Review History


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Summary

  • The initial submission of this article was received on August 5th, 2020 and was peer-reviewed by 2 reviewers and the Academic Editor.
  • The Academic Editor made their initial decision on August 12th, 2020.
  • The first revision was submitted on August 27th, 2020 and was reviewed by 2 reviewers and the Academic Editor.
  • A further revision was submitted on September 9th, 2020 and was reviewed by 1 reviewer and the Academic Editor.
  • The article was Accepted by the Academic Editor on September 16th, 2020.

Version 0.3 (accepted)

· Sep 16, 2020 · Academic Editor

Accept

All the reviewers' concerns have been correctly addressed.

·

Basic reporting

Clear and professional English.
Literature references and sufficient field background provided.
Professional article figures.
Relevant results to hypothesis

Experimental design

No comments

Validity of the findings

No comments

Comments for the author

No more comments

Version 0.2

· Sep 7, 2020 · Academic Editor

Minor Revisions

Still pending some minor changes suggested by one of the reviewers.

Reviewer 1 ·

Basic reporting

The revised manuscript meets the requirements in the aspects pertaining to English, references, structure, figures, tables, raw data sharing, and making conclusions.

Experimental design

The revised manuscript meets the requirements in the four aspects pertaining to experimental design.

Validity of the findings

The revised manuscript meets the requirements in the four aspects pertaining to validity of the findings.

Comments for the author

This manuscript has been improved significantly through the revision. The authors responded well to all the comments of reviewers. It is of considerable value to be published earlier due to the ongoing COVID-19 pandemic and the coming season for influenza vaccination in the Northern Hemisphere.

·

Basic reporting

1. Clear and professional English
2. Sufficient background provided with adequate references.
3. Professional figures
4. Self-Contained with relevant results to hypotheses

Experimental design

Line 97-163: Please consider using active voice instead of passive voice.
Line 100-105: Are you referring to states or countries? Please add the references for your justification. Please consider changing your abbreviation DP to a more suitable.
Line 105: Please consider rewriting this sentence, it is not clear what do you mean by based on confirmed infected people.
Line 115: Please consider explaining the statistical test you performed to conclude that the relationship between DP and the number of people tested was not statistically significant.
Line 116-121: Please consider rephrasing, maybe starting with: I calculated the Spearman rank correlation coefficients by comparing….

Validity of the findings

No comment

Comments for the author

Line 23-24: Please consider eliminating and a negative association was expected.
Line 25-31: The description of the statistical method you performed is still missing.
Line 42-54: Please consider rewriting the risk factors section into one paragraph and summarizing it in a coherent and straight-forward way. Since this section is not crucial for the justification of your study, it shouldn’t be two paragraphs of your introduction.
Line 55: Please consider using COVID-19 cases and deaths instead of cases of infection.
Line 62: Please consider eliminating Vitamin D, since it is considered an adjunctive therapy.
Line 63: Please consider eliminating drugs since you are already referring in this paragraph to the only two approved ones.
Line 64: Please consider using COVID-19 candidate vaccines.
Line 66-77: You didn’t introduce the concept of heterologous effects or non-specific-effects of vaccines.
Line 35-96: Please consider summarizing your introduction. You don’t need to specify the numeric results from all the papers you are referring to.
Line 97-163: Please consider using active voice instead of passive voice.
Line 100-105: Are you referring to states or countries? Please add the references for your justification. Please consider changing your abbreviation DP to a more suitable.
Line 105: Please consider rewriting this sentence, it is not clear what do you mean by based on confirmed infected people.
Line 115: Please consider explaining the statistical test you performed to conclude that the relationship between DP and the number of people tested was not statistically significant.
Line 116-121: Please consider rephrasing, maybe starting with: I calculated the Spearman rank correlation coefficients by comparing….
Line 193-260: Please consider including as an important limitation the fact that you didn’t normalize the time of arrival of the pandemic.
Line 218: Please consider using viral instead of virus infections
Line 219: Please consider using viral interference instead of virus interference
Line 233: Please consider eliminating most
Line 234: Please consider using the lack instead of a lack, using that weren’t recently affected instead of that had not been recently affected.
Line 235: Please consider using are instead of is
Line 236: Please consider eliminating is
Line 252: Please consider rephrasing, the main idea is not clear
Line 252- 260: Please consider summarizing this paragraph and emphasize the importance of this idea to your findings.

Version 0.1 (original submission)

· Aug 12, 2020 · Academic Editor

Major Revisions

Based on the reviewers' reports, you should address some issues before considering your work again for publication in PeerJ.

