[HTML][HTML] BCG vaccination history associates with decreased SARS-CoV-2 seroprevalence across a diverse cohort of health care workers

MN Rivas, JE Ebinger, M Wu, N Sun… - The Journal of …, 2021 - Am Soc Clin Investig
The Journal of clinical investigation, 2021Am Soc Clin Investig
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has
caused more than 1 million deaths worldwide; thus, there is an urgent need to develop
preventive and therapeutic strategies. The antituberculosis vaccine bacillus Calmette-Guérin
(BCG) demonstrates nonspecific, protective innate immune–boosting effects. Here, we
determined whether a history of BCG vaccination was associated with decreased SARS-
CoV-2 infection and seroconversion in a longitudinal, retrospective observational study of a …
BACKGROUND
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused more than 1 million deaths worldwide; thus, there is an urgent need to develop preventive and therapeutic strategies. The antituberculosis vaccine bacillus Calmette-Guérin (BCG) demonstrates nonspecific, protective innate immune–boosting effects. Here, we determined whether a history of BCG vaccination was associated with decreased SARS-CoV-2 infection and seroconversion in a longitudinal, retrospective observational study of a diverse cohort of health care workers (HCWs).
METHODS
We assessed SARS-CoV-2 seroprevalence and collected medical questionnaires, which included information on BCG vaccination status and preexisting demographic and clinical characteristics, from an observational cohort of HCWs in a multisite Los Angeles health care organization. We used multivariate analysis to determine whether a history of BCG vaccination was associated with decreased rates of SARS-CoV-2 infection and seroconversion.
RESULTS
Of the 6201 HCWs, 29.6% reported a history of BCG vaccination, whereas 68.9% had not received BCG vaccination. Seroprevalence of anti–SARS-CoV-2 IgG as well as the incidence of self-reported clinical symptoms associated with coronavirus disease 2019 (COVID-19) were markedly decreased among HCWs with a history of BCG vaccination compared with those without BCG vaccination. After adjusting for age and sex, we found that a history of BCG vaccination, but not meningococcal, pneumococcal, or influenza vaccination, was associated with decreased SARS-CoV-2 IgG seroconversion.
CONCLUSIONS
A history of BCG vaccination was associated with a decrease in the seroprevalence of anti–SARS-CoV-2 IgG and a lower number of participants who self-reported experiencing COVID-19–related clinical symptoms in this cohort of HCWs. Therefore, large randomized, prospective clinical trials of BCG vaccination are urgently needed to confirm whether BCG vaccination can confer a protective effect against SARS-CoV-2 infection.
The Journal of Clinical Investigation