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Tuberculosis

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

JAMA

Published Online: May 13, 2020

Research Letter

Article Information and Disclosures

Uri Hamiel, MD¹;

Eran Kozer, MD¹;

Ilan Youngster, MD, MMSc¹

Author Affiliations

¹The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

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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

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

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

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.2013-2218 PubMed Google Scholar Crossref

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/jiv332 PubMed Google Scholar Crossref

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.2014.09.006 PubMed Google Scholar Crossref

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

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.