TechNet-21 - Forum

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  1. Narayana Holla
  2. Immunization information systems & coverage monitoring
  3. Sunday, 06 September 2020

Dear all 

we wish to share the following findings for needful.

India begins study on BCG vaccine impact on Covid-19

 (https://www.hindustantimes.com/india-news/india-begins-study-on-bcg-vaccine-impact-on-covid-19/story-UG70g0qxgu6dp7XWiEVbiN.html)

“Two recently released studies, one in India and the other in US concluded that the inexpensive and widely used BCG vaccine, which protects against childhood tuberculosis, could also prevent severe infection and deaths in some Covid-19 patients”.

Based on the observation that “those who got BCG vaccination, not just in India but in other countries, are more protected than those who were not [vaccinated]…… BCG-mediated immune response would help in lowering both incidence and severity of infection – can be a “hypothesis”.                                  

The Indian Council of Medical Research-National Institute for Research in Tuberculosis (ICMR-NIRT) has initiated a multi-centric study to see if tuberculosis vaccine -- bacille Calmette Guerin (BCG) can reduce the severity of Covid-19 among people aged 60 and above residing in hot spots for SARS-CoV-2, the virus that causes the disease…….

The study will involve around 1,000 healthy volunteers above 60 years of age in six states that have reported a high Covid-19 disease burden so far.

On reading the above people started voluntary BCG vaccination.

But vaccine needs to be “administered properly” in potent condition (VVM in useable stage, correct diluent in correct quantity and temperature, correct dosage, right route – intradermally which yields a wheal of around 10mm with 0.1mL vaccine).  BCG is a live attenuated vaccine, following administration, granulomatous reaction occurs at the site of administration and pass through all six stages from erythema, nodule, pustule, ulcer, crust and a characteristic raised scar formation in 4-6 weeks period in that sequence.

 

The “wheal” of ~10mm on administering 0.1mL of BCG vaccine. Similar “wheal” can be seen on administering 0.1mL Tuberculin reagent, 0.1mL fIPV intradermally. Vaccinator should have the proper skill to administer intradermally; especially in children – administering to adults is comparatively easy.  

 

Induration  of >20mm following vaccination which remained for > a week.

 

                                                    The scar of 3 different vaccinees following 42 days.

We wish to follow the scars for a few more weeks to document the dry scar (see document attached).

If the “Rights” of vaccination are not adhered, immunogenic scar may not develop defeating the objective of vaccination as we are not able to see these stages / scar in the newborns vaccinated in the private sector (vaccine deprived of VVM etc). Hope the study will take care of the proper administration.

The PDF depicting the photos is attached for reference.

Best reading

Holla n Team

 

 

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Narayana Holla Accepted Answer

Dear Dr Bharathi Sir

 

Thanks for the response.

Concern about the quality of vaccination especially in the private sector including medical colleges was intermittently shared with the stakeholders / programme managers by the KVG team [Newborn BCG vaccination yet to be launched in a few pioneer medical college(s)]. Disappointingly we are yet to see any visible action to improve the quality either in the home district / state, other areas we do not have access. 

If time permits and there are no protocol constraints, kindly see at least a few <2yr children who may be visiting your premises for anti-rabies vaccination for the "IMMUNOGENIC" BCG scar proactively.

On "call" KVG team submitted a research proposal for studying the existing practice of BCG vaccination & Tuberculin Skin Test in the home district ~2 years back, we are still  not selected for the study, neither the technical reason for not selecting is communicated till now & hoping for the approval as a "spill over activity" though the financial year ended a year back.

Hope you and your team can throw some more light in this field as an additional centre.

With best regards

KVG Team

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Omesh K. Bharti Accepted Answer

Dear Dr. Narayana Holla, This is a very encouraging news among spreading pandemic and fear among massess.

Giood Luck.

Dr. Omesh BHarti,. Shimla

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