[# PeerJ Staff Note: Please ensure that all review comments are addressed in a rebuttal letter and any edits or clarifications mentioned in the letter are also inserted into the revised manuscript where appropriate.  It is a common mistake to address reviewer questions in the rebuttal letter but not in the revised manuscript. If a reviewer raised a question then your readers will probably have the same question so you should ensure that the manuscript can stand alone without the rebuttal letter.  Directions on how to prepare a rebuttal letter can be found at: https://peerj.com/benefits/academic-rebuttal-letters/ #]

[# PeerJ Staff Note: The review process has identified that the English language must be improved. PeerJ can provide language editing services - please contact us at editorial.support@peerj.com for pricing (be sure to provide your manuscript number and title) #]

Reviewer 1 ·

Basic reporting

This manuscript meets all the four requirements:
(1) Literature references, sufficient field background/context provided.
(2) The article should include sufficient introduction and background to demonstrate how the work fits into the broader field of knowledge. Relevant prior literature should be appropriately referenced.
(3) Professional article structure, figures, tables. Raw data shared.
(4) Self-contained with relevant results to hypotheses.

Experimental design

This manuscript meets all the four requirements, except the third:
(1) Original primary research within Aims and Scope of the journal.
(2) Research question well defined, relevant & meaningful. It is stated how research fills an identified knowledge gap.
(3) Rigorous investigation performed to a high technical & ethical standard.
(4) Methods should be described with sufficient information to be reproducible by another investigator.

This study was not performed to a high technical standard. The death rate of COVID-19 is highly associated with age distribution, prevention measures, and geographical distribution. Only the influence of these factors has been excluded, the conclusion that the influenza vaccine coverage is positively associated with the death rate of COVID-19 is reliable. Therefore, the authors need to collect the data regarding age distribution, prevention measures, and geographical distribution of the countries, and then use proper statistical methods to investigate the relationship between the influenza vaccine coverage and the death rate of COVID-19.

Validity of the findings

Please see my comments above.

Comments for the author

This manuscript is well written, and the topic is interesting, and the authors have found some novel data. However, the death rate of COVID-19 is highly associated with age distribution, prevention measures, and geographical distribution. Only the influence of these factors has been excluded, the conclusion that the influenza vaccine coverage is positively associated with the death rate of COVID-19 is somehow reliable. Therefore, the authors need to collect the data regarding age distribution, prevention measures, and geographical distribution of the investigated countries (not difficult), and then use proper statistical methods to investigate the relationship between the influenza vaccine coverage and the death rate of COVID-19. Otherwise, the conclusion could be wrong and misleading.

·

Basic reporting

The introduction needs to be improved using recent published papers, summarized and directed to address the justification.

The English language should be improved to ensure that an international audience can clearly understand your text.

Line 15: Please consider using caused instead of provoked.
Line 17: Please consider eliminating potentially, using pharmacological instead of medicinal and using proposed instead of discussed.
Line 18: Please consider eliminating disease, since it is included in the acronym COVID-19. Is Influenza vaccination a protective factor or a correlation between Influenza vaccination and COVID-19 deaths have been reported?
Line 19: The justification needs to be adapted to the type of analysis the author did, the author is expanding the knowledge of this reported correlation but not explaining the cause.
Line 20: Please consider using preventing COVID-19 deaths instead of save human lives.
Line 21: Please consider using in the elderly instead of older persons and eliminating in Europe since you are doing a worldwide analysis.
Line 23: Please consider describing the statistical analysis you performed.
Line 27: Please consider using ≥ 65 yo instead of older persons, using studies are needed to prevent COVID-19 deaths.
Line 28: Please consider using caused instead of provoked
Line 36: Please consider using could influence COVID-19 severity instead of influence COVID-19 disease.
Line 37: Please consider rephrasing, COVID-19 is not a disease of only older people, but severity increases with age, using as reference: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/older-adults.html. Please consider eliminating for example.
Line 36-47: Please consider rewriting the risk factors section into one paragraph and summarizing it in a coherent and straight-forward way.
Line 48: Please consider using the term non-pharmaceutical interventions and rephrasing this sentence using as reference: Flaxman S, Mishra S, Gandy A, et al. Estimating the effects of non-pharmaceutical interventions on COVID-19 in Europe [published online ahead of print, 2020 Jun 8]. Nature. 2020;10.1038/s41586-020-2405-7. doi:10.1038/s41586-020-2405-7
Line 49: Please consider eliminating potentially and using pharmaceutical interventions instead of medical measures
Line 48-52: Please consider rewriting this pharmaceutical interventions paragraph including as references:
-Beigel JH, Tomashek KM, Dodd LE, et al. Remdesivir for the Treatment of Covid-19 - Preliminary Report [published online ahead of print, 2020 May 22]. N Engl J Med. 2020;10.1056/NEJMoa2007764. doi:10.1056/NEJMoa2007764
-RECOVERY Collaborative Group, Horby P, Lim WS, et al. Dexamethasone in Hospitalized Patients with Covid-19 - Preliminary Report [published online ahead of print, 2020 Jul 17]. N Engl J Med. 2020;10.1056/NEJMoa2021436. doi:10.1056/NEJMoa2021436
-https://files.covid19treatmentguidelines.nih.gov/guidelines/section/section_85.pdf
Line 52: Please consider specifying that you are referring to COVID-19 vaccines and using as reference: https://www.who.int/publications/m/item/draft-landscape-of-covid-19-candidate-vaccines
Line 53: Please consider introducing the concept of heterologous effects or non-specific effects of vaccines, using as reference:
- Agrawal, Babita. “Heterologous Immunity: Role in Natural and Vaccine-Induced Resistance to Infections.” Frontiers in immunology vol. 10 2631. 8 Nov. 2019, doi:10.3389/fimmu.2019.02631
- Goodridge, Helen S et al. “Harnessing the beneficial heterologous effects of vaccination.” Nature reviews. Immunology vol. 16,6 (2016): 392-400. doi:10.1038/nri.2016.43
Please consider including the results and using as a reference: Pawlowski C., Puranik A., Venkatakrishnan AJ., et al. Exploratory analysis of immunization records highlights decreased SARS-CoV-2 rates in individuals with recent non-COVID-19 vaccinations. medRxiv 2020.07.27.20161976; doi: https://doi.org/10.1101/2020.07.27.20161976
Line 54: Please consider avoiding the use of protective factor, it is speculative since Arokiaraj performed a statistical test for correlation which does not necessarily suggest causation.
Line 61-65: Please consider summarizing the important point of the results from Wolff’s paper.
Line 66-67: Please consider rephrasing or eliminating this sentence.
Line 68: Please consider rewriting the justification of the analysis, the author is expanding the knowledge of this reported correlation but not explaining the cause.
Line 70: Please consider using in the elderly or in people ≥ 65 yo instead of older persons and eliminating in Europe since you are doing a worldwide analysis.

