BCG vaccination in infancy does not protect against COVID-19. Evidence from a natural experiment in Sweden.
Identifieur interne : 001639 ( Main/Exploration ); précédent : 001638; suivant : 001640BCG vaccination in infancy does not protect against COVID-19. Evidence from a natural experiment in Sweden.
Auteurs : Clément De Chaisemartin [États-Unis] ; Luc De Chaisemartin [France]Source :
- Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [ 1537-6591 ] ; 2020.
Abstract
BACKGROUND
The Bacille Calmette-Guérin (BCG) tuberculosis vaccine has immunity benefits against respiratory infections. Accordingly, it has been hypothesized to have a protective effect against COVID-19. Recent research found that countries with universal BCG childhood vaccination policies tend to be less affected by the COVID-19 pandemic. However, such ecological studies are biased by numerous confounders. Instead, this paper takes advantage of a rare nationwide natural experiment that took place in Sweden in 1975, where discontinuation of newborns BCG vaccination led to a dramatic fall of the BCG coverage rate, thus allowing us to estimate the BCG's effect without the biases associated with cross-country comparisons.
METHODS
Numbers of COVID-19 cases and hospitalizations were recorded for birth cohorts born just before and just after 1975, representing 1,026,304 and 1,018,544 individuals, respectively. We used regression discontinuity to assess the effect of BCG vaccination on Covid-19 related outcomes. This method used on such a large population allows for a high precision that would be hard to achieve using a randomized controlled trial.
RESULTS
The odds ratio for Covid-19 cases and Covid-19 related hospitalizations were 1·0005 (CI95: [0·8130-1·1881]) and 1·2046 (CI95: [0·7532-1·6560]), allowing us to reject fairly modest effects of universal BCG vaccination. We can reject with 95% confidence that universal BCG vaccination reduces the number of cases by 19% and the number of hospitalizations by 25%.
CONCLUSIONS
While the effect of a recent vaccination must be evaluated, we provide strong evidence that receiving the BCG vaccine at birth does not have a protective effect against COVID-19 among middle-aged individuals.
DOI: 10.1093/cid/ciaa1223
PubMed: 32829400
PubMed Central: PMC7499491
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">BCG vaccination in infancy does not protect against COVID-19. Evidence from a natural experiment in Sweden.</title><author><name sortKey="De Chaisemartin, Clement" sort="De Chaisemartin, Clement" uniqKey="De Chaisemartin C" first="Clément" last="De Chaisemartin">Clément De Chaisemartin</name><affiliation wicri:level="2"><nlm:affiliation>Department of Economics, University of California, Santa Barbara, Santa Barbara, CA 93106, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Economics, University of California, Santa Barbara, Santa Barbara, CA 93106</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="De Chaisemartin, Luc" sort="De Chaisemartin, Luc" uniqKey="De Chaisemartin L" first="Luc" last="De Chaisemartin">Luc De Chaisemartin</name><affiliation wicri:level="3"><nlm:affiliation>Immunology Department, APHP.Nord-Université de Paris, Bichat Hospital, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Immunology Department, APHP.Nord-Université de Paris, Bichat Hospital, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="1"><nlm:affiliation>Université Paris-Saclay, Inserm, "Inflammation, microbiome, immunosurveillance", Châtenay-Malabry, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Université Paris-Saclay, Inserm, "Inflammation, microbiome, immunosurveillance", Châtenay-Malabry</wicri:regionArea><wicri:noRegion>Châtenay-Malabry</wicri:noRegion><wicri:noRegion>Châtenay-Malabry</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32829400</idno><idno type="pmid">32829400</idno><idno type="doi">10.1093/cid/ciaa1223</idno><idno type="pmc">PMC7499491</idno><idno type="wicri:Area/Main/Corpus">000517</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000517</idno><idno type="wicri:Area/Main/Curation">000517</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000517</idno><idno type="wicri:Area/Main/Exploration">000517</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">BCG vaccination in infancy does not protect against COVID-19. Evidence from a natural experiment in Sweden.