Bacille Calmette-Guerin (BCG) is a live attenuated vaccine administered for prevention of tuberculosis. Recently, several groups have hypothesized that BCG may "train" the immune system to respond to a variety of unrelated infections, including viruses and in particular the coronavirus responsible for COVID-19. Trials are currently being conducted in Australia, Netherlands, Germany and the United Kingdom to evaluate its effectiveness.

Front line workers includes members of municipal and provincial police services, emergency medical personnel, firefighters, public transport employees, health service workers and food manufacturing employees. They are at high risk of infection from COVID-19, with potentially high infection rate. The investigators propose an interventional trial to evaluate the effectiveness of BCG vaccination to prevent COVID-19 infection and reduce its severity in front-line employees in Ontario.

Inclusion Criteria:

• Eighteen years of age or older
• Employee/member of: municipal or provincial police service, emergency medical services, fire services, public transport service, health service, food manufacturing facility

Exclusion Criteria:

• Prior intravesical BCG or intradermal BCG, with the exception of tuberculosis vaccination in childhood.
• Previous known history of latent or active tuberculosis
• Known kidney, liver or blood disorders which impairs organ and marrow function
• Chronic administration of steroids (>10 mg prednisone) at the time of randomization
• Current or planned concomitant biologic therapy in the next 7 months.
• Known hypersensitivity or allergy to components of VPM1002
• Pregnant or planning to become pregnant in the future 7 months.
• Breastfeeding.
• Current suspected viral or bacterial infection.
• Body temperature > 38° C
• Participation in another interventional study with potentially conflicting medication within 30 days before screening.
• The presence of an impaired immune response irrespective of whether this impairment is congenital or caused by disease, drugs or other therapy (e.g., anti-TNF therapy, methotrexate, azathioprine, antimalarials).
• Active malignancy requiring treatment.
• Known positive HIV serology.
• History of allergic reactions attributed to compounds of similar chemical or biologic composition to BCG vaccine.
• Previous positive COVID-19 confirmed infection.
• Uncontrolled intercurrent illness.
• Psychiatric illness/social situations that would limit compliance with study requirements.

The clinical trial is designed as a double-blind (observer blind) study. Observer-blind means that during the course of trial, the companions/parents/guardians of the subjects and the study personnel responsible for the evaluation of any study endpoint will be unaware which vaccine was administered.