Effects of COVID-19 vaccination and previous SARS-CoV-2 infection on omicron infection and severe outcomes in children under 12 years of age in the USA: an observational cohort study

Lin, Danyu; Xu, Yangjianchen; Gu, Yu; Zeng, Donglin; Wheeler, Bradford; Young, Hayley; Moore, Zack; Sunny, Shadia Khan

doi:10.1016/s1473-3099(23)00272-4

Cited by 16 publications

(13 citation statements)

References 27 publications

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“…These findings are consistent with the limited other data available on protection provided by the bivalent vaccine for children and adolescents. In a study by Lin et al 21 among children aged 5 to 11 years, effectiveness of the bivalent COVID-19 vaccine 2 months after receipt was 47.3% (95% CI, −17.9% to 76.4%). The estimate for vaccine effectiveness 1 month after receipt of a bivalent COVID-19 vaccine dose (76.7% [95% CI, 45.7 to 90.0]) by Lin et al 21 was higher than the estimate (51.3% [95% CI, 23.6% to 71.9%]) in the current study for those who received a bivalent COVID-19 vaccine dose within 7 to 60 days.…”

Section: Discussionmentioning

confidence: 98%

“…In a study by Lin et al 21 among children aged 5 to 11 years, effectiveness of the bivalent COVID-19 vaccine 2 months after receipt was 47.3% (95% CI, −17.9% to 76.4%). The estimate for vaccine effectiveness 1 month after receipt of a bivalent COVID-19 vaccine dose (76.7% [95% CI, 45.7 to 90.0]) by Lin et al 21 was higher than the estimate (51.3% [95% CI, 23.6% to 71.9%]) in the current study for those who received a bivalent COVID-19 vaccine dose within 7 to 60 days. However, the 95% CIs overlap, and the difference in vaccine effectiveness may be due to different sites and study periods.…”

Section: Discussionmentioning

confidence: 98%

“…In addition, the current multistate study followed up participants through January 31, 2023, whereas Lin et al followed up North Carolina residents until January 6, 2023. National surveillance data show increased circulation of variants other than BA.4/5 during those 4 weeks, and it is possible that the bivalent COVID-19 vaccine may not be as protective against those variants (eg, XBB), thus decreasing the vaccine effectiveness estimate for the entire study period.…”

Section: Discussionmentioning

confidence: 99%

“…Although data have shown that bivalent mRNA COVID-19 vaccination among adults is effective at reducing the risk of COVID-19, including severe outcomes, limited data exist on the effectiveness of bivalent COVID-19 vaccine doses among children and adolescents. Available studies are limited by small sample size and a short duration of follow-up and reliance on voluntary testing . Understanding how well children and adolescents are protected by a bivalent COVID-19 vaccine dose is important for informing public health strategies, especially in the context of updated vaccine formulations and emergence of new variants.…”

Section: Introductionmentioning

confidence: 99%

“…Available studies are limited by small sample size and a short duration of follow-up and reliance on voluntary testing. 21,22 Understanding how well children and adolescents are protected by a bivalent COVID-19 vaccine dose is important for informing public health strategies, especially in the context of updated vaccine formulations and emergence of new variants.…”

mentioning

confidence: 99%

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Effectiveness of Bivalent mRNA COVID-19 Vaccines in Preventing SARS-CoV-2 Infection in Children and Adolescents Aged 5 to 17 Years

