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BCG Vaccination and Mortality of COVID-19 across 173 Countries: An Ecological Study

Author

Listed:
  • Mitsuyoshi Urashima

    (Division of Molecular Epidemiology, The Jikei University School of Medicine, Tokyo 105-8461, Japan)

  • Katharina Otani

    (Division of Molecular Epidemiology, The Jikei University School of Medicine, Tokyo 105-8461, Japan
    Advanced Therapies Innovation Department, Siemens Healthcare K.K., Tokyo 141-8644, Japan)

  • Yasutaka Hasegawa

    (Division of Molecular Epidemiology, The Jikei University School of Medicine, Tokyo 105-8461, Japan
    Hitachi, Ltd. Research & Development Group, Tokyo 185-8601, Japan)

  • Taisuke Akutsu

    (Division of Molecular Epidemiology, The Jikei University School of Medicine, Tokyo 105-8461, Japan)

Abstract

Ecological studies have suggested fewer COVID-19 morbidities and mortalities in Bacillus Calmette–Guérin (BCG)-vaccinated countries than BCG-non-vaccinated countries. However, these studies obtained data during the early phase of the pandemic and did not adjust for potential confounders, including PCR-test numbers per population (PCR-tests). Currently—more than four months after declaration of the pandemic—the BCG-hypothesis needs reexamining. An ecological study was conducted by obtaining data of 61 factors in 173 countries, including BCG vaccine coverage (%), using morbidity and mortality as outcomes, obtained from open resources. ‘Urban population (%)’ and ‘insufficient physical activity (%)’ in each country was positively associated with morbidity, but not mortality, after adjustment for PCR-tests. On the other hand, recent BCG vaccine coverage (%) was negatively associated with mortality, but not morbidity, even with adjustment for percentage of the population ≥ 60 years of age, morbidity, PCR-tests and other factors. The results of this study generated a hypothesis that a national BCG vaccination program seems to be associated with reduced mortality of COVID-19, although this needs to be further examined and proved by randomized clinical trials.

Suggested Citation

  • Mitsuyoshi Urashima & Katharina Otani & Yasutaka Hasegawa & Taisuke Akutsu, 2020. "BCG Vaccination and Mortality of COVID-19 across 173 Countries: An Ecological Study," IJERPH, MDPI, vol. 17(15), pages 1-20, August.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:15:p:5589-:d:393781
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    References listed on IDEAS

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    1. Igor Gadelha Pereira & Joris Michel Guerin & Andouglas Gonçalves Silva Júnior & Gabriel Santos Garcia & Prisco Piscitelli & Alessandro Miani & Cosimo Distante & Luiz Marcos Garcia Gonçalves, 2020. "Forecasting Covid-19 Dynamics in Brazil: A Data Driven Approach," IJERPH, MDPI, vol. 17(14), pages 1-26, July.
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    Cited by:

    1. Wei-Ju Su & Chia-Hsuin Chang & Jiun-Ling Wang & Shu-Fong Chen & Chin-Hui Yang, 2021. "COVID-19 Severity and Neonatal BCG Vaccination among Young Population in Taiwan," IJERPH, MDPI, vol. 18(8), pages 1-7, April.

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