BCG and COVID-19
The BCG vaccine is a crucial tool for protecting babies and young children in high burden countries from TB, which killed 1.5 million people in 2019 and caused 10 million people to fall sick. Recent media reports indicating that BCG, the only licensed vaccine to protect again TB, may be protective against COVID-19 have led to new interest in this century-old vaccine. However, BCG’s ability to protect against COVID-19 infection or disease has not yet been tested in rigorous, prospective, randomized, controlled clinical trials. Such trials are now underway to study the effects of BCG in healthcare workers and others at high risk of COVID-19. Decisions on use of BCG to protect against COVID-19 should await these results and adequate supplies of BCG should be preserved to protect infants and children in high burden countries from TB.
For more information on this issue, please refer to the following resources:
- WHO Scientific Brief on Bacille Calmette-Guérin (BCG) vaccination and COVID-19
- Treatment Action Group Statement and Information Note on BCG Vaccine and COVID-19
- Bacille Calmette-Guérin (BCG) vaccine and the COVID-19 pandemic: responsible stewardship is needed, HS Schaaf et al., International Journal of Tuberculosis and Lung Disease
Resources about TB
and TB Vaccine R&D
- Meeting Report: 5th Global Forum on TB Vaccines, 21-24 February 2018, New Delhi, India, published open access in Tuberculosis (Dec 2018)
- TB Vaccines Pipeline Report is a report from Treatment Action Group (TAG) that reviews progress in the clinical development of TB vaccines. The report is updated annually.
- End TB Strategy from the World Health Organization’s Global TB Programme provides a 20-year strategy toward the goal of ending the TB epidemic, including research, development, and implementation of new tools.
- Global Plan to End TB 2018-2022 is a costed plan and roadmap for a concerted response to tuberculosis (TB) aligned with the United Nations (UN) Political Declaration on TB, including a strategic framework for TB vaccine R&D.
- WHO Preferred Product Characteristics for New Tuberculosis Vaccine presents WHO preferences for new tuberculosis vaccines, driven by the high medical need for contribution to the fight against TB, in alignment with the End TB strategy.
- BCG World Atlas is an interactive map that provides detailed information on current and past BCG vaccination policies and practices for over 180 countries.
- TB Vaccine Development Pathway, developed by IAVI and TBVI, is a tool that provides a structured development path and gating criteria for TB vaccine candidates. It also describes the different functions and capabilities required to advance a candidate TB vaccine to its next stage of development.
- Global Tuberculosis Report, published by the WHO, provides a comprehensive and up-to-date assessment of the TB epidemic, and of progress in prevention, diagnosis and treatment of the disease at global, regional and country levels. The report is updated annually.
- Global Investments in Tuberculosis Research and Development: Past, Present, and Future is a policy paper developed by WHO in collaboration with civil society groups, academia, and product development partnerships to articulate the research and funding needs to end TB.
Resources for Advocacy and Community Engagement
- The Urgent Need for New TB Vaccines is a fact sheet developed by WGNV that highlights the importance of new TB vaccines, and the strategy and funding needed to develop them.
- Vital Role for of Research for TB Elimination is a briefing document from TAG, WGNV and several other partners that provides information on TB R&D and its centrality to universal health coverage in preparation for the United National High Level Meeting on TB.
- Report on Tuberculosis Research Funding Trends, published annually by TAG, tracks how much public, private, philanthropic, and multilateral institutions spend on TB research and development (R&D) across six areas of research: basic science, diagnostics, drugs vaccines, operational research, and infrastructure/unspecified projects.
- Good Participatory Practice Guidelines for TB Vaccine Research, published by Aeras, is a user- friendly framework that defines specific standards and key elements needed for creating effective partnerships with stakeholders throughout the entire research process. Contact us if you are interested in obtaining copies of the GPP guidelines for TB vaccine research.
- Frequently Asked Questions on TB Vaccine Research, published by IAVI, is a fact sheet that provides information and answers to commonly asked questions about TB vaccine research.
- Myths and Facts about TB Vaccine Research, by IAVI, is a fact sheet that responds to some common misconceptions about vaccine research.
- Tuberculosis Vaccines and Clinical Trials, published by IAVI, provides information about TB, vaccines, and clinical trials in an illustrative and easy to understand booklet.
