ReviewThe Lancet. Infectious diseases2023
Beneficial non-specific effects of live vaccines against COVID-19 and other unrelated infections.
Review in The Lancet. Infectious diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
41 citing papers in PubMed, 79 citations in OpenAlex.
- The effect of BCG revaccination on the response to unrelated vaccines in urban Ugandan adolescents (POPVAC C): an open-label, randomised controlled trial.The Lancet. Global health · 2024Trial
- Effects of Neonatal BCG-Japan Versus BCG-Russia Vaccination on Overall Mortality and Morbidity: Randomized Controlled Trial From Guinea-Bissau (BCGSTRAIN II).Open forum infectious diseases · 2024Trial
- Randomized Trial of BCG Vaccine to Protect against Covid-19 in Health Care Workers.The New England journal of medicine · 2023Trial
- The origin of non-specific effects of vaccines and the role of randomised clinical trials.Human vaccines & immunotherapeutics · 2026Review
- Review
- Human Organoids as a Novel Tool for Vaccine Study.Advanced healthcare materials · 2026Review
- Trained Immunity Induced by Vaccines: A Shifting Paradigm for Infant and Adult Immunity.International journal of molecular sciences · 2026Review
- Immune Priming and the Risk of COVID-19, Influenza, and Other Acute Respiratory Infections: Insights From an N3C Cohort.Influenza and other respiratory viruses · 2026Article
- Faster than Virus: The Physics of Pandemic Prediction.Infectious disease reports · 2026Article
- Interactions between Innate Immune Memory and the Central Nervous System.Neuroimmunomodulation · 2026Review
- A report for the fifth International Workshop on Rotavirus and Norovirus in China.Human vaccines & immunotherapeutics · 2025Article
- Tuberculosis vaccination: microbiological and immunological summary of a series of experimental challenge studies.Veterinary research · 2025Article
- Advocating mucosal immunization: A global need in a viewpoint from China.Innovation (Cambridge (Mass.)) · 2025Review
- The impact of interferon-γ pathway on trained immunity induction by vaccination with Bacille Calmette-Guérin.Scientific reports · 2025Article
- Memory in Misfire: The Gut Microbiome-Trained Immunity Circuit in Inflammatory Bowel Diseases.International journal of molecular sciences · 2025Review
- Trained immunity in chronic inflammatory diseases and cancer.Nature reviews. Immunology · 2025Review
- Article
- Long-term immune changes after COVID-19 and the effect of BCG vaccination and latent infections on disease severity.Clinical & translational immunology · 2025Article
- Article
- A Risk Management Approach to Global Pandemics of Infectious Disease and Anti-Microbial Resistance.Tropical medicine and infectious disease · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 3 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Live attenuated vaccines could have beneficial, non-specific effects of protecting against vaccine-unrelated infections, such as BCG protecting against respiratory infection. During the COVID-19 pandemic, testing of these effects against COVID-19 was of interest to the pandemic control programme. Non-specific effects occur due to the broad effects of specific live attenuated vaccines on the host immune system, relying on heterologous lymphocyte responses and induction of trained immunity. Knowledge of non-specific effects has been developed in randomised controlled trials and observational studies with children, but examining of whether the same principles apply to adults and older adults was of interest to researchers during the pandemic. In this Personal View, we aim to define a framework for the analysis of non-specific effects of live attenuated vaccines against vaccine-unrelated infections with pandemic potential using several important concepts. First, study endpoints should prioritise severity of infection and overall patient health rather than incidence of infection only (eg, although several trials found no protection of the BCG vaccine against COVID-19 infection, it is associated with lower overall mortality than placebo). Second, revaccination of an individual with the same live attenuated vaccine could be the most effective strategy against vaccine-unrelated infections. Third, coadministration of several live attenuated vaccines might enhance beneficial non-specific effects. Fourth, the sequence of vaccine administration matters; the live attenuated vaccine should be the last vaccine administered before exposure to the pandemic infection and non-live vaccines should not be administered afterwards. Fifth, live attenuated vaccines could modify the immune response to specific COVID-19 vaccines. Finally, non-specific effects of live attenuated vaccines should always be analysed with subgroup analysis by sex of individuals receiving the vaccines.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.