Koster Kent J, Webb Hilary L, Cirillo Jeffrey D
Department of Microbial Pathogenesis and Immunology, College of Medicine, Texas A&M University, 8447 Riverside Pkwy, Bryan, TX 77807, USA.
Microorganisms. 2021 Oct 9;9(10):2120. doi: 10.3390/microorganisms9102120.
Bacille Calmette-Guérin (BCG) vaccination, widely used throughout the world to protect against infant tuberculous meningitis and miliary tuberculosis (TB), can provide broad non-specific protection against infectious respiratory diseases in certain groups. Interest in BCG has seen a resurgence within the scientific community as the mechanisms for non-specific protection have begun to be elucidated. The impact of the COVID-19 pandemic on nearly every aspect of society has profoundly illustrated the pressure that respiratory infections can place on a national healthcare system, further renewing interest in BCG vaccination as a public health policy to reduce the burden of those illnesses. However, the United States does not recommend BCG vaccination due to its variable effectiveness against adult TB, the relatively low risk of infection in most of the United States, and the vaccine's interference with tuberculin skin test reactivity that complicates TB screening. In this review, we explore the broad immune training effects of BCG vaccination and literature on the effects of BCG vaccination on COVID-19 spread, disease severity, and mortality. We further discuss barriers to scheduled BCG vaccination in the United States and how those barriers could potentially be overcome.
卡介苗（BCG）接种在全球广泛用于预防婴儿结核性脑膜炎和粟粒性肺结核，在某些人群中可提供针对传染性呼吸道疾病的广泛非特异性保护。随着非特异性保护机制开始得到阐明，科学界对卡介苗的兴趣再度兴起。新冠疫情对社会几乎各个方面的影响深刻说明了呼吸道感染给国家医疗系统带来的压力，这进一步激发了人们对将卡介苗接种作为一项公共卫生政策以减轻这些疾病负担的兴趣。然而，由于卡介苗对成人肺结核的有效性存在差异、美国大部分地区感染风险相对较低以及该疫苗会干扰结核菌素皮肤试验反应性从而使结核病筛查变得复杂，美国不建议接种卡介苗。在本综述中，我们探讨了卡介苗接种的广泛免疫训练效果以及关于卡介苗接种对新冠病毒传播、疾病严重程度和死亡率影响的文献。我们还进一步讨论了美国常规卡介苗接种的障碍以及如何有可能克服这些障碍。