</title><author><name sortKey="De Chaisemartin, Clement" sort="De Chaisemartin, Clement" uniqKey="De Chaisemartin C" first="Clément" last="De Chaisemartin">Clément De Chaisemartin</name><affiliation wicri:level="2"><nlm:affiliation>Department of Economics, University of California, Santa Barbara, Santa Barbara, CA 93106, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Economics, University of California, Santa Barbara, Santa Barbara, CA 93106</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="De Chaisemartin, Luc" sort="De Chaisemartin, Luc" uniqKey="De Chaisemartin L" first="Luc" last="De Chaisemartin">Luc De Chaisemartin</name><affiliation wicri:level="3"><nlm:affiliation>Immunology Department, APHP.Nord-Université de Paris, Bichat Hospital, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Immunology Department, APHP.Nord-Université de Paris, Bichat Hospital, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="1"><nlm:affiliation>Université Paris-Saclay, Inserm, "Inflammation, microbiome, immunosurveillance", Châtenay-Malabry, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Université Paris-Saclay, Inserm, "Inflammation, microbiome, immunosurveillance", Châtenay-Malabry</wicri:regionArea><wicri:noRegion>Châtenay-Malabry</wicri:noRegion><wicri:noRegion>Châtenay-Malabry</wicri:noRegion></affiliation></author></analytic><series><title level="j">Clinical infectious diseases : an official publication of the Infectious Diseases Society of America</title><idno type="eISSN">1537-6591</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>The Bacille Calmette-Guérin (BCG) tuberculosis vaccine has immunity benefits against respiratory infections. Accordingly, it has been hypothesized to have a protective effect against COVID-19. Recent research found that countries with universal BCG childhood vaccination policies tend to be less affected by the COVID-19 pandemic. However, such ecological studies are biased by numerous confounders. Instead, this paper takes advantage of a rare nationwide natural experiment that took place in Sweden in 1975, where discontinuation of newborns BCG vaccination led to a dramatic fall of the BCG coverage rate, thus allowing us to estimate the BCG's effect without the biases associated with cross-country comparisons.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>Numbers of COVID-19 cases and hospitalizations were recorded for birth cohorts born just before and just after 1975, representing 1,026,304 and 1,018,544 individuals, respectively. We used regression discontinuity to assess the effect of BCG vaccination on Covid-19 related outcomes. This method used on such a large population allows for a high precision that would be hard to achieve using a randomized controlled trial.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>The odds ratio for Covid-19 cases and Covid-19 related hospitalizations were 1·0005 (CI95: [0·8130-1·1881]) and 1·2046 (CI95: [0·7532-1·6560]), allowing us to reject fairly modest effects of universal BCG vaccination. We can reject with 95% confidence that universal BCG vaccination reduces the number of cases by 19% and the number of hospitalizations by 25%.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>While the effect of a recent vaccination must be evaluated, we provide strong evidence that receiving the BCG vaccine at birth does not have a protective effect against COVID-19 among middle-aged individuals.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">32829400</PMID><DateRevised><Year>2020</Year><Month>09</Month><Day>22</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1537-6591</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Aug</Month><Day>23</Day></PubDate></JournalIssue><Title>Clinical infectious diseases : an official publication of the Infectious Diseases Society of America</Title><ISOAbbreviation>Clin. Infect. Dis.</ISOAbbreviation></Journal><ArticleTitle>BCG vaccination in infancy does not protect against COVID-19. Evidence from a natural experiment in Sweden.</ArticleTitle><ELocationID EIdType="pii" ValidYN="Y">ciaa1223</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1093/cid/ciaa1223</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">The Bacille Calmette-Guérin (BCG) tuberculosis vaccine has immunity benefits against respiratory infections. Accordingly, it has been hypothesized to have a protective effect against COVID-19. Recent research found that countries with universal BCG childhood vaccination policies tend to be less affected by the COVID-19 pandemic. However, such ecological studies are biased by numerous confounders. Instead, this paper takes advantage of a rare nationwide natural experiment that took place in Sweden in 1975, where discontinuation of newborns BCG vaccination led to a dramatic fall of the BCG coverage rate, thus allowing us to estimate the BCG's effect without the biases associated with cross-country comparisons.