If I were North American/West European/Australian, I will take BCG vaccination now against the novel coronavirus pandemic.

If I were North American/West European/Australian, I will take BCG vaccination now against the novel coronavirus pandemic.


If I were North American/West European/Australian, I will take BCG vaccination now against the novel coronavirus pandemic.

I am not a medical expert and this is just a hypothesis; taking BCG vaccination may strengthen immune to the novel coronavirus. If I were American/West European/Australian, I will take BCG vaccination now. Five reasons follow.

1) Scientists started to work on this hypothesis

Can a century-old TB vaccine steel the immune system against the new coronavirus?

The Max Planck Institute (the best German science institution with 33 Novel Prize winners that developed BCG vaccine a century ago)
Immune boost against the coronavirus

Some countries, the U.S. and Australia will start a trial to give BCG vaccine to healthcare workers.

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.

A: The country currently has universal BCG vaccination program.*
B: The country used to recommend BCG vaccination for everyone, but currently does not.

The year the country stopped it; Spain 1981, Germany 1998, UK and France 2005-2007 etc.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3062527/

C: The country never had universal BCG vaccination programs.
*In Portugal the BCG vaccine was mandatory from 1965 to 2017. https://twitter.com/ruipalma79/status/1243304538469273600
The major correlations are;
  • 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.

In Latin America, Ecuador is the only country that never had universal BCG vaccination programs and all the other countries have universal BCG vaccination programs. Total deaths per million, Ecuador: 2, Colombia: 0.08, Peru: 0.3, Brazil: 0.3.

(Added on 29 Mar)
A reader told me there is an article (not yet certifed by peer review)
https://www.medrxiv.org/content/10.1101/2020.03.24.20042937v1

The article has this chart. I believe if we can adjust for the timing of coronavirus spread, the correlation would be even higher.

* 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.

** 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 low BCG vaccination rate, which may result in high death rate than the other western Europe, but probably better than Spain.

3) There are several strains of BCG vaccination and Soviet/Japan/Brazil 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.

https://www.japantimes.co.jp/opinion/2020/03/21/commentary/japan-commentary/japan-still-coronavirus-outlier/#comment-4843977551
* 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.

Soviet/Japan strains of BCG vaccination are old-type and similar while Western European stains are recent and different.

Below is a map of German states with confirmed coronavirus cases. You can see the difference between ex-East Germany and ex-West Germany. The density of the population doesn’t explain this much difference. East Germany had used the Soviet strain of BCG vaccination and West Germany had used the Western Europe strain of BCG vaccination and stopped its mandatory vaccination in 1998. The vaccination strains/policies may be the cause of the difference.

Then, look at the number of deaths by state. Summing up by ex-West Germany and ex-East Germany (excluding Berlin), the number of deaths per 100K of ex-West Germany states is 0.35 while ex-East Germany is 0.11 and Berlin is in between; 0.21 (as of 27 Mar).

I obtained a map showing which strains are used in each country though this map maybe not perfectly correct.

https://twitter.com/io302/status/1243441971709894657
https://twitter.com/io302/status/1243441971709894657/photo/1

High-level impression; BCG Brazil, BCG Russia/Bulgaria, BCG Japan countries may immune to novel coronavirus. Countries that use more than one BCG vaccine strain look immune, too. BCG Brazil, BCG Russia/Bulgaria, BCG Japan are categorized in “I” and this may be the effective strain category.

Then, I looked into how BCG strains are categorized. I found the chart below. BCG Russia/Japan/Moreau(Brazil) are the first generation of the BCG vaccines.

In the same article, there is a table that shows the differences in each strain character. Though I don’t understand any jargon in the first row, I can see there is quite a difference between BCG Tokyo/Moreau(Brazil)/Russia/Sweden and BCG Copenhagen(Denmark)/Glaxo/Pasteur/Tice. BCG Denmark is the common strain among Western Europe.

https://jata.or.jp/rit/rj/tenbo/48toida.pdf
https://twitter.com/xcvbnm67890/status/1243723927907471361

While Iraq uses the Japan strain, Iran uses different strains. According to http://www.bcgatlas.org/ Iran had used its local (original?) BCG vaccine from 1947 to 1984. Please check and compare Iraq and Iran figures. You will be surprised to see how different they are.

https://www.worldometers.info/coronavirus/
(Iran: 27 deaths per million, Iraq: 0.9 deaths per million as of 27 Mar; added)

In Asian countries, China uses a different local produced strain and Korea uses basically BCG Denmark but sometime BCG Japan. Taiwan uses the Japan strain (though the map shows a locally produced strain).

BCG Japan(Tokyo) looks working quite well against the novel coronavirus. 1) Japan, Thailand, Taiwan, and Iraq have used BCG Tokyo and all of them have low death rates though they are close to China or Iran. 2) And so far, it is not reported that any Japanese got severely infected or died in Italy or Western Europe. 3) In Japan, there are 1,349 cases reported, and 934 are Japanese and 415 are non-Japanese. Hmm, quite a high ratio of non-Japanese (as of 28 Mar).
https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/0000164708_00001.html#kokunaihassei

The website below seems to have a lot of information about BCG vaccination though this is not perfect, either.
http://www.bcgatlas.org/
I am afraid that I cannot digest this detailed medical information. Expert explanations will be welcomed.

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. I expected a high speed of spread but the actual speed is low so far (though it’s beginning to explode).
Here in Brisbane or the other Australian capital cities, the normal social distance is much longer than Tokyo and I expected a slower spread. But the speed of spread is faster.
I was wondering about this, and so far this hypothesis may seem to be the most plausible. Maybe ~60% probability.

4) In Japan and Portugal, the deaths come only to the age group without the mandatory BCG vaccine program period. A weak hypothesis.

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/).

In Portugal, the BCG vaccine was mandatory from 1965 to 2017 (https://twitter.com/ruipalma79/status/1243304538469273600), which means between 3 and 55 years old are vaccinated. And it looks deaths happen only to over 50 (as of 27 Mar, https://www.dgs.pt/em-destaque/relatorio-de-situacao-n-024-26032020-pdf.aspx).

Also, as Portugal introduced the mandatory BCG vaccine program very late together with Spain, in 1965, and there should be many elderly who had not BCG vaccinated, I anticipate that the number of deaths per million will be higher than the other Western European countries where BCG vaccination programs were usually imposed in the 1950s. But Portugal should be better than Spain that stopped the program in 1981, though.

However, this hypothesis is weak since the fatality basically skews to the elderly worldwide. I saw some news that the younger generation became severely ill in Western Europe or the U.S. but have never seen that in Japan. More statistics are required to examine this hypothesis.

5) BCG vaccination has a long history and there seems no little downside to human beings.

BCG vaccination may not work but even in that case, there will be little downside.
CDC states the reason it is not recommended in the U.S.

In Japan, all babies since 1951 have BCG vaccination and I have not heard a problem with it.

If I were North American/European/Australian, I will take BCG vaccination now.

(Added on 28 Mar)
I had carefully avoided talking about adult or elderly people to have BCG vaccination again as I don’t know anything about the risk of re-vaccination. But I found a Japanese medical article about re-vaccination to bedridden elderly people published in 2003. BCG re-vaccination significantly reduced the probability of pneumonia.

https://medical.nikkeibp.co.jp/inc/all/hotnews/archives/237265.html

I hope medical experts all over the world examine this. I hear that developing a new vaccine will take two years but the BCG vaccine is already here. BCG Russia/Tokyo/Brazil looks promising. BTW, I used to work at the Tokyo office of Boston Consulting Group, which is called BCG Tokyo 🙂

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