French Racists, COVID-19 and the BCG vaccine
By Nana Dadzie Ghansah

As COVID-19 broke out in China and began its inexorable spread worldwide, epidemiologists noticed the paucity of cases in places like India and countries in the southern hemisphere like Brazil. They also compared mortality in a country like Japan with what was going on in Italy, Spain and later the US.

In a paper by titled “Correlation between universal BCG vaccination policy and reduced morbidity and mortality for COVID-19: an epidemiological study”, Aaron Miler and his group hit upon a possible cause for this:
The Bacillus Calmette-Guérin (BCG) vaccine used to prevent tuberculosis.
In a paper great on correlation but sparse in causality, they make the claim that COVID-19 is not that severe in countries with active BCG vaccination schedules.
Researchers in Australia and the Netherlands had also come to the same conclusion and are even planing a trial of the vaccine in healthcare workers.

So what is the BCG vaccine?
It was found by two French bacteriologists – Albert Calmette and Camille Guérin – and went into use in 1921. Tuberculosis is caused by the pathogen Mycobacterium tuberculosis. The two men working together found that an attenuated version of another Mycobacterium, M. bovis, when injected into mice caused antibodies to be produced that were protective against M. tuberculosis.
The vaccine gained popularity and has been in use since then. It is one of the vaccines newborns are given. However, there are several countries, mostly in the northern hemisphere, which do not use the vaccine. This is because they believe that the incidence of tuberculosis in their countries is low and the treatments available for the disease are quite effective.

Now as the use of the vaccine went on, doctors started making an interesting observation. They realized that children who got the vaccine did not seem to get other infectious diseases as much. In Guinea-Bissau in West Africa, observational studies showed BCG-vaccinated kids had a 30-50% less mortality from other infectious diseases up to age 2. In Uganda, it was up to age 5. Similar effects were noticed in India.
It turns out that there were real physiologic changes behind these observations. The BCG vaccine induced changes in the innate immune system (too complex to even bother with) that made these vaccinated kids fight off other pathogens better. The phenomenon came to be known as “Trained Immunity”.
It was also noted that vaccines for the poxes – small and chicken – had similar effects.
This effect was also noted in adults who got the vaccine.

However, where treatment options are concerned, there is a real danger in finding a correlation between a treatment option and the disease when the cause of this correlation may be totally attributable to chance! It makes people take things for granted and not do the things that are protective and really help to stop the spread.

The Miller paper shows a correlation but it fails at showing a causality. As we are all finding out, the number of infected patients depends on how many tests a country does. Also, the case fatality rate is closely related to how effective the flatten-the-curve measures are. Countries like Spain, the US, and Italy do not use the vaccine or have stopped using the vaccine but they also implemented flatten-the-curve measures late or non-uniformly and have not tested extensively. Germany stopped using the vaccine in 1975 but has a rather low COVID-19 case fatality rate.
Travel in and out of these countries could also be important.

As noted earlier, the BCG vaccine does induce “trained immunity” in children and adults who get the vaccine. The problem is no one is sure of how long it lasts. Protection from BCG against TB is rated to last anywhere from 10-20 years so maybe “trained immunity” lasts that long too.
That would mean that the only ones with protection are those who received the vaccine after 2000 or so. It might not last forever because like the study noted:
“Interestingly, there was no significant correlation (r=0.21, p=0.27) between the year that vaccination started and the total number of COVID-19 cases, suggesting that early vaccination of the elderly population was not a factor in reducing the number of cases.”

Also, there is no clear indication of the pathogens it is protective against. BCG is still used extensively in Africa but it did not seem to have helped much against the HIV virus.
The efficacy of the vaccine itself is very variable. It has been shown to be dependent on the strain of Mycobacterium bovis used, genetics of the population and concomitant non-tuberculous mycobacterial and parasitic infections in a population. It has been found to range from 19-50%, with the vaccines and strains used in the West being much better than those in the southern hemisphere. So the induced “trained immunity” might not be homogenous.

Maybe, the vaccine may be protective against SARS-CoV-2. The vaccine trials in Australia and the Netherlands will tell us. However, I beg anyone who had the vaccine in the past and thinks it may be protective because of the Miller study to be really careful and not take chances.

Which brings me to French men, who in discussing the BCG trials yesterday on a French TV channel, brought up Africans as possible unwitting lab rats in the study.
(The videos of their distasteful exchange are all over social media).
I will like to remind those two French doctors – Camille Locht, head of research at the Inserm health research group, and Jean-Paul Mira, head of intensive care at Cochin hospital in Paris – that studying the BCG vaccine in Africa as a way to combat COVID-19 will be challenging since millions on the continent already had the vaccine. Unless they plan to inject Africans with the live SARS-CoV-2 virus and watch how many of them die, it would be difficult to control such a study.
Moreover, I think it is because of idiots like them and their racists and colonialistic views that anti-vaxxers and conspiracy theorists make the work of public health officials on the continent so difficult.
May people like them soon be a thing of the past but unfortunately, I know that is wishful thinking.

Stay safe y’all!