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Tuberculosis News

BCG Vaccination immunity effect on COVID19?
관리자|2020-04-22 Hit|686

BCG Vaccination immunityeffect on COVID19?

 

 

Asthe world is in turmoil over the unprecedented Corona19, high attention isbeing paid to Korea that is showing mild spread and low fatality rate. Recently,South Korea has known another success background that has emerged as a hottopic in academia. Tuberculosis vaccination (BCG) in South Korea was introducedin the 1970s and currently has a vaccination rate of over 95 percent. 

 

Lastmonth, a paper was posted on MedRxiv, a pre-released site for medical papers. Thetitle of this paper, written by the NYIT research team, is "TheCorrelation between the General BCG vaccination Policy, the Corona19 DiseaseRate and the Fatality Rate,". This paper includes that the TB Vaccine(BCG) strengthens the immune system against Corona19.

 

Thecontents of the paper is simple. Countries with a population of more than 1million that implement BCG vaccination policies and countries that do not,compared the number of confirmed cases and deaths per million by the 21st oflast month.

 

Theresult was clear. The mortality per million in 55 countries undergoing BCGvaccination stood at 0.78, while 16.39 in five countries (Italy, the UnitedStates, Lebanon, the Netherlands and Belgium) were 21 times higher. Theresearch team also compared Japan (0.28 people) and Brazil (0.0573 people)where implemented the BCG vaccination in 1947 and 1920 respectively. As theearly implementation, death rate caused by Corona 19 show the low level ofmortality. 

 

Theresearch team explained that BCG vaccination increases inflammatory cytokinessuch as interleukin-1 beta (IL-1β) to enhance immunity to corona19. IL-1β isknown to play an important role in antiviral immunity.

 

Thepaper aroused high interest from the domestic and foreign media. Starting withNews1 on the 30th of last month, major news agencies and dailies introduced thecontents of the paper, and the BCG vaccination was also described as a hope foran end to the Corona19.

 

Onthe other hand, NewsTop, a fact-checking media outlet, pointed out on the 2ndof April that the paper did not go through a peer review, and that the deathrates of Japan and Brazil, which were mentioned to prove the effectiveness ofthe BCG vaccination, were reversed on the 31st of last month.

 

The NYIT announcement followed by aseries of related studies

 

AsNewsTop pointed out, the papers posted on MedArchive have not undergonecross-examination by peer-view, or experts in related fields, which areessential procedures for publishing academic journals. Therefore, it is toomuch to be used as a reference for clinical trials or preventive measuresagainst epidemics

 

However,it is a different matter whether the assumption of the correlation between BCGvaccination and Corona19 is completely groundless or a subject that requiresfurther study. In fact, MedArchive has posted 10 more papers in regarding tothe correlation between BCG vaccination and Corona19 on the 24th of last month.Among these papers, 5 review articles support the NYIT research team'sargument. The other three are opposed. 2 review articles show the conditionallyrecognition.

 

Acommon key issue dealt with by 10 papers is "conflict variables." TheNYIT research team may not have noticed the existence of other variables thatcould distort the causal relationship between BCG vaccination and Corona19,such as national economic level, medical infrastructure, when Corona 19occurred, gender ratio and age.

 


Proponents, "Considering variousvariables, the BCG vaccine effect is clear"


The 5 papers which is supporting the corona19 inhibitory effect of BCG vaccinationhas made efforts to expand the surveyed countries or add potential confoundingcandidates to the analysis model to complement the limitations of the NYIT research team. For example, a paper released by a research team by JohnsHopkins Bloomberg School of Public Health on the 1st added variables such asper capita gross national product (GDP) and the proportion of people aged 65 orolder to the existing analysis model. According to the research team'scomparison of deaths per million in the top 50 countries as of the 29th of lastmonth, the death rate of countries inoculating BCG vaccines is 5.78 times lower than that of countries that do not.


