Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19/immunology , COVID-19/prevention & control , Immunization, Secondary/methods , Immunocompromised Host , Immunosuppressive Agents/adverse effects , Inflammatory Bowel Diseases/immunology , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/complications , Child , Humans , Immunization Schedule , Immunization, Secondary/standards , Immunosuppressive Agents/therapeutic use , Inflammatory Bowel Diseases/complications , Inflammatory Bowel Diseases/drug therapy , Middle Aged , Practice Guidelines as Topic , United Kingdom , Young AdultSubject(s)
COVID-19/prevention & control , Health Personnel/legislation & jurisprudence , Mandatory Programs/legislation & jurisprudence , State Medicine/legislation & jurisprudence , Vaccination/legislation & jurisprudence , Attitude of Health Personnel , COVID-19/epidemiology , COVID-19/virology , England/epidemiology , Health Personnel/standards , Humans , Immunization, Secondary/standards , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Mandatory Programs/standards , Pandemics/prevention & control , SARS-CoV-2/pathogenicity , State Medicine/standards , Vaccination/standardsSubject(s)
COVID-19 Vaccines/standards , COVID-19/prevention & control , Health Personnel/statistics & numerical data , Immunization, Secondary/standards , Adult , Aged , BNT162 Vaccine/immunology , COVID-19/immunology , COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/immunology , Global Health , Humans , Middle Aged , SARS-CoV-2/immunology , Vaccination/legislation & jurisprudence , Vaccination/standardsSubject(s)
COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , Evidence-Based Medicine/standards , Immunization, Secondary/standards , SARS-CoV-2/pathogenicity , COVID-19/epidemiology , COVID-19/immunology , COVID-19/virology , COVID-19 Vaccines/adverse effects , COVID-19 Vaccines/immunology , Evidence-Based Medicine/methods , Evidence-Based Medicine/statistics & numerical data , Humans , Immunity , Immunization, Secondary/methods , Immunization, Secondary/statistics & numerical data , Immunogenicity, Vaccine , Observational Studies as Topic , Pandemics/prevention & control , Randomized Controlled Trials as Topic , SARS-CoV-2/immunology , Treatment OutcomeABSTRACT
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.