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Association between live childhood vaccines and COVID-19 outcomes: a national-level analysis
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Association between live childhood vaccines and COVID-19 outcomes: a national-level analysis
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Association between live childhood vaccines and COVID-19 outcomes: a national-level analysis
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Journal Article
Association between live childhood vaccines and COVID-19 outcomes: a national-level analysis
2021
Overview
We investigated whether countries with higher coverage of childhood live vaccines [BCG or measles-containing-vaccine (MCV)] have reduced risk of coronavirus disease 2019 (COVID-19)-related mortality, while accounting for known systems differences between countries. In this ecological study of 140 countries using publicly available national-level data, higher vaccine coverage, representing estimated proportion of people vaccinated during the last 14 years, was associated with lower COVID-19 deaths. The associations attenuated for both vaccine variables, and MCV coverage became no longer significant once adjusted for published estimates of the Healthcare access and quality index (HAQI), a validated summary score of healthcare quality indicators. The magnitude of association between BCG coverage and COVID-19 death rate varied according to HAQI, and MCV coverage had little effect on the association between BCG and COVID-19 deaths. While there are associations between live vaccine coverage and COVID-19 outcomes, the vaccine coverage variables themselves were strongly correlated with COVID-19 testing rate, HAQI and life expectancy. This suggests that the population-level associations may be further confounded by differences in structural health systems and policies. Cluster randomised studies of booster vaccines would be ideal to evaluate the efficacy of trained immunity in preventing COVID-19 infections and mortality in vaccinated populations and on community transmission.
Publisher
Cambridge University Press
Subject
BCG Vaccine - administration & dosage
/ Children
/ COVID-19
/ COVID-19 - prevention & control
/ Delivery of Health Care - standards
/ Delivery of Health Care - statistics & numerical data
/ Humans
/ Immunity, Innate - immunology
/ Immunization, Secondary - standards
/ Immunization, Secondary - statistics & numerical data
/ Measles
/ Measles Vaccine - administration & dosage
/ Measles Vaccine - immunology
/ Quality of Health Care - standards
/ Quality of Health Care - statistics & numerical data
/ Severe acute respiratory syndrome coronavirus 2
/ Vaccination Coverage - statistics & numerical data
/ Vaccines
