Abstract
This study examines the relationship of pneumococcal vaccination rates, influenza, measles-mumps-rubella (MMR) diphtheria-tetanus-pertussis vaccinations (DTP), polio, Haemophilus influenzae type B (Hib), and Bacillus Calmette–Guerin (tuberculosis) vaccination rates to COVID-19 case and death rates for 51 nations that have high rates of COVID-19 testing and for which nearly complete childhood, at-risk adult and elderly pneumococcal vaccination data were available. The study is unique in a large number of nations examined, the range of vaccine controls, in testing effects of combinations of vaccinations, and in examining the relationship of COVID-19 and vaccination rates to invasive pneumococcal disease (IPD). Analysis of Italian regions and the states of the United States were also performed. Significant positive correlations were found between IPD (but not lower respiratory infections) and COVID-19 rates, while significant negative correlations were found between pneumococcal vaccination and COVID-19 rates. Influenza and MMR vaccination rates were negatively correlated with lower respiratory infection (LRI) rates and may synergize with pneumococcal vaccination rates to protect against COVID-19. Pneumococcal and influenza vaccination rates were independent of other vaccination rates. These results suggest that endemic rates of bacterial pneumonias, for which pneumococci are a sentinel, may set regional and national susceptibility to severe COVID-19 disease and death.
Highlights
The ongoing COVID-19 pandemic poses two outstanding problems
Fifty-one countries were included in the current study, chosen by several criteria: (1) high rates or severe acute respiratory disease (SARS)-CoV-2 testing; (2) availability of national rates of obesity and diabetes and percent of population 65 years of age or older; and (3) the availability of data corresponding to all of the vaccination and disease rate categories just listed, with three exceptions: a country was still included in the study even if invasive pneumococcal disease (IPD) data, and/or pneumococcal vaccination rates among at-risk adults and/or adult influenza vaccination rates could not be located
T Data concerning the rates of COVID-19 cases and deaths in the 50 states of the United States of America; the rates of pneumococcal vaccination (PNEUM) among children, at-risk adults 18 to years of age, and adults years of age and older; the sum of those pneumococcal vaccination rates; and influenza vaccination (INF) rates among adults 65 years of age and older and among the general population of all ages
Summary
One is why the symptoms associated with SARS-CoV-2 infection vary in individuals from unnoticeable to requiring intensive care. The effects of a new infection vary according to the health of the individual, and the susceptibility of a population to a new infection is dependent on its overall, preexisting disease burden (including health factors such as nutrition). In this context, significant research has been devoted to the possibility that various non-SARS-CoV-2 vaccines may affect the propensity of individuals and of populations to contract COVID-19 and to die from its effects. This paper tests the particular possibility that vaccination rates and endemic bacterial disease burden significantly influence individual risks of contracting severe COVID-19 and affect COVID-19 case and death rates
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