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Tags Coronavirus , diseases , tuberculosis , vaccination

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Old 7th April 2020, 03:03 AM   #1
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Post Covid-19 and Calmette-Guerin

There's some interesting correlations between the use of the Calmette-Guerin inoculation against tuberculosis (BCG) and improved survival rates amongst those infected with Covid-19.

This might explain the strikingly different death rates among culturally and socially similar countries such as Spain and Portugal.

This does seem rather odd on first glance; BCG is aimed at protecting against tuberculosis, a rather different disease to coronavirus (bacterial rather than viral for example). However these has been evidence from past BCG studies of a broad, general, protective effect against respiratory infections, as well as measles and malaria.

For those unfamiliar with BCG it's an old vaccination developed over a century ago, trialed in the 1920s and commonly administered today in the developing world. It's named after the bacteriologists involved in it's development; Albert Calmette and Camille Guerin.

Australia has begun a BCG vaccination clinical trial among 4,0000 health workers and five other countries have similar trials.

Here's one of the first papers on the subject.
Correlation between universal BCG vaccination policy and reduced morbidity and mortality for COVID-19: an epidemiological study [Pre-print, not yet peer reviewed]
Originally Posted by Abstract
COVID-19 has spread to most countries in the world. Puzzlingly, the impact of the disease is different in different countries. These differences are attributed to differences in cultural norms, mitigation efforts, and health infrastructure. Here we propose that national differences in COVID-19 impact could be partially explained by the different national policies respect to Bacillus Calmette-Guerin (BCG) childhood vaccination. BCG vaccination has been reported to offer broad protection to respiratory infections. We compared large number of countries BCG vaccination policies with the morbidity and mortality for COVID-19. We found that countries without universal policies of BCG vaccination (Italy, Nederland, USA) have been more severely affected compared to countries with universal and long-standing BCG policies. Countries that have a late start of universal BCG policy (Iran, 1984) had high mortality, consistent with the idea that BCG protects the vaccinated elderly population. We also found that BCG vaccination also reduced the number of reported COVID-19 cases in a country. The combination of reduced morbidity and mortality makes BCG vaccination a potential new tool in the fight against COVID-19.
More.
Euronews piece..
Bloomberg.
Critique in Nature.
UroToday.
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Old 7th April 2020, 05:01 AM   #2
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Originally Posted by catsmate View Post
There's some interesting correlations between the use of the Calmette-Guerin inoculation against tuberculosis (BCG) and improved survival rates amongst those infected with Covid-19.

This might explain the strikingly different death rates among culturally and socially similar countries such as Spain and Portugal.

This does seem rather odd on first glance; BCG is aimed at protecting against tuberculosis, a rather different disease to coronavirus (bacterial rather than viral for example). However these has been evidence from past BCG studies of a broad, general, protective effect against respiratory infections, as well as measles and malaria.

For those unfamiliar with BCG it's an old vaccination developed over a century ago, trialed in the 1920s and commonly administered today in the developing world. It's named after the bacteriologists involved in it's development; Albert Calmette and Camille Guerin.

Australia has begun a BCG vaccination clinical trial among 4,0000 health workers and five other countries have similar trials.

Here's one of the first papers on the subject.
Correlation between universal BCG vaccination policy and reduced morbidity and mortality for COVID-19: an epidemiological study [Pre-print, not yet peer reviewed]


More.
Euronews piece..
Bloomberg.
Critique in Nature.
UroToday.
We discussed this in the other thread, France and UK don't fit the hypthesis.

Let's see if it passes peer review.
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Old 7th April 2020, 06:26 AM   #3
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I'm sure there is some correlation, but I doubt it has anything to do with the BCG vaccine itself.
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Old 7th April 2020, 07:49 AM   #4
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I saw a few articles about this and got pretty hopeful for a few minutes - I served in the Peace Corps and we got a boatload of immunizations. I was hoping this was one of them.

Alas, it was not. We "only" got vaccinated for:
rabies,
typhoid,
hepatitis,
measles mumps rubella,
meningitis,
Japanese encephalitis,
diphtheria,
tetanus,
polio.

Plus gamma globulin, which is not a vaccine but provides some antibodies.

No TB vaccine for us, I'm afraid. We did all get regular skin tests for TB, plus chest x-rays at the close of service.
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Old 7th April 2020, 04:54 PM   #5
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Old 7th April 2020, 06:36 PM   #6
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Originally Posted by Capsid View Post
We discussed this in the other thread, France and UK don't fit the hypthesis.

Let's see if it passes peer review.
France started BCG in 1950 & UK in 1953, so if the vast majority of their deaths are 70+, they might not negate the idea.

