COVID-19 Severity and Neonatal BCG Vaccination among Young Population in Taiwan

• Published in: International journal of environmental research and public health 2021-04, Vol.18 (8), p.4303
• Main Authors: Su, Wei-Ju, Chang, Chia-Hsuin, Wang, Jiun-Ling, Chen, Shu-Fong, Yang, Chin-Hui
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age groups; Asymptomatic; BCG Vaccine; Birth; Child; Child, Preschool; Communication; Coronaviruses; COVID-19; COVID-19 diagnostic tests; COVID-19 vaccines; Disease control; Electronic records; Epidemics; Fatalities; Humans; Immunization; Infant, Newborn; Infections; Morbidity; Mortality; Neonates; Pandemics; Patients; Pneumonia; Population; Respiratory distress syndrome; SARS-CoV-2; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Taiwan - epidemiology; Tuberculosis; Vaccination; Vaccines; Viral infections; Young Adult
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph18084303

Data have not been reported to explore the relation between COVID-19 severity and BCG vaccination status at the individual patient level. Taiwan has a nationwide neonatal BCG vaccination program that was launched in 1965. The Taiwan Centers for Disease Control established a web-based National Immunization Information System (NISS) in 2003 and included all citizens' BCG vaccination records in NISS for those born after 1985. We identified COVID-19 Taiwanese patients born after 1985 between 21 January and 19 March 2021. Study participants were further classified into ages 4-24 years (birth year 1996-2016) and 25-33 years (birth year 1986-1995). We described their clinical syndrome defined by the World Health Organization and examined the relation between the COVID-19 severity and BCG vaccination status. In the 4-24 age group, among 138 BCG vaccinated individuals, 80.4% were asymptomatic or had mild disease, while 17.4% had moderate disease, 1.5% had severe disease, and 0.7% had acute respiratory distress syndrome but none of them died. In contrast, all 6 BCG unvaccinated individuals in this age group experienced mild illness. In the 25-33 age group, moderate disease occurred in 14.2% and severe disease occurred in 0.9% of the 106 patients without neonatal BCG vaccination records, as compared to 19.2% had moderate disease and none had severe or critical disease of the 78 patients with neonatal BCG vaccination records. Our finding indicated that BCG immunization might not relate to COVID-19 severity in the young population.