- Being Part of Tuberculosis Vaccine Clinical Trials is a speaking book published by Books of Hope in collaboration with Aeras, that provides potential clinical trial participants with information about tuberculosis and what is involved in participating in a clinical trial. The information is in both English and Afrikaans. Hard copies of the speaking book are available on request. Contact us if you are interested in obtaining copies of the speaking book.
Recent Scientific Publications
- Tuberculosis vaccine development: from classic to clinical candidates. Li J, Zhao A, Tang J, Wang G, Shi Y, Zhan L, Qin C. Eur J Clin Microbiol Infect Dis. 2020 Aug. doi: 10.1007/s10096-020-03843-6. Epub 2020 Feb 15.
- Mycobacterium tuberculosis-specific plasmablast levels are differentially modulated in tuberculosis infection and disease. Gindeh A, Owolabi O, Donkor S, Sutherland JS. Tuberculosis (Edinb). 2020 Aug 1. doi: 10.1016/j.tube.2020.101978. Online ahead of print.
- Nutritional status positively impacts humoral immunity against its Mycobacterium tuberculosis, disease progression, and vaccine development. Niki M, Yoshiyama T, Nagai H, Miyamoto Y, Niki M, Oinuma KI, Tsubouchi T, Kaneko Y, Matsumoto S, Sasaki Y, Hoshino Y. PLoS One. 2020 Aug 6. doi: 10.1371/journal.pone.0237062. eCollection 2020.
- The effect of Bacillus Calmette-Guérin (BCG) vaccination in preventing sever infectious respiratory diseases other than TB: Implications for the COVID-19 pandemic. Yitbarek K, Abraham G, Girma T, Tilahun T, Woldie M. Vaccine. 2020 Aug 10. doi: 10.1016/j.vaccine.2020.08.018. Online ahead of print. Review.
- Impact of routine infant BCG vaccination in young generation on prevention of local COVID-19 spread in Japan. Kinoshita M, Tanaka M. J Infect. 2020 Aug 11. doi: 10.1016/j.jinf.2020.08.013. Online ahead of print.
- Development of a Counterselectable Transposon To Create Markerless Knockouts from an 18,432-Clone Ordered Mycobacterium bovis Bacillus Calmette-Guérin Mutant Resource. Borgers K, Vandewalle K, Van Hecke A, Michielsen G, Plets E, van Schie L, Vanmarcke S, Schindfessel L, Festjens N, Callewaert N. mSystems. 2020 Aug 11. doi: 10.1128/mSystems.00180-20.
- Development of a novel T cell-oriented vaccine using CTL/Th-hybrid epitope long peptide and biodegradable microparticles, against an intracellular bacterium. Tanaka K, Enomoto N, Uehara M, Furuhashi K, Sakurai S, Yasui H, Karayama M, Hozumi H, Suzuki Y, Fujisawa T, Inui N, Nakamura Y, Nagata T, Suda T. Microbiol Immunol. 2020 Aug 12. doi: 10.1111/1348-0421.12836. Online ahead of print.
- Lymph nodes-The neglected battlefield in tuberculosis. Ganchua SKC, White AG, Klein EC, Flynn JL. PLoS Pathog. 2020 Aug 13. doi: 10.1371/journal.ppat.1008632. eCollection 2020 Aug. Review.
- The Biological Rationale for the Repurposing of BCG Vaccine against SARS-CoV-2. Glisic S, Perovic VR, Sencanski M, Paessler S, Veljkovic V. J Proteome Res. 2020 Aug 14. doi: 10.1021/acs.jproteome.0c00410. Online ahead of print.
- Peripheral Blood Mucosal-Associated Invariant T Cells in Tuberculosis Patients and Healthy Mycobacterium tuberculosis-Exposed Controls. Suliman S, Gela A, Mendelsohn SC, Iwany SK, Tamara KL, Mabwe S, Bilek N, Darboe F, Fisher M, Corbett AJ, Kjer-Nielsen L, Eckle SBG, Huang CC, Zhang Z, Lewinsohn DM, McCluskey J, Rossjohn J, Hatherill M, León SR, Calderon RI, Lecca L, Murray M, Scriba TJ, Van Rhijn I, Moody DB. J Infect Dis. 2020 Aug 17. doi: 10.1093/infdis/jiaa173.
