skip to Main Content
BCC_Discussion-Forum-Page-Header-new

IMPORTANT: The Bladder Cancer Canada discussion forum is not a substitute for professional medical advice or treatment. The opinions & contents in this forum is for information only and is not reviewed by medical professionals. They are experiences & opinions of patient members like you, and is NOT intended to represent the best or only approach to a situation. Always consult your physician and do not rely solely on the information in this site when making decisions about your health.

Homepage – Forum Forums Research, Clinical Trials, and New Treatments The verdict is out. BCG vaccine reduces Covid-19 related death by 71%

  • This topic has 14 replies, 3 voices, and was last updated 3 years ago by Tana.
Viewing 15 posts - 1 through 15 (of 15 total)
  • Author
    Posts
  • #39963
    Joe
    Participant

    As we are aware, since  March 2020, several trials have been going to evaluate if the BCG vaccine works for the COVID-19 virus.

    The result was just published today in Nature.

    Conclusion For countries included in our analysis using an a priori, rigid entry criteria, the presence of an active BCG immunization program for the past 15 years and total population are associated with improved COVID-19 specific mortality while the share of the population over 65 years of age is associated with increased CRM. For the included countries BCG15 vaccination programs are associated with a 71% reduction in the risk for CRM independent of population, population density, temperature, share of population above 65 years, and the stringency index of each country. A reduction in CRM was observed in 80% of country clusters for BCG15. This ecological analysis provides the most robust data regarding the association of COVID-19 specific mortality and BCG vaccination programs. These findings suggest that BCG vaccination is one of many potential additions to our armamentarium in the fight to reduce mortality related to COVID-19.

    This is good and also raises some worry.

    The good news is that those who had BCG treatment for bladder cancer may have some benefit.

    The concern  is that there can be an increase in demand for BCG and it may impact the supply of BCG for bladder cancer.

    There was a surge in the demand for BCG vaccine in Japan early this year because of the sudden increase of the order for Intravesical BCG for bladder cancer.  They speculated that some doctors started hoarding Intravesical BCG, which they were going to use for the COVID-19 virus.  The association of the urologists in Japan had stepped in and the BCG manufacturer stopped selling the intravesical BCG to general doctors.   At that time, it was just speculation that BCG would have some efficacy against the COVID-19 virus.  But now BCG is shown to benefit against the COVID-19 virus, those countries who cannot access the vaccines for COVID-19 may opt for the BCG vaccine.  This will not only impact the BCG vaccine for tuberculosis but also BCG for bladder cancer treatment.   For Canadians, we should be okay as MERCK only manufactures BCG for bladder cancer treatment, not for BCG vaccine for tuberculosis.  But, we should be paying attention to BCG demand worldwide because of this published result.  Below is the link to the paper.

    https://www.nature.com/articles/s41598-020-80787-z.epdf?sharing_token=bhOBjxMGq-6Sd9tTHusjitRgN0jAjWel9jnR3ZoTv0MAotRhM7lgLXsQpRod-W3HdKM5X0hK1KjyekbXti9-EL0C86Erpka0FVSwx_ck-_2rLts42f71DVcsZMOcvd1tQFPmot2yw-9UbQV3i6_gdHxAIqLFzNyTYzX-7j4wOLY%3D

    So, it is likely than less likely that bladder cancer patients with BCG treatment get the benefit

     

    #39964
    Jack Moon
    Keymaster

    Thanks for posting Joe.

    All the best

    Jack

    #39966
    Joe
    Participant

    Sorry folks, I might have misunderstood and misinformed.

