New trial tests BCG vaccine to protect healthcare workers against COVID-19

A man sits in a treatment chair with two female nurses standing beside him
Dr Laurens Manning getting a blood test as part of the BRACE trial
March 16, 2021

At the height of the COVID-19 pandemic in March 2020, Fiona Stanley Hospital (FSH) Infectious Disease Specialist, Dr Laurens Manning was one of the first to put his hand up to participate in the BRACE trial. 

The trial in Western Australia is a collaborative team effort between FSH, Sir Charles Gairdner Hospital, Perth Children’s Hospital and Telethon Kids Institute and was designed to find out whether the Bacille Calmette-Guérin (BCG) vaccine, used over the last 100 years to protect against tuberculosis, could protect against COVID-19 or reduce the severity of the virus in healthcare workers.

As Principal Investigator, Dr Manning led the recruitment of healthcare workers at FSH and with support from the FSH Infection Prevention and Management team, the annual influenza vaccination program was brought forward to early April 2020. 

“By embedding the BRACE trial with the influenza vaccine, the recruitment rate was extremely high,” Dr Manning said.

“Of the 2,000 Western Australian BRACE participants, 750 of these were FSH healthcare workers, randomised for either BCG plus influenza vaccine, or influenza alone.” 

Dr Manning was one of those participants. 

“I have to be prepared to do whatever I ask the participants to do,” he said.

The BRACE trial, led by Murdoch Children’s Research Institute (MCRI), is the largest and most ambitious trial of the BCG vaccine globally and was the first to start in Australia during the height of the COVID-19 pandemic. Participants have also been recruited throughout Australia, Spain, Nedlands, UK and Brazil.

While developed to protect against tuberculosis, in more recent times the BCG vaccine has been shown to boost immunity to protect against other viral infections. 

As part of the trial, BRACE participants have blood samples taken every three months and must track their symptoms weekly via an app. 

“Though there haven’t been many primary outcomes so far due to the rate of COVID-19 being much lower than expected, there is still a lot to be gained from this ongoing trial,” Dr Manning said.

“We are learning so much about the biology of the BCG vaccine.

“We will be able to look at whether the combined BCG vaccine and flu vaccine has a much more robust response to the just the standalone flu vaccine which has a low success rate and then, who knows, we may even start using BCG in the future to prevent the flu or other respiratory tract infections. “

While Fiona Stanley Hospital participants will be one of the first groups to finish the trial in April 2021, it will be another 12 months before primary outcomes of all BRACE participants are known worldwide. 

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