprint posted March 28, 2020. doi:10.1101/2020.03.24.20042937
2.
Berg  MK , Yu  Q , Salvador  CE ,  et al. Mandated bacillus Calmette-Guérin (BCG) vaccination predicts flattened curves for the spread of COVID-19. medRxiv. Preprint posted May 4, 2020. doi:10.1101/2020.04.05.20054163
3.
Hollm-Delgado  MG , Stuart  EA , Black  RE .  Acute lower respiratory infection among bacille Calmette-Guérin (BCG)-vaccinated children.   Pediatrics. 2014;133(1):e73-e81. doi:10.1542/peds.2013-2218PubMedGoogle ScholarCrossref
4.
Leentjens  J , Kox  M , Stokman  R ,  et al.  BCG vaccination enhances the immunogenicity of subsequent influenza vaccination in healthy volunteers: a randomized, placebo-controlled pilot study.   J Infect Dis. 2015;212(12):1930-1938. doi:10.1093/infdis/jiv332PubMedGoogle ScholarCrossref
5.
Netea  MG , van Crevel  R .  BCG-induced protection: effects on innate immune memory.   Semin Immunol. 2014;26(6):512-517. doi:10.1016/j.smim.2014.09.006PubMedGoogle ScholarCrossref
6.
Israel Central Bureau of Statistics. Jews by continent of origin, sex and age. Accessed April 25, 2020. https://www.cbs.gov.il/en/publications/Pages/2018/Immigration-Statistical-Abstract-of-%20Israel-2018-No-69.aspx
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