Cell Reports Medicine (Aug 2020)
Safety and COVID-19 Symptoms in Individuals Recently Vaccinated with BCG: a Retrospective Cohort Study
- Simone J.C.F.M. Moorlag,
- Rosanne C. van Deuren,
- Cornelis H. van Werkhoven,
- Martin Jaeger,
- Priya Debisarun,
- Esther Taks,
- Vera P. Mourits,
- Valerie A.C.M. Koeken,
- L. Charlotte J. de Bree,
- Thijs ten Doesschate,
- Maartje C. Cleophas,
- Sanne Smeekens,
- Marije Oosting,
- Frank L. van de Veerdonk,
- Leo A.B. Joosten,
- Jaap ten Oever,
- Jos W.M. van der Meer,
- Nigel Curtis,
- Peter Aaby,
- Christine Stabell-Benn,
- Evangelos J. Giamarellos-Bourboulis,
- Marc Bonten,
- Reinout van Crevel,
- Mihai G. Netea
Affiliations
- Simone J.C.F.M. Moorlag
- Department of Internal Medicine and Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, the Netherlands
- Rosanne C. van Deuren
- Department of Internal Medicine and Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, the Netherlands; Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
- Cornelis H. van Werkhoven
- The Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Martin Jaeger
- Department of Internal Medicine and Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, the Netherlands
- Priya Debisarun
- Department of Internal Medicine and Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, the Netherlands
- Esther Taks
- Department of Internal Medicine and Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, the Netherlands
- Vera P. Mourits
- Department of Internal Medicine and Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, the Netherlands
- Valerie A.C.M. Koeken
- Department of Internal Medicine and Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, the Netherlands
- L. Charlotte J. de Bree
- Department of Internal Medicine and Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, the Netherlands; Danish Institute for Advanced Study, University of Southern Denmark, Denmark; OPEN, Institute of Clinical Research, University of Southern Denmark/Odense University Hospital, Odense, Denmark
- Thijs ten Doesschate
- The Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Maartje C. Cleophas
- Department of Internal Medicine and Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, the Netherlands
- Sanne Smeekens
- Department of Internal Medicine and Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, the Netherlands
- Marije Oosting
- Department of Internal Medicine and Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, the Netherlands
- Frank L. van de Veerdonk
- Department of Internal Medicine and Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, the Netherlands
- Leo A.B. Joosten
- Department of Internal Medicine and Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, the Netherlands
- Jaap ten Oever
- Department of Internal Medicine and Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, the Netherlands
- Jos W.M. van der Meer
- Department of Internal Medicine and Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, the Netherlands
- Nigel Curtis
- Department of Paediatrics, The University of Melbourne; and Murdoch Children’s Research Institute, Royal Children’s Hospital Melbourne, Parkville, VIC 3052, Australia
- Peter Aaby
- Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau
- Christine Stabell-Benn
- Danish Institute for Advanced Study, University of Southern Denmark, Denmark; OPEN, Institute of Clinical Research, University of Southern Denmark/Odense University Hospital, Odense, Denmark
- Evangelos J. Giamarellos-Bourboulis
- 4th Department of Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece; 4th Department of Internal Medicine, ATTIKON University Hospital, Athens, Greece
- Marc Bonten
- Department of Medical Microbiology, The Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Reinout van Crevel
- Department of Internal Medicine and Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, the Netherlands
- Mihai G. Netea
- Department of Internal Medicine and Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, the Netherlands; Immunology and Metabolism, Life and Medical Sciences Institute (LIMES), University of Bonn, Bonn, Germany; Corresponding author
- Journal volume & issue
-
Vol. 1,
no. 5
p. 100073
Abstract
Summary: Bacille Calmette-Guérin (BCG) induces long-term boosting of innate immunity, termed trained immunity, and decreases susceptibility to respiratory tract infections. BCG vaccination trials for reducing SARS-CoV-2 infection are underway, but concerns have been raised regarding the potential harm of strong innate immune responses. To investigate the safety of BCG vaccination, we retrospectively assessed coronavirus disease 2019 (COVID-19) and related symptoms in three cohorts of healthy volunteers who either received BCG in the last 5 years or did not. BCG vaccination is not associated with increased incidence of symptoms during the COVID-19 outbreak in the Netherlands. Our data suggest that BCG vaccination might be associated with a decrease in the incidence of sickness during the COVID-19 pandemic (adjusted odds ratio [AOR] 0.58, p < 0.05), and lower incidence of extreme fatigue. In conclusion, recent BCG vaccination is safe, and large randomized trials are needed to reveal if BCG reduces the incidence and/or severity of SARS-CoV-2 infection.