Certainly needs more work.
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And for anyone interested in the anomaly between countries & territories, there's a thread on that subject here: http://www.internationalskeptics.com...d.php?t=343009
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Old 7th April 2020, 07:45 PM   #7
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Perhaps the OP (or anyone) can shed some light on how to know if a person has had this specifically correlated vaccine.

I recall in High School (California) that the older kids had 'the TB arm scar', but my grade did not. So in my area the vaccine that left that scar would have ended for people born after 1968 or so.
Is it just that one vaccine that left 'the scar' that is the preventative one being discussed? Or does it apply to more modern TB vaccinations as well? Or other methods of delivery?

Last edited by Sherkeu; 7th April 2020 at 07:48 PM.
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Old 7th April 2020, 08:05 PM   #8
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I don't know the answers to those, but one thing to keep an eye on might be Brazil, because they've had universal vaccine with oral vaccine since very early on.
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Old 7th April 2020, 08:30 PM   #9
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Originally Posted by Sherkeu View Post
Perhaps the OP (or anyone) can shed some light on how to know if a person has had this specifically correlated vaccine.

I recall in High School (California) that the older kids had 'the TB arm scar', but my grade did not. So in my area the vaccine that left that scar would have ended for people born after 1968 or so.
Is it just that one vaccine that left 'the scar' that is the preventative one being discussed? Or does it apply to more modern TB vaccinations as well? Or other methods of delivery?
In California, that scar was due to the smallpox vaccine. The TB vaccine was not given en masse in the US.
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Old 7th April 2020, 08:59 PM   #10
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Originally Posted by xjx388 View Post
In California, that scar was due to the smallpox vaccine. The TB vaccine was not given en masse in the US.
Oh thanks!

I assumed since people mentioned an upper arm scar that it was the same!
I knew it was some old vaccine but wouldnt have imagined 2 separate vaccines caused the same shaped scar in the same place.

I guess I am not vaccinated for smallpox then! ...and TB for that matter.

Last edited by Sherkeu; 7th April 2020 at 09:08 PM.
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Old 7th April 2020, 11:10 PM   #11
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Originally Posted by The Atheist View Post
France started BCG in 1950 & UK in 1953, so if the vast majority of their deaths are 70+, they might not negate the idea.

Certainly needs more work.
I remember having the BCG at secondary school. That would be when I was at least 13, maybe older.

If people in the UK and France were getting BCG at the same ages, then it would only be people in their mid to late 80s who would have had no BCG.
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Old 7th April 2020, 11:25 PM   #12
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Originally Posted by angrysoba View Post
I remember having the BCG at secondary school. That would be when I was at least 13, maybe older.

If people in the UK and France were getting BCG at the same ages, then it would only be people in their mid to late 80s who would have had no BCG.
Yeah, I wasn't allowing for that - they needed to be old enough to be vaccinated, so 80+ is about right.

53% of English deaths are 80+.

There'd be no way of finding out, but it'd be interesting to see if migrants were strongly featured in the 39% of deaths aged 60-79.

https://metro.co.uk/2020/04/03/coron...e-uk-12506448/

(quite a few 40-59 yos dying, too)
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Old 8th April 2020, 02:15 AM   #13
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Originally Posted by angrysoba View Post
I remember having the BCG at secondary school. That would be when I was at least 13, maybe older.

If people in the UK and France were getting BCG at the same ages, then it would only be people in their mid to late 80s who would have had no BCG.
The UK scrapped routine BCG vaccination in 2005 but prior to that most school children aged 10-14 got it.
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Old 8th April 2020, 02:44 AM   #14
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Originally Posted by angrysoba View Post
I remember having the BCG at secondary school. That would be when I was at least 13, maybe older.

If people in the UK and France were getting BCG at the same ages, then it would only be people in their mid to late 80s who would have had no BCG.
Routine BCG vaccination in the UK was stopped in 2005. As said the universal BCG vaccination in the UK began in 1953 and was given at age 13, at that time the year before compulsory education ceased. So persons born between 1940 and roughly 1990 will have been vaccinated (30 - 80 yr old) (ETA there were supply problems before the program was withdrawn and in practice vaccination had been patchy before then). BCG vaccination leaves a small white scar differing from the larger scar from variolation (small pox vaccination), in the UK it was always given on the left shoulder. I would expect given high rates of TB BCG would be fairly universal in China. BCG vaccination in the UK then became selective neonatal vaccination for the children of parents in high risk groups. I think the NHS still offers BCG to staff at increased risk. Trials of BCG in the US failed to show much effect and it was never widely used unlike the rest of the world. BCG is not a very effective vaccine for preventing TB but seem somewhat effective at preventing leprosy.