    The article was not the result of various clinical studies such as  “BCG Vaccine for Health Care Workers as Defense Against COVID 19 (BADAS)”, which is still going on with an estimated primary completion date of May 2021.   The article is not evidence, but rather it is still about the association between BCG vaccine and COVID-19 related death rate.   The evidence data from BADAS should be available in May 2021 time frame.    Having said that well known Dr. Ashish Kamat of MD Anderson in Texas is the authors’ list. MD Anderson is the sponsor for BADAS clinical trial and Dr. Kamat is involved in BADAS clinical trial as a urologist who is familiar with intravesical BCG treatment for bladder cancer.   I thought If the interim result of BADAS trial is so compelling, they would have announced the result early to save the lives of many people by BCG vaccine.  But, there has been no announcement of the interim result.  So, I was thinking that BADAS trial was not showing good efficacy against COVID-19 virus in the clinical trial.  So, when I saw Dr. KAMAT name on the authors’ list, I jumped to the conclusion prematurely that this was also to do with the result of the clinical trials.   My apology.   Stil,  the fact that the paper was published in Nature now, in the midst of the pandemic crisis, and it looks like a well-known business consulting firm McKinsey India was involved in the analysis of data using machine learning (AI) (I have guessed their involvement by seeing several authors are from McKinsey), someone must have thought that the paper has significance in dealing with the current pandemic.

    It looks like the paper was submitted to Nature in June 2020 and accepted in December 2020.

     

    #40835
    Tana
    Participant

    Hi Joe- So its not sure yet the BCG is a bonus against Covid if I’m reading this correctly,

    I do have a question about the vaccines though as to which one is best to get? I have NIMBC TA high. I am one year no recurrence and am on BCG. My next three weeks of the instillation of BCG is in June. I do have a phone appointment next week with my family doctor to ask which she recommends ( but wonder if I should be asking my urologist?) .

    I see that the AstraZeneca is soon to be offered here in B.C. to age group 55-65 but I am wondering whether to wait for the Pfizer or Moderna instead?

    Thanks

    Tana

    #40855
    Joe
    Participant

    Hi Tana,

    That is correct.   We do not have the result from the clinical trials yet.   There are two clinical trials with larger cohorts had started in early 2020. On clinical trial (BADAS) have been recruiting 1,800 healthcare workers in the US.  Another clinical trial (BRACE) has been recruiting 10,000 healthcare workers in Australia, UK, Spain, Brazil, Netherland.  Interestingly, Brazil is the only country that is recruiting participants as of Feb 12, 2021.  It is possible that other countries had paused because of the availability of actual vaccines now.

    In terms of vaccine, according to Dr. Black’s seminar on COVID-19 vaccine on bladder cancer patients, if you keep one week apart between the day of BCG treatment and the date of vaccination, it is fine.   One week apart was decided on him talking with immunologists.   I know some hospitals say two weeks apart as the standard protocol of BCG treatment and other influenza vaccines.

    Which vaccine is the best?   See the attached comparison by BBC.  According to a publication dated March 29 by the Ministry Heath of Ontario Vaccine
    efficacy 14 days after dose one and before dose two is estimated to be over 90% for Pfizer-BioNTech and Moderna and over 70% for AstraZeneca.  When the result of the clinical trials was announced for those three vaccines, I recall for 70+ years old, Pfizer and Moderna were 90%+ but AstraZeneca was 70%.   So, if you can get either Pfizer, Moderna, or AstraZeneca at the same time, Pfizer or Moderna is the choice.  But the situation has changed. The daily cases have been increasing, especially in BC. Today it surpassed over 1,000, the highest since the beginning of the pandemic.  I recall that BC was much better than Ontario and Quebec in terms of daily cases / 100,000.    The population of BC is 5.1 mil and QC is 8.5 m in 2020 or 60%.   Today, the new daily cases were 1,032 in BC and 1,025 in QC.  Recent one-week totals just above 6,000 in BC and QC.  So, the risk of getting COVID-19 /100,000 in BC is now almost 1.7 times that in QC. If you look at the chart, the daily new cases curve in BC is alarming sharply high compared to other provinces.  We don’t know how fast and how high the daily new cases will increase in BC.  Also, considering the risk of getting hospitalized and death of age group 50-64 is 25 times and 440 times respectively compared to the age group of 5-17,  it makes more sense to get vaccinated with AstraZeneca even if their efficacy is a bit lower than Pfizer and Modena.   Furthermore, Dr. Hentry’s recent statement was “We know from the millions of doses used worldwide, and especially in the U.K., it is highly effective and the benefits to those over age 55 far outweigh the very real risks of getting COVID-19″.

