(COMMENTS reached the max) If I were North American/West European/Australian, I would take BCG vaccination now against the novel coronavirus pandemic.
I declare that there is no conflict of interest for BCG vaccination but I have a big interest in stopping this pandemic. One of my businesses is an online tourism agency and its sales have dried up!
1) Scientists have started to work on this hypothesis
(Added on 9 Apr) They seem to use only BCG Denmark. I strongly recommend using BCG Japan/Russia in those clinical trials. You will understand after reading this post.
Immune boost against the coronavirus
2) If you look at the map displaying BCG vaccination policy by country, there seems to be a correlation to the speed of coronavirus spread and its spread among young people.
- The spread speed is fast in Italy and western Europe and the U.S. while the spread speed among Russia, eastern European countries, and Asian countries except Wuhan city is slow.
- In Asian countries, there are few young infected people or almost zero serious cases among young people. However, in western Europe and the U.S., there are cases among young people.**
- In Western Europe, you can compare Italy vs Croatia, Spain vs Portugal***, UK vs Ireland, Sweden vs Norway, ex-West Germany vs ex-East Germany. In the former countries, BCG vaccine is not mandatory while in the latter countries, BCG vaccine is mandatory. Now, you can compare the U.S. and Mexico.
- I live in Tokyo and Brisbane. Though the normal social distance is much longer and less crowded in Brisbane and the government policy is 10 times stricter, the spread speed is faster in Brisbane than in Tokyo.
* (Added on 5 Apr) A reader told me that Ecuador has its BCG program. However, it started in 1977. No strain information. (Added on 29 Apr) Another reader said that Ecuador started its universal BCG vaccination program in 2018. Reliable information with a source is welcomed.
According to http://www.bcgatlas.org/, the start year for Columbia: 1960, Peru: 1945, Brazil: 1976. Brazil was late to introduce the program but it uses BCG Moreau.
(Added on 29 Mar)
A reader told me there is a pre-print article (not yet certified by peer review)
The article has this chart. I believe if we can adjust for the timing of coronavirus spread, the correlation would be even higher.
(Added on 10 Apr)
BCG vaccine contains an attenuated form of the bacteria (germ) that causes TB (I learned this in this April...). Then the prevalence of TB can correlate with COIVD-19. Below is the map of TB prevalence from WHO. You can easily see the correlation. I guess that the amount of BCG vaccine + TB prevalence is the key driver. Interestingly, Iran's TB prevalence is as low as western Europe. Immunologists' explanations are welcomed.
(Added on 30 Mar)
In the world map of the BCG vaccine policies above, Canada is in orange and categorized in C: The country never had universal BCG vaccination programs. However, if you look at Canada in http://www.bcgatlas.org/, it seems that Canada had a "routine" BCG vaccination program until 1960s-1970s (Please correct me if I read wrongly). This means people elder than 40s mostly vaccinated! This may be the reason why Canada has a low death rate compared with the U.S. And Canada used
(Added on 14 Apr) Canada had used BCG Connaught, not Tokyo. Please check this post for the detail. And if you check the post below, please skip the next section grayed out.
One more weak fact. In Canada, people elder than the 60s had a BCG vaccine while people younger than 50s had not. Then, look at the age distribution of COVID-19 cases in Canada. Skew to people younger than the 50s?! But infection rate may not vary by age, only hospitalization/ICU/death rate may vary by age. I'm looking for that data and BCG vaccine penetration data by age group for Canada.
(Added on 6 Apr)
Ultra-Orthodox Jews are said to refuse BCG vaccination historically. In New York or Israel, huge spikes of COVID-19 (more than 40% of the community infected) are reported in the Ultra-Orthodox Jews communities. The articles say their pray style or lifestyle can be the causes but I believe this is because of lacking the BCG vaccine.
** I couldn't find good stats on this. Only anecdotal news stories. Eg. Greta Thunberg got infected by the novel coronavirus. Well, she is Swedish and born in 2003. Sweden stopped BCG vaccination in 1975.(Added on 13 Apr) Finally, I get a quantitative analysis of this! Please check this post.
*** Among West European countries that had/have universal BCG vaccination program, Spain and Portugal are (one of) the last countries introduced it in 1965. And Spain is (one of ) the first country to stop it in 1981 and Portugal stopped it in 2017. Portuguese elder than 55 may have a low BCG vaccination rate, which may result in a high death rate than the other western Europe, but probably better than Spain.
3) There are several strains of BCG vaccination and Japan/Russia strains may be the most effective against the novel coronavirus.This comment by Tiger Paw sounds most plausible regarding the country differences though the article itself is worthless.
* The comment was deleted for some reason. The initial idea of this section attributes to Tiger Paw. If I hadn't read his comment, I would not know there are multiple types of BCG vaccine.
You can see this table updated on 4 Apr.
(Added on 25 Apr)
According to UNICEF's data, the percentage of live births who received BCG in Iran is 1980: 7, 1981: 6, 1982: 10, 1983: 10, 1984: 10, 1985: 79. Most Iranian who are elder than 36 years old were not BCG vaccinated.