Experimental design

Since you are analyzing different countries, with different socioeconomic status, demographic structure, urban/rural settings, time of arrival of pandemic and national control strategies, you should consider mitigating effects of potentially confounding factors. The results might be different if you take into account all of these aspects, or only analyze similar countries that meet the same criteria.

Line 72-94: Please consider using active voice instead of passive voice. Since you are analyzing different countries, with different socioeconomic status, demographic structure, urban/rural settings, time of arrival of pandemic and national control strategies, consider mitigating effects of potentially confounding factors. Consider reviewing Escobar LE, Molina-Cruz A, Barillas-Mury C. BCG vaccine protection from severe coronavirus disease 2019 (COVID-19). Proc Natl Acad Sci U S A. 2020;117(30):17720-17726. doi:10.1073/pnas.2008410117
Line 71: Please consider not repeating the results of the papers you have already described.
Line 75: Please consider explaining why you only chose to analyze countries with at least 0.5 million inhabitants.
Line 76: Please consider using COVID-19 deaths per million instead of dead persons by COVID-19 per Million inhabitants as the depend variable.
Line 77: Please consider using Case Fatality Ratio instead of proportion of COVID-19 deaths of confirmed infected persons.
Line 78: Please consider using COVID-19 tests per million inhabitants instead of number of tested persons for COVID-19 per million inhabitants.
Line 79: Please consider using in people ≥ 65 years old instead of persons aged 65 and older.
Line 82: Please consider eliminating also on July 25, 2020, since this data is not continuously updating and using IVRs were taken from instead of the data of IVR were taken.
Line 85-86: Please consider using 2017 Vietnam’s and Singapore’s IVR were obtained from xx and xx, respectively.
Line 88-89: Please consider explaining the statistical test you performed and if by not modified are you referring to a cofounder.
Line 104: please consider using was instead of were.

Validity of the findings

Line 113-116: please consider using contrary to what was expected instead of contrary to was expected and rephrasing the paragraph, for example, our worldwide analysis and European sub-analysis do not support the previously reported negative association between COVID-19 deaths and influenza vaccination rate.
134-140: Please consider rephrasing, the main idea is not clear.
141-144: Please consider rephrasing, the current phrasing makes comprehension difficult. Please consider using the great variation instead of strong variation and initiation of interventions instead of reaction speed.
148-149: please consider using studies are needed to prevent COVID-19 deaths instead of exploration is valuable to save human lives.
149: Please consider specifying which type of studies are suitable to explain your findings. Maybe clinical trials?

Images: Consider adding the p value so it is possible to quickly know if it is statistically significant or not

Figure legend: Consider adding the results of the statistical analysis.

Comments for the author

Your most important issue is the fact of not considering the differences between countries. Since you are analyzing different countries, with different socioeconomic status, demographic structure, urban/rural settings, time of arrival of pandemic and national control strategies, you should consider mitigating effects of potentially confounding factors. The results might be different if you take into account all of these aspects, or only analyze similar countries that meet the same criteria.

The next most important item is that the introduction needs to be improved using recent published papers, summarized and directed to address the justification.

The least important is that the English language should be improved to ensure that an international audience can clearly understand your text.

153-154: Please consider rewriting this paragraph, for example: I would like to express my gratitude to xxx and xxx for their careful review and insightful comments

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