Cedars-Sinai Research: Century-Old Vaccine May Be Useful Against COVID-19 Coronavirus

Administering Vaccine

A widely administered tuberculosis vaccine is linked to a decreased likelihood of contracting COVID-19. This suggests that an FDA-approved vaccine could potentially prevent coronavirus infections or lessen disease severity.

TB Vaccine Linked to Lower Risk of Contracting COVID-19

A widely used tuberculosis vaccine is associated with reduced likelihood of contracting COVID-19 (coronavirus), according to a new study by Cedars-Sinai. The findings raise the possibility that a vaccine already approved by the U.S. Food and Drug Administration may help prevent coronavirus infections or reduce the severity of the disease.

The vaccine, known as Bacillus Calmette-Guérin (BCG), was developed between 1908 and 1921 and is administered to more than 100 million children around the world every year. In the U.S., it is FDA-approved as a drug to treat bladder cancer and as a vaccine for people at high risk of contracting TB. The BCG vaccine is currently being tested in multiple clinical trials worldwide for effectiveness against COVID-19.

In the new study, published online on November 19, 2020, in The Journal of Clinical Investigation, investigators tested the blood of more than 6,000 healthcare workers in the Cedars-Sinai Health System for evidence of antibodies to SARS-CoV-2, the virus that causes COVID-19, and also asked them about their medical and vaccination histories.

They found that workers who had received BCG vaccinations in the past-nearly 30% of those studied-were significantly less likely to test positive for SARS-CoV-2 antibodies in their blood or to report having had infections with coronavirus or coronavirus-associated symptoms over the prior six months than those who had not received BCG. These effects were not related to whether workers had received meningococcal, pneumococcal, or influenza vaccinations.

The reasons for the lower SARS-CoV-2 antibody levels in the BCG group were not clear, according to Moshe Arditi, MD, director of the Pediatric and Infectious Diseases and Immunology Division at Cedars-Sinai and co-senior author of the study.

“It appears that BCG-vaccinated individuals either may have been less sick and therefore produced fewer anti-SARS-CoV-2 antibodies, or they may have mounted a more efficient cellular immune response against the virus,” said Arditi, professor of Pediatrics and Biomedical Sciences. “We were interested in studying the BCG vaccine because it has long been known to have a general protective effect against a range of bacterial and viral diseases other than TB, including neonatal sepsis and respiratory infections.”

In the new study, the lower antibody levels in the BCG group persisted despite the fact that these individuals had higher frequencies of hypertension, diabetes, cardiovascular diseases, and COPD, which are known risk factors for being more susceptible to SARS-CoV-2 and developing the more severe forms of COVID-19 illness.

While noting that no one believes BCG will be more effective than a specific vaccine for COVID-19, Arditi explained that it could be more quickly approved and made available, given that it has a strong safety profile demonstrated by many years of use. “It is a potentially important bridge that could offer some benefit until we have the most effective and safe COVID-19 vaccines made widely available,” he said.

“Given our findings, we believe that large, randomized clinical trials are urgently needed to confirm whether BCG vaccination can induce a protective effect against SARS-CoV2 infection,” said Susan Cheng, MD, MPH, MMSc, associate professor of Cardiology and director of Public Health Research at the Smidt Heart Institute at Cedars-Sinai. She was the other co-senior author of the study. The first author was Magali Noval Rivas, PhD, assistant professor of Pediatrics at Cedars-Sinai.

In fact, a number of randomized clinical trials have been launched to study the potential protective effects of BCG vaccination against COVID-19. Along with Texas A&M University, Baylor College of Medicine, and the University of Texas MD Anderson Cancer Center, Cedars Sinai is a site for the U.S. arm of this ongoing trial, which is recruiting hundreds of healthcare workers. Arditi serves as the principal investigator of this clinical trial at Cedars-Sinai.

“It would it be wonderful if one of the oldest vaccines that we have could help defeat the world’s newest pandemic,” Arditi said.

Reference: “BCG vaccination history associates with decreased SARS-CoV-2 seroprevalence across a diverse cohort of healthcare workers” by Magali Noval Rivas, Joseph E. Ebinger, Min Wu, Nancy Sun, Jonathan Braun, Kimia Sobhani, Jennifer E. Van Eyk, Susan Cheng and Moshe Arditi, 19 November 2020, The Journal of Clinical Investigation.
DOI: 10.1172/JCI145157

Funding: Research reported in this publication was supported by Cedars Sinai, the National Cancer Institute of the National Institutes of Health under award number U54 CA26059 and the Erika J. Glazer Family Foundation.

2 Comments on "Cedars-Sinai Research: Century-Old Vaccine May Be Useful Against COVID-19 Coronavirus"

  1. Is this rampart bureaucracy at work or what?
    • The BCG vaccine is safe
    • The BCG vaccine is probably inexpensive since it has been out of patent for > 100 years
    • The BCG vaccine has shown some efficacy (“significantly less likely” some numbers should have been reported)
    • A lot of people will contract Covid-19 within the next six months
    • It is unlikely that a Covid-19 specific vaccine will be widely available within six months
    • Off label usage is quite common and accepted
    • BCG supplies and distribution infrastructure is already in place

    Given these facts (and assumptions about cost and distribution), why not promote widespread inoculation with BCG?

    There is a short window of opportunity here. To wait for “large, randomized clinical trials” of BCG that won’t be complete for over six months seems stupid and asinine. By the time a BCG study is complete Covid-19 specific vaccines with 90+% efficacy should be widely available and the use of BCG irrelevant. But during this window, assuming BCG does in fact have some efficacy, needless suffering and deaths could be prevented by widespread use of BCG. If it turns out that BCG did not have significant efficacy nothing much would have been lost. In other words, to quote an off used phrase: “It couldn’t hurt”. In either case, it would accomplish the goal of a clinical BCG efficacy study.

  2. BCG likely protects against Covid by triggering the production of anti-viral nitric oxide… https://www.medpagetoday.com/infectiousdisease/covid19/86410

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