Immunogenicity, effectiveness, and safety of COVID-19 vaccines among children and adolescents aged 2–18 years: an updated systematic review and meta-analysis

Gao, Peng; Kang, Liangyu; Liu, Jue; M, Liu

doi:10.1007/s12519-022-00680-9

Cited by 17 publications

(13 citation statements)

References 119 publications

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“…Children aged 5–11 years were the last age group receiving vaccine authorization during the study period, making it difficult to disentangle the effect of age group and variant era. Both data sources suggested lower VE in 5- to 11-year-olds and in the omicron era—consistent with other studies 31 —but there were key differences in the magnitude of the VE estimates across data sources in these subgroups. Although calendar time and geography were balanced across vaccination groups within each data source (accounting for local differences in COVID-19 circulation and severity), the two data sources covered different geographic areas and timeframes.…”

Section: Discussionsupporting

confidence: 88%

“…Our study utilized two data sources, and the overall results of higher VE estimates for hospital/ED-diagnosed COVID-19 than for medically diagnosed COVID-19 across all age groups is consistent with the results of other studies. 30,31 Additionally, many of the age and variant subgroup results were largely consistent across data sources. Children aged 5-11 years were the last age group receiving vaccine authorization during the study period, making it difficult to disentangle the effect of age group and variant era.…”

Section: Discussionmentioning

confidence: 62%

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Effectiveness of BNT162b2 COVID-19 Vaccination in Children Aged 5–17 Years in the United States

Ogilvie,

Layton,

Lloyd

et al. 2023

Preprint

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Importance: COVID–19 vaccines are authorized for use in children in the United States; real–world assessment of vaccine effectiveness in children is needed. Objective: To estimate the effectiveness of receiving a complete primary series of monovalent BNT162b2 (Pfizer–BioNTech) COVID-19 vaccine in US children. Design: A cohort study of children aged 5—17 years vaccinated with BNT162b2 matched with unvaccinated children. Setting: Participants identified in Optum and CVS Health insurance administrative claims databases were linked with Immunization Information System (IIS) COVID-19 vaccination records from 16 US jurisdictions between December 11, 2020, and May 31, 2022 (end date varied by database and IIS). Participants: Vaccinated children were followed from their first BNT162b2 dose and matched to unvaccinated children on calendar date, US county of residence, and demographic and clinical factors. Censoring occurred if vaccinated children failed to receive a timely dose 2 or if unvaccinated children received any dose. Exposure: BNT162b2 vaccinations were identified using IIS vaccination records and insurance claims. Main Outcomes and Measures: Two COVID–19 outcome definitions were evaluated: COVID–19 diagnosis in any medical setting and COVID–19 diagnosis in hospitals/emergency departments (EDs). Propensity score–weighted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated with Cox proportional hazards models, and vaccine effectiveness (VE) was estimated as 1 minus HR. VE was estimated overall, within age subgroups, and within variant–specific eras. Sensitivity, negative control, and quantitative bias analyses evaluated various potential biases. Results: There were 453,655 eligible vaccinated children one–to–one matched to unvaccinated comparators (mean age 12 years; 50% female). COVID-19 hospitalizations/ED visits were rare in children, regardless of vaccination status (Optum, 41.2 per 10,000 person– years; CVS Health, 44.1 per 10,000 person– years). Overall, vaccination was associated with reduced incidence of any medically diagnosed COVID–19 (meta–analyzed VE = 38% [95% CI, 36%–40%]) and hospital/ED–diagnosed COVID-19 (meta–analyzed VE = 61% [95% CI, 56%–65%]). VE estimates were lowest among children 5—11 years and during the omicron variant era. Conclusions and Relevance: Receipt of a complete BNT162b2 vaccine primary series was associated with overall reduced medically diagnosed COVID–19 and hospital/ED–diagnosed COVID–19 in children; observed VE estimates differed by age group and variant era.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 62%

Effectiveness of BNT162b2 COVID-19 Vaccination in Children Aged 5–17 Years in the United States

Ogilvie,

Layton,

Lloyd

et al. 2023

Preprint

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“…[11] Similar incidence rates were reported for acute allergic reaction and convulsions, although in fewer studies. [11] Further investigations of potential adverse events following SARS-CoV-2 mRNA vaccination in adolescents are warranted to fill knowledge gaps and ensure trust in the vaccines.…”

