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BCG vaccination policy and preventive chloroquine usage: do they have an impact on COVID-19 pandemic?

ABSTRACT: Coronavirus disease 2019 (COVID-19) is a severe acute respiratory syndrome caused by Coronavirus 2 (SARS-CoV-2). In the light of its rapid global spreading, on 11 March 2020, the World Health Organization has declared it a pandemic. Interestingly, the global spreading of the disease is not uniform, but has so far left some countries relatively less affected. The reason(s) for this anomalous behavior are not fully understood, but distinct hypotheses have been proposed. Here we discuss the plausibility of two of them: the universal vaccination with Bacillus Calmette-Guerin (BCG) and the widespread use of the antimalarial drug chloroquine (CQ). Both have been amply discussed in the recent literature with positive and negative conclusions: we felt that a comprehensive presentation of the data available on them would be useful. The analysis of data for countries with over 1000 reported COVID-19 cases has shown that the incidence and mortality were higher in countries in which BCG vaccination is either absent or has been discontinued, as compared with the countries with universal vaccination. We have performed a similar analysis of the data available for CQ, a widely used drug in the African continent and in other countries in which malaria is endemic; we discuss it here because CQ has been used as the drug to treat COVID-19 patients. Several African countries no longer recommend it officially for the fight against malaria, due to the development of resistance to Plasmodium, but its use across the continent is still diffuse. Taken together, the data in the literature have led to the suggestion of a possible inverse correlation between BCG immunization and COVID-19 disease incidence and severity.

SUBMITTER: Sharma A

PROVIDER: S-EPMC7341995 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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BCG vaccination policy and preventive chloroquine usage: do they have an impact on COVID-19 pandemic?

Sharma Abhibhav A Kumar Sharma Saurabh S Shi Yufang Y Bucci Enrico E Carafoli Ernesto E Melino Gerry G Bhattacherjee Arnab A Das Gobardhan G

Cell death & disease 20200708 7

Coronavirus disease 2019 (COVID-19) is a severe acute respiratory syndrome caused by Coronavirus 2 (SARS-CoV-2). In the light of its rapid global spreading, on 11 March 2020, the World Health Organization has declared it a pandemic. Interestingly, the global spreading of the disease is not uniform, but has so far left some countries relatively less affected. The reason(s) for this anomalous behavior are not fully understood, but distinct hypotheses have been proposed. Here we discuss the plausib ...[more]

PMID: 32641762

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Project description:BackgroundAnnual vaccination for influenza is globally recommended for some prioritized groups due to its high morbidity and mortality. Until 2019, South Korea has provided free influenza vaccination to children aged ≤12, adults aged ≥65, and pregnant women to enhance vaccination coverage. In 2020, with the COVID-19 pandemic, free flu vaccination was temporarily broadened to adults aged 62-64 and children aged 13-18. We analyzed the trends in influenza vaccination coverages in South Korea and evaluated the impact of the COVID-19 pandemic and the expansion of the free vaccination policy on influenza vaccination coverage.MethodsWe conducted a cross-sectional study with nationwide survey data from Korea National Health and Nutrition Examination Survey (KNHANES). We evaluated the trends in influenza vaccination coverages of target populations from 2010 to 2020. Influenza vaccination coverages of children aged 13-18, adults aged 62-64, and adults aged ≥65 were compared between 2019 and 2020.ResultsIn total, 72,443 individuals were analyzed. From 2019 to 2020, with the expansion of free influenza vaccination and the COVID-19 pandemic, the vaccination coverage of children aged 13-18 increased from 27.8% to 43.5% (P<0.001) but that of people aged 62-64 showed insignificant change from 57.4% to 51.5% (P = 0.266). Furthermore, the vaccination coverage in adults aged ≥65 declined from 87.2% to 79.1% (P<0.001).ConclusionIn 2020, along with COVID-19 outbreaks, a decline of influenza vaccination coverage in older adults was observed regardless of free immunizations. It is likely due to behavioral changes to reduce the risk of COVID-19 transmission. This is supported by a greater reduction of influenza vaccination coverage in regions with higher COVID-19 outbreaks, as well as by South Korea's high medical accessibility and highly congested medical facilities. To sustain a high level of vaccination coverage of high-risk population during epidemics, additional efforts beyond free vaccination policies should be implemented.

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BCG vaccination policy and preventive chloroquine usage: do they have an impact on COVID-19 pandemic?

Publications

BCG vaccination policy and preventive chloroquine usage: do they have an impact on COVID-19 pandemic?

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