The University of Michigan research team also re-analyzed the correlation betweenBCG vaccine and Corona 19 in consideration of variables such as per capita GDP,median age, total population and population density, net migration rate and geographical location. What is special about this paper is that it analyzed theincrease in the one-month period after the occurrence of the confirmed person,not the same number as the number of confirmed and confirmed deaths per million. Studies have shown that countries that vaccinate BCG vaccines haveshown a significantly gradual increase compared to those that stoppedvaccinating before 2000 or have never introduced a vaccination policy at all.In other words, the BCG vaccine has a "flatening the curve" effect.



Opposite side, "The number ofCorona19 tests, the time of occurrence, and the age of 'conflict variables'


On the other hand, papers opposing the NYIT research team claim that there areclearly confounding variables that distort the causal relationship between BCGvaccines and Corona19. According to a paper released by a research team at the University of Texas' MD Anderson Cancer Center on the 8th, the most likelyconfounding variable is the number of tests. As of the 7th, they limited thenumber of analysis targets to 44 countries with more than 2,500 cases of Corona19 tests per million out of 78 countries with more than 500 confirmedcases. Subsequently, the correlation between whether to adopt the BCGvaccination policy and the number of confirmed cases and fatalities per millionresulted in statistically insignificant results.


Most countries that have stopped or have never introduced a BCG vaccination policyare concentrated in Europe and North America. This is because as tuberculosisis treated as a "reverse-country disease," the universal BCG vaccine inoculation policy is not implemented in advanced Western countries withextremely low incidence rates.


The problem is that these countries show relatively high Corona19 test rates, whichcould result in relatively high numbers of confirmed and dead compared tocountries with low test rates. On the other hand, in low-income countries that still have universal inoculation of BCG vaccines, the number of confirmed andfatalities may have been tallied lower than in reality due to low test ratesdue to a lack of medical infrastructure.


Mean while,a team of researchers from Baylor College of Medicine noted that the timing ofthe Corona19 outbreak varies from country to country. In a paper released onthe 9th, they explained that the death toll per million varies sharply depending on whether the BCG vaccine was inoculated or not, but there is notmuch difference compared to the "one-day mortality rate" divided bythe period after the Corona19 outbreak.



Tuberculosis experts, "BCG effects,uncertain steps"


As Corona19 is still ongoing, it is too early to affirm the effectiveness of theBCG vaccine inoculation. Although researchers who support the effects of theBCG vaccination argue that adding a variety of variables to the analysis modelstill shows a clear correlation, there is no guarantee that re-analysis in thesame way a month from now will produce the same result.


Analytical units are also a problem. Maduka Pai, founder of BCG World Atlas, who was thebasis for research on the effects of BCG vaccination, said in an article toForbes on the 12th (local time), "There is a limit to raising personal reasoning based on studies based on national analysis units." It isdifficult to assert the effectiveness of the BCG vaccination unless therelationship between the inoculation of an individual's BCG vaccination and therisk of infection and death is analyzed.


However, this does not mean that the effects of the BCG vaccination need not beconsidered. Many studies so far argue that the effects of BCG vaccinationshould not be unilaterally believed, but rather that they should be fullyreviewed as they are likely to work. If there is any possibility of resolvingthe Corona19 situation, it cannot be asserted that efforts to verify theeffectiveness of the BCG vaccination are meaningless at all.


In fact, experiments are being conducted overseas to verify the effects of BCGvaccination. The Murdoch Children's Institute in Melbourne, Australia, recentlysaid it will launch a six-month BCG vaccine test involving thousands of medical staff.


"The only way to verify the effectiveness of the BCG vaccine is to test it,"said Professor Nigel Curtis, who oversees the clinical trial. "If Ithought it wouldn't work, I wouldn't have started it in the first place."


Professor Maduka Pai advises that a cautious attitude is needed on the effects of BCGvaccines. He told Forbes on the 12th that "the limitations of existingresearch have already been discussed a lot, and clinical trials are the onlyway to verify it," adding, "Let's calm the cheers and wait forevidence of clinical trials."


He went on to say, "It is worth considering the hypothesis (that the BCGvaccine has the effect of suppressing Corona19)," and added, "Untilthe results of the test are released, we should focus on measures such associal distance keeping, tracking movements, aggressive inspections andisolation," and emphasized that preventive measures should not beneglected.