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The Spread of COVID-19 and the BCG Vaccine: A Natural Experiment in Reunified Germany

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Abstract

As COVID-19 has spread across the globe, several observers noticed that countries still administering an old vaccine against tuberculosis—the BCG vaccine—have had fewer COVID-19 cases and deaths per capita in the early stages of the outbreak. This paper uses a geographic regression discontinuity analysis to study whether and how COVID-19 prevalence changes discontinuously at the old border between West Germany and East Germany. The border used to separate two countries with very different vaccination policies during the Cold War era. We provide formal evidence that there is indeed a sizable discontinuity in COVID-19 cases at the border. However, we also find that the difference in novel coronavirus prevalence is uniform across age groups and show that this discontinuity disappears when commuter flows and demographics are accounted for. These findings are not in line with the BCG hypothesis. We then offer an alternative explanation for the East-West divide. We simulate a canonical SIR model of the epidemic in each German county, allowing infections to spread along commuting patterns. We find that in the simulated data, the number of cases also discontinuously declines as one crosses from west to east over the former border.

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  • Richard Bluhm & Maxim L. Pinkovskiy, 2020. "The Spread of COVID-19 and the BCG Vaccine: A Natural Experiment in Reunified Germany," Staff Reports 926, Federal Reserve Bank of New York.
    • Handle: RePEc:fip:fednsr:87993
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    Cited by:

    1. Pronkina, Elizaveta & Berniell, Inés & Fawaz, Yarine & Laferrère, Anne & Mira, Pedro, 2023. "The COVID-19 curtain: Can past communist regimes explain the vaccination divide in Europe?," Social Science & Medicine, Elsevier, vol. 321(C).
    2. Reinhold Kosfeld & Timo Mitze & Johannes Rode & Klaus Wälde, 2021. "The Covid‐19 containment effects of public health measures: A spatial difference‐in‐differences approach," Journal of Regional Science, Wiley Blackwell, vol. 61(4), pages 799-825, September.
    3. Wei-Ju Su & Chia-Hsuin Chang & Jiun-Ling Wang & Shu-Fong Chen & Chin-Hui Yang, 2021. "COVID-19 Severity and Neonatal BCG Vaccination among Young Population in Taiwan," IJERPH, MDPI, vol. 18(8), pages 1-7, April.
    4. Ehlert, Andree, 2021. "The socio-economic determinants of COVID-19: A spatial analysis of German county level data," Socio-Economic Planning Sciences, Elsevier, vol. 78(C).
    5. Philipp Breidenbach & Timo Mitze, 2022. "Large-scale sport events and COVID-19 infection effects: evidence from the German professional football ‘experiment’ [Semiparametric difference-in-differences estimators]," The Econometrics Journal, Royal Economic Society, vol. 25(1), pages 15-45.
    6. Kim, Seonghoon & Koh, Kanghyock & Lyou, Wonjun, 2024. "The Effects of Patient Cost-Sharing on Adolescents' Healthcare Utilization and Financial Risk Protection: Evidence from South Korea," IZA Discussion Papers 16897, Institute of Labor Economics (IZA).

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    More about this item

    Keywords

    COVID-19; BCG vaccine; SIR model with commuting flows;
    All these keywords.

    JEL classification:

    • C21 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Cross-Sectional Models; Spatial Models; Treatment Effect Models
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J60 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - General

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