Vaccine Effectiveness, School Reopening, and Risk of Omicron Infection Among Adolescents Aged 12–17 Years

Risk, Malcolm; Miao, Heidi; Freed, Gary L.; Shen, Chen

doi:10.1016/j.jadohealth.2022.09.006

Cited by 9 publications

(7 citation statements)

References 9 publications

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“…47 Moving forward, this protection is increased further by a bivalent booster dose containing Omicron's Spike mRNA, which is now being used in booster programmes across the world. 48 Despite increased transmission of Omicron versus previous variants, including in schools, 49 the continued vaccination of children, 50 which was not widespread in previous waves, may compensate for the transmission advantage of Omicron.…”

Section: Discussionmentioning

confidence: 99%

School closures during COVID-19: an overview of systematic reviews

Hume

Brown

Mahtani

2023

BMJ EBM

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ObjectivesTo assess the benefits and drawbacks of school closures and in-school mitigations during the COVID-19 pandemic.DesignOverview of systematic reviews (SRs).Search methodsWe searched six databases and additional resources on 29 July 2022: MEDLINE, Embase, Google Scholar, Cochrane Library, COVID-END inventory of evidence synthesis, and Epistemonikos.Eligibility criteriaWe selected SRs written in English that answered at least one of four specific questions concerning the efficacy and drawbacks of school closures. Their primary studies were conducted in primary and secondary schools, including pupils aged 5–18. Interventions included school closures or mitigations (such as mask usage) introduced in schools.Data collection and analysisWe used AMSTAR 2 to assess confidence in the included SRs, and GRADE was used to assess certainty of evidence. We performed a narrative synthesis of the results, prioritising higher-quality SRs, those which performed GRADE assessments and those with more unique primary studies. We also assessed the overlap between primary studies included in the SRs.Main outcome measuresOur framework for summarising outcome data was guided by the following questions: (1) What is the impact of school closures on COVID-19 transmission, morbidity or mortality in the community? (2) What is the impact of COVID-19 school closures on mental health (eg, anxiety), physical health (eg, obesity, domestic violence, sleep) and learning/achievement of primary and secondary pupils? (3) What is the impact of mitigations in schools on COVID-19 transmission, morbidity or mortality in the community? and (4) What is the impact of COVID-19 mitigations in schools on mental health, physical health and learning/achievement of primary and secondary pupils?ResultsWe identified 578 reports, 26 of which were included. One SR was of high confidence, 0 moderate, 10 low and 15 critically low confidence. We identified 132 unique primary studies on the effects of school closures on transmission/morbidity/mortality, 123 on learning, 164 on mental health, 22 on physical health, 16 on sleep, 7 on domestic violence and 69 on effects of in-school mitigations on transmission/morbidity/mortality.Both school closures and in-school mitigations were associated with reduced COVID-19 transmission, morbidity and mortality in the community. School closures were also associated with reduced learning, increased anxiety and increased obesity in pupils. We found no SRs that assessed potential drawbacks of in-school mitigations on pupils. The certainty of evidence according to GRADE was mostly very low.ConclusionsSchool closures during COVID-19 had both positive and negative impacts. We found a large number of SRs and primary studies. However, confidence in the SRs was mostly low to very low, and the certainty of evidence was also mostly very low. We found no SRs assessing the potential drawbacks of in-school mitigations on children, which could be addressed moving forward. This overview provides evidence that could inform policy makers on school closures during future potential waves of COVID-19.

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Section: Discussionmentioning

confidence: 99%

School closures during COVID-19: an overview of systematic reviews

Hume

Brown

Mahtani

2023

BMJ EBM

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“…And a total of 32 studies ( 10–12 , 17–41 , 43–45 ) explored complete vaccination (2-dose), yielding an overall RR of 0.50 (95% CI: 0.45 to 0.56, I 2 = 93%, p < 0.01; Figure 3 ; VE: 50, 95% CI: 44 to 55%; Table 1 ). Additionally, 10 studies ( 12 , 17 , 19 , 25 , 28–30 , 36 , 39 , 42 ) focused on booster vaccination (3-dose), presenting an overall RR of 0.39 (95% CI: 0.27 to 0.55, I 2 = 97%, p < 0.01; Figure 3 ; VE: 61, 95% CI: 45 to 73%; Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

The effect of COVID-19 vaccine to the Omicron variant in children and adolescents: a systematic review and meta-analysis