Section: Introductionmentioning

confidence: 63%

Adverse Events Following SARS-CoV-2 mRNA Vaccination in Adolescents: A Norwegian Nationwide Register-Based Study

Larsen,

Gunnes,

Gran

et al. 2023

Preprint

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BackgroundVaccination of older adolescents against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) started in the spring of 2021 and continued with younger adolescents throughout the summer and fall. We assessed risks of adverse events following immunization (AEFI) in adolescents aged 12–19 years following SARS-CoV-2 vaccination with a messenger RNA (mRNA) vaccine in Norway.Materials and MethodsThe study sample included 496,432 adolescents born in 2002–2009, residing in Norway, and unvaccinated against SARS-CoV-2 at the beginning of the age-specific waves of vaccination in 2021. The exposures under study were first- and second-dose SARS-CoV-2 mRNA vaccinations vs. no dose. We applied Poisson regression and self-controlled case series (SCCS) analysis to estimate incidence rate ratios (IRRs) of 17 preselected outcomes, with associated 95% confidence intervals (CIs), between vaccinated and unvaccinated subjects using predefined post-vaccination risk windows.ResultsMost outcome-specific numbers of cases were low. There were no statistically significant associations between first-dose vaccination and any of the outcomes. In the main Poisson regression, second-dose vaccination was associated with increased risks of anaphylactic reaction (adjusted IRR [aIRR]: 10.05; 95% CI: 1.22–82.74), lymphadenopathy (aIRR: 2.33; 95% CI: 1.46–3.72), and myocarditis and pericarditis (aIRR: 5.27; 95% CI: 1.98–14.05). We also observed increased incidence of acute appendicitis outside the 14-day risk window. When expanding the risk window to 42 days in a post-hoc analysis, there was increased incidence of acute appendicitis following both first-dose vaccination (aIRR: 1.39; 95% CI: 1.09–1.78) and second-dose vaccination (aIRR: 1.43; 95% CI: 1.07–1.91). Results of the SCCS analysis were similar to the Poisson regression.ConclusionsIn general, potential AEFI were rare among adolescents. We found increased risks of anaphylactic reaction, lymphadenopathy, and myocarditis and pericarditis following second-dose vaccination. There were also indications of increased acute appendicitis risk when applying longer risk windows.

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“…There is limited information on the effectiveness of the booster doses of COVID-19 vaccines among children and adolescents. 1 We evaluated nationwide information surveillance systems in Brazil to estimate vaccine effectiveness (VE) against outcomes of COVID-19 in children and young persons.…”

Section: Association Of Prior Covid-19 Vaccination With Sars-cov-2 In...mentioning

confidence: 99%

“…

There is limited information on the effectiveness of the booster doses of COVID-19 vaccines among children and adolescents. 1 We evaluated nationwide information surveillance systems in Brazil to estimate vaccine effectiveness (VE) against outcomes of COVID-19 in children and young persons.Methods | We used a test-negative case-control design to analyze data between December 2021 and August 2022 during Omicron variant dominance. 2 Cases and controls were defined as individuals with a positive and negative test result for SARS-CoV-2 infection enrolled in the systems in the same time frame, respectively.

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mentioning

confidence: 99%

Association of Prior COVID-19 Vaccination With SARS-CoV-2 Infection and Death in Children and Young Persons During the Omicron Variant Period in Brazil

Oliveira

Silva

et al. 2023

JAMA Pediatr

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Immunogenicity, effectiveness, and safety of COVID-19 vaccines among children and adolescents aged 2–18 years: an updated systematic review and meta-analysis

Cited by 17 publications

References 119 publications

Effectiveness of BNT162b2 COVID-19 Vaccination in Children Aged 5–17 Years in the United States

Effectiveness of BNT162b2 COVID-19 Vaccination in Children Aged 5–17 Years in the United States

Adverse Events Following SARS-CoV-2 mRNA Vaccination in Adolescents: A Norwegian Nationwide Register-Based Study

Association of Prior COVID-19 Vaccination With SARS-CoV-2 Infection and Death in Children and Young Persons During the Omicron Variant Period in Brazil

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