Feldstein,

Britton,

Grant

et al. 2024

JAMA

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ImportanceBivalent mRNA COVID-19 vaccines were recommended in the US for children and adolescents aged 12 years or older on September 1, 2022, and for children aged 5 to 11 years on October 12, 2022; however, data demonstrating the effectiveness of bivalent COVID-19 vaccines are limited.ObjectiveTo assess the effectiveness of bivalent COVID-19 vaccines against SARS-CoV-2 infection and symptomatic COVID-19 among children and adolescents.Design, Setting, and ParticipantsData for the period September 4, 2022, to January 31, 2023, were combined from 3 prospective US cohort studies (6 sites total) and used to estimate COVID-19 vaccine effectiveness among children and adolescents aged 5 to 17 years. A total of 2959 participants completed periodic surveys (demographics, household characteristics, chronic medical conditions, and COVID-19 symptoms) and submitted weekly self-collected nasal swabs (irrespective of symptoms); participants submitted additional nasal swabs at the onset of any symptoms.ExposureVaccination status was captured from the periodic surveys and supplemented with data from state immunization information systems and electronic medical records.Main Outcome and MeasuresRespiratory swabs were tested for the presence of the SARS-CoV-2 virus using reverse transcriptase–polymerase chain reaction. SARS-CoV-2 infection was defined as a positive test regardless of symptoms. Symptomatic COVID-19 was defined as a positive test and 2 or more COVID-19 symptoms within 7 days of specimen collection. Cox proportional hazards models were used to estimate hazard ratios for SARS-CoV-2 infection and symptomatic COVID-19 among participants who received a bivalent COVID-19 vaccine dose vs participants who received no vaccine or monovalent vaccine doses only. Models were adjusted for age, sex, race, ethnicity, underlying health conditions, prior SARS-CoV-2 infection status, geographic site, proportion of circulating variants by site, and local virus prevalence.ResultsOf the 2959 participants (47.8% were female; median age, 10.6 years [IQR, 8.0-13.2 years]; 64.6% were non-Hispanic White) included in this analysis, 25.4% received a bivalent COVID-19 vaccine dose. During the study period, 426 participants (14.4%) had laboratory-confirmed SARS-CoV-2 infection. Among these 426 participants, 184 (43.2%) had symptomatic COVID-19, 383 (89.9%) were not vaccinated or had received only monovalent COVID-19 vaccine doses (1.38 SARS-CoV-2 infections per 1000 person-days), and 43 (10.1%) had received a bivalent COVID-19 vaccine dose (0.84 SARS-CoV-2 infections per 1000 person-days). Bivalent vaccine effectiveness against SARS-CoV-2 infection was 54.0% (95% CI, 36.6%-69.1%) and vaccine effectiveness against symptomatic COVID-19 was 49.4% (95% CI, 22.2%-70.7%). The median observation time after vaccination was 276 days (IQR, 142-350 days) for participants who received only monovalent COVID-19 vaccine doses vs 50 days (IQR, 27-74 days) for those who received a bivalent COVID-19 vaccine dose.Conclusion and RelevanceThe bivalent COVID-19 vaccines protected children and adolescents against SARS-CoV-2 infection and symptomatic COVID-19. These data demonstrate the benefit of COVID-19 vaccine in children and adolescents. All eligible children and adolescents should remain up to date with recommended COVID-19 vaccinations.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Effectiveness of Bivalent mRNA COVID-19 Vaccines in Preventing SARS-CoV-2 Infection in Children and Adolescents Aged 5 to 17 Years

Feldstein,

Britton,

Grant

et al. 2024

JAMA

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Vaccination against COVID-19 — risks and benefits in children

Munro,

Jones,

Faust

2024

Eur J Pediatr

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Countries in Europe and around the world have taken varying approaches to their policies on COVID-19 vaccination for children. The low risk of severe illness from COVID-19 means that even small risks from vaccination warrant careful consideration. Vaccination appears to result in a decreased risk of severe illness including the paediatric multi-system inflammatory syndrome known to be associated with COVID-19. These risks have already decreased significantly with the emergence of the Omicron variant and its subvariants, and due to widespread population immunity through previous infection. There is a relatively high risk of myocarditis following second doses of mRNA vaccines in adolescent males, although the general course of this condition appears mild. Conclusion: COVID-19 vaccination only provides a transient reduction in transmission. Currently, insufficient evidence exists to determine the impact of vaccination on post-acute COVID syndromes in children, which are uncommon. What is Known:• Vaccines against COVID-19 have significantly reduced morbidity and mortality around the world.• Whilst countries have universally recommended vaccines for adults and continue to recommend them for vulnerable populations, there has been more variability in recommendations for children. What is New:• In the setting of near universal existing immunity from infection, the majority of the initial benefit in protecting against severe illness has been eroded.• The risks of myocarditis following mRNA vaccination for children is low, but an important consideration given the modest benefits.

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A panoramic view of hospitalized young children in the metropolitan area of the valley of Mexico during COVID-19

Padilla-Rivas,

Santoyo-Suarez,

Benitez-Chao

et al. 2023

IJID Regions

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Effects of COVID-19 vaccination and previous SARS-CoV-2 infection on omicron infection and severe outcomes in children under 12 years of age in the USA: an observational cohort study

Cited by 16 publications

References 27 publications

Effectiveness of Bivalent mRNA COVID-19 Vaccines in Preventing SARS-CoV-2 Infection in Children and Adolescents Aged 5 to 17 Years

Effectiveness of Bivalent mRNA COVID-19 Vaccines in Preventing SARS-CoV-2 Infection in Children and Adolescents Aged 5 to 17 Years

Vaccination against COVID-19 — risks and benefits in children

A panoramic view of hospitalized young children in the metropolitan area of the valley of Mexico during COVID-19

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