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A Theory On why Children May be safer #COVID-19

All along in medicine, we have described the extremes of ages: the very old and the very young as the most vulnerable especially in the case of infections. Indeed you may have noticed that school-going children have common colds almost every other week with adults catching the same sporadically. The argument has long been that the immunity in these two extremes is not as strong as for human body at its peak immunity.

Come COVID-19 and all of sudden studies are showing that the children are not only less susceptible to virus, but they also develop less severe disease (to be clear, children of all ages have been affected and at least one, a 14 year old boy has died from the virus)

We thank God that our children are relatively safe but what is the scientific reason? There are many theories but this is mine. Starting from the “fact” that children’s immunity is not stronger than that of healthy adults, I look to see what children may have that adults don’t that would confer an advantage. The answer I arrive at, and this is no more than a theory, is vaccines for other illnesses and the concept booster doses in vaccinations.

What vaccines aim to do is to 1. prevent illnesses and 2. result in milder symptoms should the patient catch the disease nonetheless. What this means is that vaccinated individuals are less likely to catch the infection against which they were vaccinated and if they do, it will be less severe. But then, most adults also got the same vaccines the children have right? Yes. But this is where the concept of booster doses comes in. You see, in many vaccines, for as long as one is not exposed to the disease, the immunity acquired from the vaccine tends to wear off with time and a booster dose is required at some point. This may be the case in adults.

Finally, there is the obvious issue that there is currently no vaccine against SARS-CoV-2, the virus that causes COVID-19 and therefore, there is no possibility that any child could ever have got it. This is true. However, the whole theory is that there is an existing vaccine now that is given in childhood that has some efficacy against SARS-CoV-2 and COVID-19. Childhood vaccines cover a number of organisms including viruses such as those that cause Measles, Mumps, Rubella, Polio and hepatitis viruses. In addition, there are non-core vaccines that are increasingly provided to children including seasonal flu vaccines, rotavirus and many other viruses. All these are viruses first before they branch out into their respective families. Some are closer than others, but there are some commonalities across board. It is therefore not inconceivable that a vaccine designed against one organism could be bear some efficacy against another.

Whereas this is just a theory, which in effect amounts to just a hunch not backed by any study, studies into the treatment of COVID-19 already present such possibilities. The drug chloroquine and its relative hyrdoxychloroquine were created for completely different diseases but are now being investigated for their efficacy against COVID-19. Early reports from China have shown promise.

Most theories are not correct but even when they are, they require studies to prove them. Still, I choose to document this view, today, 22nd March 2020, just in case there is merit to it. I am yet to come across an alternative argument that makes sense to me.

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  1. KUMAR N S says:

    BCG alone is the vaccine for protection in lung diseases.Though it’s anti bacterial it may have some protection against COVID 19 virus too.i learn that this virus keeps on mutating and the one attacked us in India is said to have 2 lobes against 4 in many nations.
    Most nations are racing to find a vaccine for COVID 19 but the earliest is possible only after a year.
    Till then BCG alone is the hope Early study and quick action is dire necessity.Elders have to be saved.
    KUMAR N S M
    CHENNAI INDIA.

    1. ovngani says:

      Thank you Kumar. You are quite right. Here is a link to a study that came out about a week ago suggesting that countries without a mandatory BCG vaccination policy such as Italy and the US fair worse against COVID-19 as compared to countries that do. It’s a bit too early to draw final conclusions but there is a lot of research work that has started in the last week looking exactly into this. Here is the link to the staudy:
      https://www.medrxiv.org/content/10.1101/2020.03.24.20042937v1.full.pdf

  2. Dr. Ng’ani; I am a pediatric certified RN in the USA. I have never heard of this vaccine. How do the numbers correlate to countries that DO and DO not give this vaccine. I have never heard of it. In areas where this vaccine is given, at what age is it given? Do they check a titre at some point? Is there a booster or second series vaccine of this BCG?

    1. ovngani says:

      Dear Dr. Kerry, Thank you for your comment and question. BCG is given at birth. Usually, a single subcutaneous dose is thought to be sufficient to confer life-long immunity. There are times in history when a second dose has been given due to prevailing public health concerns. There is a recent study, (here’s the link: https://www.medrxiv.org/content/10.1101/2020.03.24.20042937v1.full.pdf ) reporting that the prevalence and severity of COVID-19 is much higher in countries such as Italy and the USA that do not have a mandatory BCG vaccination policy as compared to countries that do. There is a prospective study that has just started and is ongoing in Melbourne Australia in which about 4,000 healthcare workers are being given different childhood vaccines including BCG, I hope this helps and best of luck. I guess that applies to all of us in the health sector across the world. God bless!

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