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Numbers of COVID-19 cases and hospitalizations were recorded for birth cohorts born just before and just after 1975, representing 1,026,304 and 1,018,544 individuals, respectively. We used regression discontinuity to assess the effect of BCG vaccination on Covid-19 related outcomes. This method used on such a large population allows for a high precision that would be hard to achieve using a randomized controlled trial.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">The odds ratio for Covid-19 cases and Covid-19 related hospitalizations were 1·0005 (CI95: [0·8130-1·1881]) and 1·2046 (CI95: [0·7532-1·6560]), allowing us to reject fairly modest effects of universal BCG vaccination. We can reject with 95% confidence that universal BCG vaccination reduces the number of cases by 19% and the number of hospitalizations by 25%.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">While the effect of a recent vaccination must be evaluated, we provide strong evidence that receiving the BCG vaccine at birth does not have a protective effect against COVID-19 among middle-aged individuals.</AbstractText><CopyrightInformation>© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>de Chaisemartin</LastName><ForeName>Clément</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Economics, University of California, Santa Barbara, Santa Barbara, CA 93106, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>de Chaisemartin</LastName><ForeName>Luc</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Immunology Department, APHP.Nord-Université de Paris, Bichat Hospital, Paris, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Université Paris-Saclay, Inserm, "Inflammation, microbiome, immunosurveillance", Châtenay-Malabry, France.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>08</Month><Day>23</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Clin Infect Dis</MedlineTA><NlmUniqueID>9203213</NlmUniqueID><ISSNLinking>1058-4838</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">BCG</Keyword><Keyword MajorTopicYN="N">Covid-19</Keyword><Keyword MajorTopicYN="N">Regression discontinuity</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>06</Month><Day>30</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>8</Month><Day>24</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>8</Month><Day>24</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>8</Month><Day>24</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>aheadofprint</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32829400</ArticleId><ArticleId IdType="pii">5896039</ArticleId><ArticleId IdType="doi">10.1093/cid/ciaa1223</ArticleId><ArticleId IdType="pmc">PMC7499491</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>France</li><li>États-Unis</li></country><region><li>Californie</li><li>Île-de-France</li></region><settlement><li>Paris</li></settlement></list><tree><country name="États-Unis"><region name="Californie"><name sortKey="De Chaisemartin, Clement" sort="De Chaisemartin, Clement" uniqKey="De Chaisemartin C" first="Clément" last="De Chaisemartin">Clément De Chaisemartin</name></region></country><country name="France"><region name="Île-de-France"><name sortKey="De Chaisemartin, Luc" sort="De Chaisemartin, Luc" uniqKey="De Chaisemartin L" first="Luc" last="De Chaisemartin">Luc De Chaisemartin</name></region><name sortKey="De Chaisemartin, Luc" sort="De Chaisemartin, Luc" uniqKey="De Chaisemartin L" first="Luc" last="De Chaisemartin">Luc De Chaisemartin</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Sante/explor/CovidFranceV1/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 001639 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 001639 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Sante
|area= CovidFranceV1
|flux= Main
|étape= Exploration
|type= RBID
|clé= pubmed:32829400
|texte= BCG vaccination in infancy does not protect against COVID-19. Evidence from a natural experiment in Sweden.
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Exploration/RBID.i -Sk "pubmed:32829400" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd \
| NlmPubMed2Wicri -a CovidFranceV1
| This area was generated with Dilib version V0.6.37. |  |