Safety and effectiveness of vaccines against COVID-19 in children aged 5–11 years: a systematic review and meta-analysis

Piechotta, Vanessa; Siemens, Waldemar; Thielemann, Iris; Toews, Markus; Koch, Judith; Vygen-Bonnet, Sabine; Kothari, Kavita; Grummich, Kathrin; Braun, C.; Kapp, Philipp; Labonté, Valérie; Wichmann, Ole; Meerpohl, Joerg J; Harder, Thomas

doi:10.1016/s2352-4642(23)00078-0

Cited by 39 publications

(19 citation statements)

References 63 publications

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“…The findings of this study are aligned with two meta‐analyses of VE against Omicron infections in 5–11‐year‐old population, which reported pooled VE estimates of 41.6%, 9 and 45.18%, 10 after two doses of the COVID‐19 vaccine. The study also revealed that the highest magnitude of VE against Omicron infection (62.7%) in children aged 5–11 years was observed in the first 6 weeks after full vaccination, with a subsequent decline in VE.…”

Section: Discussionsupporting

confidence: 83%

“…This observation was consistent with the meta-analysis conducted by Piechotta and colleagues, which concluded that all studies included in their meta-analysis reported at least a 15% decline in VE since the first time point estimate. 9 Regarding the VE against Omicron in children aged 12-17-yearold, the findings of this study are in line with the pooled VE from the meta-analysis by Li et al (73%). 10 Similarly, Sabu and colleagues reported a higher VE against Delta compared with Omicron in their meta-analysis.…”

Section: Covid-19 Vaccine Effectiveness In 12-17-year-old Populationsupporting

confidence: 91%

“…Due to the rarity of COVID-19 hospitalization in the pediatric age group, the study observed a very small number of children (5)(6)(7)(8)(9)(10)(11) or 12-17 years) admitted for COVID-19, making it unfeasible to estimate VE against hospitalization. Thus, larger studies are warranted to evaluate this outcome.…”

Section: Discussionmentioning

confidence: 99%

“…The second criterion was applied because the time taken for an antibody response to the vaccine is longer in individuals who have not been previously infected. 16 We excluded from the study: such as when showing any respiratory disease symptom, getting admitted to emergency departments or hospitalized for a non-COVID condition, or being in contact with a SARS-CoV-2 positive case; (7) negative SARS-CoV-2 tests that occurred within 15 days before or after a positive test to avoid the inclusion of false-negative test results; (8) tests undertaken in subjects whose age does not fall within the 5-11 or 12-17-year-old age criterion; (9) tests undertaken in individuals who had received more than two vaccine doses; (10) tests undertaken in individuals who had received mixed vaccine combinations, that is, the first and second vaccine dose was not from the same brand.…”

Section: Methodsmentioning

confidence: 99%

“…However, evidence suggests that COVID‐19 vaccine effectiveness (VE) declines over time and that emerging SARS‐CoV‐2 variants may evade vaccine‐induced immune protection. Ongoing research on COVID‐19 VE in the pediatric population, especially in young children aged 5–11 years, has shown variable findings, likely influenced by factors such as vaccine type, settings, baseline immunity, population genetics, and waning vaccine‐induced immunity from early follow‐up data 9,10 . The heterogeneity among studies makes it challenging to generalize VE across populations.…”

Section: Introductionmentioning

confidence: 99%

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COVID‐19 vaccine effectiveness in children by age groups. A population‐based study in Galicia, Spain

Mallah,

Pardo‐Seco,

Ares‐Gómez

et al. 2023

Pediatric Allergy Immunology

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BackgroundStudies on vaccine effectiveness (VE) against COVID‐19 in the pediatric population are outgoing. We aimed to quantify VE against SARS‐CoV‐2 in two pediatric age groups, 5–11 and 12–17‐year‐old, while considering vaccine type, SARS‐CoV‐2 variant, and duration of protection.MethodsA population‐based test‐negative control study was undertaken in Galicia, Spain. Children 5–11‐year‐old received the Comirnaty® (Pfizer, US) vaccine, while those aged 12–17‐year‐old received the Comirnaty® (Pfizer, US) or SpikeVax® (ModernaTX, Inc) vaccine. Participants were categorized into unvaccinated (0 doses or one dose with <14 days since vaccination), partially vaccinated (only one dose with ≥14 days, or two doses with <14 days after the second dose administration), and fully vaccinated (two doses with ≥14 days after the second injection). Adjusted odds ratios (OR) and their 95% confidence intervals (CI) were estimated using multiple logistic regression models. VE was calculated as (1‐OR) * 100. Stratified and sensitivity analyses were performed.ResultsIn the fully vaccinated 5–11‐year‐old children, VE against the Omicron variant was 44.1% (95% CI: 38.2%–49.4%). In the fully vaccinated 12–17‐year‐old individuals, VE was 83.4% (95% CI: 81.2%–85.3%) against Delta and 74.8% (95% CI: 58.5%–84.9%) against Omicron. Comirnaty® and SpikeVax® vaccines showed a similar magnitude of VE against Delta [Comirnaty® VE: 81.9% (95% CI: 79.3%–84.1%) and SpikeVax® VE: 85.3% (95% CI: 81.9%–88.1%)]. Comirnaty® (Pfizer, US; VE: 79.7%; 95% CI: 50.7%–92.4%) showed a slightly higher magnitude of protection against Omicron than SpikeVax® (ModernaTX, Inc), yet with an overlapping CI (VE: 74.3%; 95% CI: 56.6%–84.9%). VE was maintained in all age subgroups in both pediatric populations, but it declined over time.ConclusionsIn Galicia, mRNA VE was moderate against SARS‐CoV‐2 infections in the 5–11‐year‐old populations, but high in older children. VE declined over time, suggesting a potential need for booster dose schedules.