Lu,

Zeng,

Yao

et al. 2024

Front. Public Health

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BackgroundOmicron (B.1.1.529), a variant of SARS-CoV-2, has emerged as a dominant strain in COVID-19 pandemic. This development has raised concerns about the effectiveness of vaccination to Omicron, particularly in the context of children and adolescents. Our study evaluated the efficacy of different COVID-19 vaccination regimens in children and adolescents during the Omicron epidemic phase.MethodsWe searched PubMed, Cochrane, Web of Science, and Embase electronic databases for studies published through March 2023 on the association between COVID-19 vaccination and vaccine effectiveness (VE) against SARS-CoV-2 infection in children and adolescents at the Omicron variant period. The effectiveness outcomes included mild COVID-19 and severe COVID-19. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was prospectively registered in PROSPERO (CRD42023390481).ResultsA total of 33 studies involving 16,532,536 children were included in the analysis. First, in children and adolescents aged 0–19 years, the overall VE of the COVID-19 vaccine is 45% (95% confidence interval [CI]: 40 to 50%). Subgroup analysis of VE during Omicron epidemic phase for different dosage regimens demonstrated that the VE was 50% (95% CI: 44 to 55%) for the 2-dose vaccination and 61% (95% CI: 45 to 73%) for the booster vaccination. Upon further analysis of different effectiveness outcomes during the 2-dose vaccination showed that the VE was 41% (95% CI: 35 to 47%) against mild COVID-19 and 71% (95% CI: 60 to 79%) against severe COVID-19. In addition, VE exhibited a gradual decrease over time, with the significant decline in the efficacy of Omicron for infection before and after 90 days following the 2-dose vaccination, registering 54% (95% CI: 48 to 59%) and 34% (95% CI: 21 to 56%), respectively.ConclusionDuring the Omicron variant epidemic, the vaccine provided protection against SARS-CoV-2 infection in children and adolescents aged 0–19 years. Two doses of vaccination can provide effective protection severe COVID-19, with booster vaccination additionally enhancing VE.

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“…Children were eligible for inclusion on or after the date BNT162b2 was authorized for their age group (December 11, 2020, for ages 16-17; May 10, 2021, for ages 12-15; October 29, 2021, for ages [5][6][7][8][9][10][11]. Vaccinated and matched unvaccinated children were required to meet the following inclusion criteria (Additional file, eFigure 1): at least 365 days of continuous medical and pharmacy coverage before Time 0 (including the date of the age group-specific vaccine authorization to ensure observation of all COVID-19 vaccine doses); be aged within the vaccine-authorized age range at Time 0; and reside within the catchment area of the linked claims-IIS data.…”

Section: Population and Data Sourcementioning

confidence: 99%

“…The effectiveness of COVID-19 vaccines has been evaluated in different US geographic and healthcare settings, time periods, and age groups using an array of study designs and data sources [5][6][7][8][9][10]. As part of its continued surveillance of authorized vaccines, the US Food and Drug Administration (FDA) Biologics Effectiveness and Safety (BEST) Initiative evaluated the real-world effectiveness of monovalent BNT162b2 in US children using national insurance claims databases linked to immunization information system (IIS) vaccination records to improve vaccine capture and limit bias.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of BNT162b2 COVID-19 primary series vaccination in children aged 5–17 years in the United States: a cohort study

Ogilvie,

Layton,

Lloyd

et al. 2024

BMC Pediatr

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Background COVID-19 vaccines are authorized for use in children in the United States; real-world assessment of vaccine effectiveness in children is needed. This study’s objective was to estimate the effectiveness of receiving a complete primary series of monovalent BNT162b2 (Pfizer-BioNTech) COVID-19 vaccine in US children. Methods This cohort study identified children aged 5–17 years vaccinated with BNT162b2 matched with unvaccinated children. Participants and BNT162b2 vaccinations were identified in Optum and CVS Health insurance administrative claims databases 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). 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. 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 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. Registration The study protocol was publicly posted on the BEST Initiative website (https://bestinitiative.org/wp-content/uploads/2022/03/C19-VX-Effectiveness-Protocol_2022_508.pdf).

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Vaccine Effectiveness, School Reopening, and Risk of Omicron Infection Among Adolescents Aged 12–17 Years

Cited by 9 publications

References 9 publications

School closures during COVID-19: an overview of systematic reviews

School closures during COVID-19: an overview of systematic reviews

The effect of COVID-19 vaccine to the Omicron variant in children and adolescents: a systematic review and meta-analysis

Effectiveness of BNT162b2 COVID-19 primary series vaccination in children aged 5–17 years in the United States: a cohort study

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