     

    “health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html”

    https://healthydebate.ca/2021/03/topic/comparing-vaccines”

    #40857
    Joe
    Participant

    #40861
    Tana
    Participant

    Oh wow- thanks Joe for this information. It seems to make sense to get the First  vaccine that comes up. That’s what my son is encouraging me to do. Thanks for the timing for BCG and vaccine. Looks like if the province has enough vaccines that I should be vaccinated before my instalments of BCG in June.

    Are we classified immune compromised? I was speaking to a lady who has a different cancer and is finished chemo and she’s waiting for a letter from Dr.Bonnie Henry to get her in faster than to wait for her age group. She does not want the Astra Zeneca and wants to wait for Pfizer or Moderna. By the looks of it the age group 55-65 for Astra is now available but I saw on the news all the people in lineups for it. I still haven’t discovered where to register and are we given a time slot? I will look into this. I still would prefer the Pfizer or Moderna so am hoping they come up available.

    Thanks again- I love receiving this information.

    Tana

    #40863
    Joe
    Participant

    Hi Tana,

    AstraZeneca has been on US clinical trial since August 2020 involving about 32,000 US citizens.    About 20,000 people were vaccinated with the vaccine (2 doses) and 10,000 people were injected with saline placebo. The 2nd dose was injected 28 days after the first dose.   Below is the screen shot of CNBC on March 26.    CBC news  stated on March 22, “In a statement, AstraZeneca said its COVID-19 vaccine had a 79 per cent efficacy rate at preventing symptomatic COVID-19 and was 100 per cent effective in stopping severe disease and hospitalization. Investigators said the vaccine was effective across adults of all ages, including older people — which previous studies in other countries had failed to establish.”    AstraZaneca changed the efficacy from 79% to 76% later.      I do not know the number of case2s 190, 8 severe means on CNBC report.   They may be talking about the control group – those people who were injected with saline-placebo.  Astrazeneca did another trial which ended in Februray, involving Brazil, UK and South Africa.  17,177 people were recruted, a half was vaccinated and a half were injected with saline-placebo.  No one from the vaccinated group were hospitalized but 15 people from the blacebo group were hospitalized.

    Anyway, the key point is that AstraZeneca showed 100% protection against people from being hospitalized or death from COVID-19 virus.

     

     

     

    #40868
    Tana
    Participant

    Then that makes me feel safe!

    tThanks Joe- this info is greatly appreciated!

    Tans

    #40870
    Joe
    Participant

    Hi Tana,

    This site has a list of pharmacies for vaccination.

    https://immunizebc.ca/initial-covid-19-vaccines-pharmacies

    best

    #40919
    Joe
    Participant

    Hi Tana,

     

    Chemotherapy makes the patients immuno-compromised

    According to National Cancer Institute (NCI), chemotherapy tends to kill fast-dividing cells, which include cancer cells, intestine cells,  hair follicle cells, and blood cells (red blood cells and white blood cells)  in the bone marrow.  White blood cells include many different immune cells, which include dendritic cells, macrophages, B-cells, and T-cells.  Those immune cells are essential to fight infection.   Because chemotherapy can kill those immune cells in the white blood cells, and make the patient under chemotherapy susceptible to infection including COVID-19 virus infection.  In other words,  chemotherapy treatment makes the patient immuno-compromised during the treatment.    So, to protect the patient from the COVID-19 virus, it seems to make sense for them to receive the vaccine as soon as possible.   The problem is that the clinical trials for the vaccine did not include immune-compromised patients although Pfizer clinical trial included about 100 AID patients. The data for those AIDs patients have not come out yet.  So, we do not know how effective the vaccine will be for immune-compromised yet.  Because the efficacy of the vaccine depends upon how many antibodies and T-cells can produce by the vaccine, which then depends upon how good the patient’s immune system is functioning.

    BC Cancer Agency explains to the patients with chemotherapy for solid-tumor as follows.

    “Doctors and researchers have looked at the evidence. They agree that unless you have a
    very serious allergy to any of the vaccine ingredients, you should strongly consider
    getting a COVID-19 vaccine because you have a higher chance of experiencing severe
    symptoms if you get COVID-19.”