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Section: Discussionsupporting

confidence: 83%

Section: Covid-19 Vaccine Effectiveness In 12-17-year-old Populationsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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COVID‐19 vaccine effectiveness in children by age groups. A population‐based study in Galicia, Spain

Mallah,

Pardo‐Seco,

Ares‐Gómez

et al. 2023

Pediatric Allergy Immunology

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Humoral and cellular immune responses in vaccinated and unvaccinated children following SARS‐CoV‐2 Omicron infection

Toh,

Anderson,

Mazarakis

et al. 2024

Clin & Trans Imm

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ObjectivesThe immune response in children elicited by SARS‐CoV‐2 Omicron infection alone or in combination with COVID‐19 vaccination (hybrid immunity) is poorly understood. We examined the humoral and cellular immune response following SARS‐CoV‐2 Omicron infection in unvaccinated children and children who were previously vaccinated with COVID‐19 mRNA vaccine.MethodsParticipants were recruited as part of a household cohort study conducted during the Omicron predominant wave (Jan to July 2022) in Victoria, Australia. Blood samples were collected at 1, 3, 6 and 12 months following COVID‐19 diagnosis. Humoral immune responses to SARS‐CoV‐2 Spike proteins from Wuhan, Omicron BA.1, BA.4/5 and JN.1, as well as cellular immune responses to Wuhan and BA.1 were assessed.ResultsA total of 43 children and 113 samples were included in the analysis. Following Omicron infection, unvaccinated children generated low antibody responses but elicited Spike‐specific CD4 and CD8 T‐cell responses. In contrast, vaccinated children infected with the Omicron variant mounted robust humoral and cellular immune responses to both ancestral strain and Omicron subvariants. Hybrid immunity persisted for at least 6 months post infection, with cellular immune memory characterised by the generation of Spike‐specific polyfunctional CD8 T‐cell responses.ConclusionSARS‐CoV‐2 hybrid immunity in children is characterised by persisting SARS‐CoV‐2 antibodies and robust CD4 and CD8 T‐cell activation and polyfunctional responses. Our findings contribute to understanding hybrid immunity in children and may have implications regarding COVID‐19 vaccination and SARS‐CoV‐2 re‐infections.

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Review of pediatric emergency care and the COVID‐19 pandemic

Foster,

Walls,

Alade

et al. 2023

JACEP Open

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The coronavirus disease 2019 (COVID‐19) pandemic posed new challenges in health care delivery for patients of all ages. These included inadequate personal protective equipment, workforce shortages, and unknowns related to a novel virus. Children have been uniquely impacted by COVID‐19, both from the system of care and socially. In the initial surges of COVID‐19, a decrease in pediatric emergency department (ED) volume and a concomitant increase in critically ill adult patients resulted in re‐deployment of pediatric workforce to care for adult patients. Later in the pandemic, a surge in the number of critically ill children was attributed to multisystem inflammatory syndrome in children. This was an unexpected complication of COVID‐19 and further challenged the health care system. This article reviews the impact of COVID‐19 on the entire pediatric emergency care continuum, factors affecting ED care of children with COVID‐19 infection, including availability of vaccines and therapeutics approved for children, and pediatric emergency medicine workforce innovations and/or strategies. Furthermore, it provides guidance to emergency preparedness for optimal delivery of care in future health‐related crises.

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Safety and effectiveness of vaccines against COVID-19 in children aged 5–11 years: a systematic review and meta-analysis

Cited by 39 publications

References 63 publications

COVID‐19 vaccine effectiveness in children by age groups. A population‐based study in Galicia, Spain

COVID‐19 vaccine effectiveness in children by age groups. A population‐based study in Galicia, Spain

Humoral and cellular immune responses in vaccinated and unvaccinated children following SARS‐CoV‐2 Omicron infection

Review of pediatric emergency care and the COVID‐19 pandemic

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