- Japan 0.8
- Bangladesh 0.1
- Pakistan 0.3
- Iraq*** 2
- Saudi Arabia* 1
- Taiwan 0.2
- Thailand 0.5
- Oman 0.6
- South Africa(~2000) 0.3
- Kazakhstan 0.4
- Bhutan 0
- Nigeria 0.03
** Kuwait used the BCG Pasteur strain from 1962 to at least 1990. I couldn't find when Kuwait switched to the BCG Tokyo strain but the majority were vaccinated with the BCG Pasteur strain.
Unique Gene Expression Profiles in Infants Vaccinated with Different Strains of Mycobacterium bovis Bacille Calmette-Guérin.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1932948/
I live in Tokyo and Brisbane and have been wondering why the spread speed is faster in Australia than Japan.
Tokyo is a very crowded city and it's impossible to keep the social distance. People are packed in a very crowded train twice a day and I expected a high speed of spread but the actual speed is low so far (though it's beginning to explode).
4) Deaths and severe cases skew to people who probably have not BCG vaccinated.
In Japan, all babies since 1951 have BCG vaccination and the coronavirus deaths in Japan are skewed drastically to the elderly born before 1951. 44 out of 45 deaths happen to those older than 70 (as of 26 Mar, https://toyokeizai.net/sp/visual/tko/covid19/).
- China started its BCG vaccination program in 1978 (->42 years old), not universally but partially.
- Penetration varies by province. Among high/middle/low penetration categories, Hubei Province(where Wuhan is) is in the low category. Beijing and Shanghai are in the high category.
- China uses its own local strain produced in China.
- In this 60-year follow-up of a clinical trial of the BCG vaccine that included 2963 participants vaccinated at a median age of 8 years, those who received the BCG vaccine had a subsequent lung cancer rate of 18.2 cases per 100 000 person-years. Participants who received the placebo had a lung cancer rate of 45.4 cases per 100 000 person-years.
5) BCG vaccination has a long history and there seems no little downside to human beings.
(Added on 28 Mar)
BCG Pasteur strain was used in this trial. BCG Pasteur is probably the weakest strain against COVID-19, weaker than BCG Denmark/Brazil.
Another randomized clinical trial in the Netherlands in 2015, injected with influenza vaccine 14 days after BCG Denmark vaccination. The rate of antibody production and seroconversion to H1N1 flu was significantly improved. Modulation of cytokine responses against unrelated pathogens was observed.
In this paper, C19 and BCG are predicted.
If a variant of influenza comes out, another Spanish flu of 1918 could happen. A specific vaccine would take longer to develop and be less effective.
Non-specific trained immunity enhancement with BCG should be adopted as a vaccine against that type of pandemic.
6) Lockdown reduces the reproduction rate significantly but lockdown may not be enough for the countries where BCG vaccination has not been mandatory.(Added on 1 Apr)
I checked the Imperial College COVID-19 report as of 30 Mar and read the chart of 13 west European countries. I am afraid that I don't check other than the chart below.
- 12 out of 13 countries already implemented lockdown and have reduced their R1 significantly. Sweden is the only country not implementing lockdown and making the virus to spread fast (R1=3).
- Sadly, lockdown may not be enough to contain COVID-19. All countries except one seem to have their R1>1. This is a very bad sign.
- Hey, look at Norway! Norway seems to be the only country where its R1<1! And look at the first map I cited. Norway is the only one light orange country among these 13 countries; Mandatory BCG vaccine. To be precise, according to http://www.bcgatlas.org/, Norway had its compulsory BCG vaccine program from 1947 to 2009 for 62 years, which is the longest among these 13 countries.
- If a country doesn't have a long history of mandatory BCG vaccination program, lockdown may not be enough to contain COVID-19. Additional measures required. BCG vaccine?
- If a country has a long history of mandatory BCG vaccination program even if it is BCG Denmark strain, a country can contain COVID-19 by the lockdown.
- BCG can reduce the infection rate by half no matter what strain is.
- Lockdown can reduce the infection rate to 40%.
- What BCG strain matter seems to be in the death rate. While weak strains such as BCG Denmark may not so effective to reduce the death rate, strong strains such as BCG Tokyo can reduce the death rate to one-tenth.
Probably the most exhaustive and most accurate estimate of COVID-19's lethality at this time. After correcting for data censoring errors and demographic differences, the overall result is 1.38%. A very important implication is that elaboration of treatment does not appear to have much effect on this figure.
Coincidentally, the result is the same as my deep-learning analysis. From my deep-learning analysis, the death rate (no BCG & Ordinary life) was estimated at 1.38%! And BCG Tokyo reduces it to around 0.1%.
(Added on 5 Apr)
The U.S. and Irish medical and scientific experts have started to work on this. Please check this recording.
- BCG vaccination is safe for adults and healthcare workers.
- The U.S. is expecting the second wave of the pandemic in fall/winter. BCG vaccine can prevent that second pandemic.
- In the U.S., the BCG vaccine supply is limited and in shortage.
- The researchers are BATTLING AGAINST THE CLOCK.
(Added on 6 Apr)
A miracle idea from a clinical doctor "Colors"! The Japanese method of BCG vaccination is the safest and effective but 99% of living bacteria don't go to under-skin space and get wasted on skin. If we employ the bifurcated needle way, we don't waste any vaccine, which may mean increasing the number of people who can get BCG vaccination 100 times!
(Added on 4 Apr)
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