key: cord-0682042-r926vume
authors: Senoo, Yuki; Suzuki, Yosuke; Tsuda, Kenji; Takahashi, Kenzo; Tanimoto, Tetsuya
title: Prioritizing infants in a time of Bacille Calmette–Guérin vaccine shortage caused by premature expectations against COVID-19
date: 2020-05-22
journal: QJM
DOI: 10.1093/qjmed/hcaa179
sha: e92330e1fd9dd0f74bc79fe605ec316ba1b12b75
doc_id: 682042
cord_uid: r926vume

nan

The coronavirus disease 2019 (COVID-19) pandemic has accelerated a worldwide shortage not only of diagnostic test kits but also of essential drugs and vaccines. 1 The consequences of such shortage are particularly complicated in case of Bacille Calmette-Guérin vaccine (BCGV). Following the recent publication of new clinical trials conducted on the efficacy of BCGV against COVID-19, 2, 3, 4 the expectation of the potential protective effect of BCGV against COVID-19 has immediately spread through countries via numerous news media, researchers, and non-experts.

In response to the widespread media coverage on BCGV, although the administration of BCGV to prevent COVID-19 has not yet been approved due to a lack of evidence, several hospitals and clinics in Japan have encountered people who expected the preventive efficacy of COVID-19, causing a shortage of BCGV. As a result, Japan BCG Laboratory, the exclusive supplier of BCGV in Japan, rapidly increased their shipment volume of BCGV. 5 Worse still, reports have stated that incorrect routes of BCGV administration caused adverse health effects in immature medical institutions. 6 Taken into context, several professional medical societies in Japan as well as the World Health Organization have expressed concern regarding the off-label use of BCGV and alerted clinicians to discontinue BCGV inoculation against COVID-19.

Evidence of new therapeutic targets should be confirmed first before wide implementation of BCGV against the pandemic. Until then, the supply of BCGV should be prioritized for its approved use with known benefits and side effects, namely the prevention of tuberculous meningitis and miliary tuberculosis in infants. 7 

Fewer coronavirus deaths seen in countries that mandate tuberculosis vaccine

Request on BCG vaccine administration

Tuberculosis vaccine drawing attention in fight against coronavirus

Effect of BCG vaccination on childhood tuberculous meningitis and miliary tuberculosis worldwide: a meta-analysis and assessment of cost-effectiveness