    “If you are on treatment or your treatment needs to start before you can get the vaccine,
    do not delay your cancer treatment. Book your vaccine as soon as you can.
    If you know that you will be scheduled for more than one cancer treatment, for example
    chemotherapy given every 3 or 4 weeks, try and book your vaccine one week before
    your next treatment.”

    “If you are taking systemic corticosteroids, such as dexamethasone, try to book your
    vaccine 28 days after your last dose of corticosteroids. Corticosteroids may lower your
    immune response to the vaccine. However, if this is not possible, you can still book your
    vaccine”

     

    Patients under intravesical BCG treatment are not immuno-compromised

    BCG does not kill white blood cells or immune cells.  But, because intravesical BCG utilizes our immune system to kill bladder cancer cells by activating various immune cells,  it may interfere with the vaccine-induced immune system activities, which are essential to produce a volume of antibodies and T-cells against the virus.  That is why, I think,  a one or two weeks gap is recommended between the BCG treatment and the vaccine, vise versa.

    best

     

    #40921
    Tana
    Participant

    Ah; I see. This is very good information Joe.

    Thanks for your research and typing this all out!

    Mom not in chemo ; just the BCG so hopefully the Pfizer in my age group comes up for at least two weeks before June 15th!

    Cheers; Tana

    #41472
    Joe
    Participant

    The first study, which I am aware of,  of intravesical BCG for bladder cancer and its effect on COVID 19 has been published.

    The study was done by a single medical institution in Chile, reviewing 175 patients who had received intravesical BCG treatments, of which 43 patients were infected with COVID-19.

    The report concluded by saying “According to our results, patients with NMIBC submitted to instillations with BCG have a lower case-fatality rate than the national registry of patients between 70 and 79 years (2.3% vs. 14%, respectively). Intravesical BCG could decrease the mortality due to COVID-19, so instillation schemes should not be suspended in a pandemic.”

    The study was peer-reviewed by a few and commented on the need for a larger study.

    https://bmcurol.biomedcentral.com/articles/10.1186/s12894-021-00823-6

     

     

     

     

     

     

    #41518
    Tana
    Participant

    Hi Joe- thanks; that’s interesting.

    Stay safe! Regards- Tana

    #41527
    Tana
    Participant

    Hi again; About the previous post on am I immunocompromised.  Just a thought concerning the eligibility list for early vaccine. I understand Chemo makes a person more immune compromised but I feel that anyone who has cancer regardless of treatment has immune deficiency. My son kept insisting to get my vaccine early. I did see on the B.C. Government list that people taking immunotherapy were eligible.

    I asked my doctor and she said yes I am eligible as I have cancer. My age group had just come up so that was fine. So I figure having cancer means I am immune compromised?

    Cancer – I got it because my immune system was compromised??? I’m taking BCG to build up my immune system- to get it working? To kill the cancer? So my doctor said I’m eligible but my age group came up and I am now gratefully vaccinated against Covid ( with second shot) which hopefully comes earlier than 4 months!

    Am continuing working at building my health stronger. Don’t feed the cancer with sugar I’ve read. Keep exercising. Get good sleep. Purge old negative emotions. Have a social group. But what of all the toxins; pesticides; poisons in our environment ( air) and food and water?  That’s hard to be clean from. I lived off the land for 15 plus years in the bush in the Cariboo with gravity fed spring water; built a house; grew own vegetables; froze and canned my own and had a dirt root cellar; fished for trout; milk cow – sold milk ; made yogurt; raised chickens – turkeys. I wonder if I stayed doing that I’d be free from cancer? I do know I felt the healthiest there. I have read there are studies done on certain groups of people and how they live and eat and are healthy; carrying their health into living their long lives. Food for thought.

    So I have cancer now but thank goodness for BCG for me.

    And Keeping safe- keeping sane best I can!

    Best to all – Cheers- Tana

     

Viewing 15 posts - 1 through 15 (of 15 total)
  • You must be logged in to reply to this topic.
Back To Top