- Advances in nanomaterial vaccine strategies to address infectious diseases impacting global health. Fries CN, Curvino EJ, Chen JL, Permar SR, Fouda GG, Collier JH. Nat Nanotechnol. 2020 Aug 17. doi: 10.1038/s41565-020-0739-9. Online ahead of print.
- First insight into the whole-genome sequence variations in Mycobacterium bovis BCG-1 (Russia) vaccine seed lots and their progeny clinical isolates from children with BCG-induced adverse events. Narvskaya O, Starkova D, Levi D, Alexandrova N, Molchanov V, Chernyaeva E, Vyazovaya A, Mushkin A, Zhuravlev V, Solovieva N, Vishnevskiy B, Mokrousov I. BMC Genomics. 2020 Aug 18. doi: 10.1186/s12864-020-06973-5.
- The impact of human single nucleotide polymorphisms on Bacillus Calmette-Guérin responses. Messina NL, Netea MG, Curtis N. Vaccine. 2020 Aug 18. doi: 10.1016/j.vaccine.2020.07.032. Online ahead of print.
- MAIT cell-directed therapy of Mycobacterium tuberculosis infection. Sakai S, Kauffman KD, Oh S, Nelson CE, Barry CE 3rd, Barber DL. Mucosal Immunol. 2020 Aug 18. doi: 10.1038/s41385-020-0332-4. Online ahead of print.
- Antituberculosis BCG vaccination: more reasons for varying innate and adaptive immune responses. Prentice S, Dockrell HM. J Clin Invest. 2020 Aug 19. doi: 10.1172/JCI141317. Online ahead of print.
- Integrating fish models in tuberculosis vaccine development. Saralahti AK, Uusi-Mäkelä MIE, Niskanen MT, Rämet M. Dis Model Mech. 2020 Aug 23. doi: 10.1242/dmm.045716.
- BCG vaccination in infancy does not protect against COVID-19. Evidence from a natural experiment in Sweden. de Chaisemartin C, de Chaisemartin L. Clin Infect Dis. 2020 Aug 23. doi: 10.1093/cid/ciaa1223. Online ahead of print.
- A new step toward tuberculosis vaccine? Tersigni C, Galli L.EBioMedicine. 2020 Aug 25;59:102965. doi: 10.1016/j.ebiom.2020.102965. Online ahead of print.
- Mucosal delivery of ESX-1-expressing BCG strains provides superior immunity against tuberculosis in murine type 2 diabetes. Sathkumara HD, Muruganandah V, Cooper MM, Field MA, Alim MA, Brosch R, Ketheesan N, Govan B, Rush CM, Henning L, Kupz A. Proc Natl Acad Sci U S A. 2020 Aug 25. doi: 10.1073/pnas.2003235117. Epub 2020 Aug 10.
- Is There a Rationale for Using Bacillus Calmette-Guerin Vaccine in Coronavirus Infection? Maheshwari N, Jain A. Viral Immunol. 2020 Aug 26. doi: 10.1089/vim.2020.0079. Online ahead of print.
- Biological Rationale for the Repurposing of BCG Vaccine against SARS-CoV-2. Glisic S, Perovic VR, Sencanski M, Paessler S, Veljkovic V. J Proteome Res. 2020 Aug 28. doi: 10.1021/acs.jproteome.0c00410. Online ahead of print.
- Correlation between immunity from BCG and the morbidity and mortality of COVID-19. Wickramasinghe D, Wickramasinghe N, Kamburugamuwa SA, Arambepola C, Samarasekera DN. Trop Dis Travel Med Vaccines. 2020 Aug 28. doi: 10.1186/s40794-020-00117-z. eCollection 2020
- Mycobacterium tuberculosis infection is associated with increased B cell responses to unrelated pathogens. Kimuda SG, Andia-Biraro I, Sebina I, Egesa M, Nalwoga A, Smith SG, Bagaya BS, Levin J, Elliott AM, Raynes JG, Cose S. Sci Rep. 2020 Aug 31. doi: 10.1038/s41598-020-71044-4.