So those persons in the higher risk group age 50+ should all be vaccinated whilst younger people will not. So not great evidence for a significant effect of BCG on covid-19.

Whilst there is evidence that neonatal BCG vaccination in particular has some non-specific effects on immunity e.g. reducing risks of allergy. The evidence is poor in adults whose immune system is pretty well set in its way. Adolescents are probably still malleable. BCG has been frequently used as an adjuvant if you give a vaccine along with BCG the effects of the other vaccine can be enhanced. BCG is used as an anticancer treatment for bladder cancer, BCG is squirted into the bladder, causes a local infection (BCG is a live vaccine- an attenuated form of TB), and the strong immune reaction generated kills by standing cancer cells - TNF - tumour necrosis factor is generated by BCG infection.

So I think it is unlikely trying to launch a mass BCG campaign will have any benefits and is likely to divert resources better used elsewhere.

Last edited by Planigale; 8th April 2020 at 02:45 AM.
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Old 8th April 2020, 02:48 AM   #15
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Originally Posted by The Atheist View Post
Yeah, I wasn't allowing for that - they needed to be old enough to be vaccinated, so 80+ is about right.

53% of English deaths are 80+.

There'd be no way of finding out, but it'd be interesting to see if migrants were strongly featured in the 39% of deaths aged 60-79.

https://metro.co.uk/2020/04/03/coron...e-uk-12506448/

(quite a few 40-59 yos dying, too)
Excluding USians, most migrants especially from ISC were vaccinated and BCG was generally offered to migrants who were from high prevalence countries who did not have a vaccination scar.
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Old 8th April 2020, 02:50 AM   #16
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Originally Posted by The Atheist View Post
I don't know the answers to those, but one thing to keep an eye on might be Brazil, because they've had universal vaccine with oral vaccine since very early on.
I think the only oral vaccine would have been polio, certainly not BCG.
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Old 8th April 2020, 02:55 AM   #17
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Originally Posted by Planigale View Post
I think the only oral vaccine would have been polio, certainly not BCG.
Yeah, I think I got mixed up there.

The whole premise seems unlikely to me anyway.
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Old 8th April 2020, 02:57 AM   #18
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Originally Posted by Capsid View Post
We discussed this in the other thread, France and UK don't fit the hypthesis.

Let's see if it passes peer review.
The biggest issue is that different countries are at different stages in the epidemic so you cannot directly compare death rates. My guess is this paper will disappear into the long grass once the reviewers get hold of it.
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Old 8th April 2020, 10:04 AM   #19
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Originally Posted by Planigale View Post
I think the only oral vaccine would have been polio, certainly not BCG.
It was an oral vaccine from the start until a lab mix up in Lubeck Germany killed dozens of newborns in 1930 (Lubeck Disaster). It moved mostly to intradermal from then on. Brazil continued oral BCG until the mid 1970's. Not sure why, but I looked it up for someone yesterday.
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Old 8th April 2020, 12:14 PM   #20
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Originally Posted by Sherkeu View Post
Oh thanks!

I assumed since people mentioned an upper arm scar that it was the same!
I knew it was some old vaccine but wouldnt have imagined 2 separate vaccines caused the same shaped scar in the same place.

I guess I am not vaccinated for smallpox then! ...and TB for that matter.

There’s a complicating factor my wife told me about. In Mexico, the immunization was and is still given. So there are a lot of people in the border communities who have a TB scar who are too young to have gotten the Smallpox vaccine. The scars look similar so it causes some confusion.
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Old 11th April 2020, 04:31 PM   #21
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Originally Posted by xjx388 View Post
There’s a complicating factor my wife told me about. In Mexico, the immunization was and is still given. So there are a lot of people in the border communities who have a TB scar who are too young to have gotten the Smallpox vaccine. The scars look similar so it causes some confusion.
The scars aren't that similar.

On me at least.

One is wide, flat and the skin surfaces is shinier.

The other, the TB vaccine is a very small thickening of the skin, like a scar from an old pimple.

Before coming to Australia in the late 1960s, I had to have a number of vaccines, two were memorable.

1. Was like a bunch of needles with cotton wool wrapped amongst them.
(This was smallpox vaccine)
2. The other was a small amount of powder, mixed into a teaspoon of McRobertson's black current jam! (This was the polio vaccine).

In Australia, in High School, I received the TB vaccine under discussion, despite an abnormal skin test which indicated immunity. The result was fine for me, but a nightmare for my brother who ended up with a one inch ulcer on his arm.

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Old 17th April 2020, 01:32 PM   #22
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Mod InfoThis thread has been closed due to its many duplications with other science and medicine threads about Covid-19. Members are directed to a new, single thread HERE. Members may freely quote from this thread and import discussions here into the new catchall science thread. Thank you.
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