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

• Published in: The Journal of clinical investigation Vol. 131; no. 2; pp. 1 - 11
• Main Authors: Rivas, Magali Noval, Ebinger, Joseph E, Wu, Min, Sun, Nancy, Braun, Jonathan, Sobhani, Kimia, Van Eyk, Jennifer E, Cheng, Susan, Arditi, Moshe
• Format: Journal Article
• Language: English
• Published: United States American Society for Clinical Investigation 19.01.2021
• Subjects: Adult; BCG vaccination; BCG Vaccine - immunology; BCG Vaccine - pharmacology; Biomedical research; Clinical Medicine; Clinical trials; Cohort Studies; Coronaviridae; Coronaviruses; COVID-19; COVID-19 - epidemiology; COVID-19 - immunology; COVID-19 - prevention & control; Disease; Epigenetics; Female; Fever; Health aspects; Health care; Health Personnel; Humans; Immunity, Innate; Immunoglobulin G; Infections; Influenza; Influenza Vaccines - immunology; Influenza Vaccines - pharmacology; Longitudinal Studies; Los Angeles - epidemiology; Male; Medical personnel; Meningococcal Vaccines - immunology; Meningococcal Vaccines - pharmacology; Middle Aged; Multivariate Analysis; Pandemics; Pneumococcal Vaccines - immunology; Pneumococcal Vaccines - pharmacology; Public health; Retrospective Studies; Seroconversion; Seroepidemiologic Studies; Serology; Severe acute respiratory syndrome coronavirus 2; Tuberculosis; Vaccination; Vaccines; Viral infections; Los Angeles; United States; Los Angeles County California; United States > US; COVID-19; Innate immunity; Vaccines
• ISSN: 0021-9738; 1558-8238
• DOI: 10.1172/JCI145157

BACKGROUNDSevere 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).METHODSWe 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.RESULTSOf 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.CONCLUSIONSA 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.