Eurosurv. COVID-19 vaccine effectiveness in the paediatric population aged 5–17 years: a multicentre cohort study using electronic health registries in six European countries, 2021 to 2022

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• Patrícia Soares^1,* , Ausenda Machado^1,* , Nathalie Nicolay² , Susana Monge^3,4 , Chiara Sacco⁵ , Christian Holm Hansen⁶ , Hinta Meijerink⁷ , Iván Martínez-Baz^4,8 , Susanne Schmitz⁹ , James Humphreys¹⁰ , Massimo Fabiani⁵ , Aitziber Echeverria⁸ , Ala’a AlKerwi⁹ , Anthony Nardone¹⁰ , Alberto Mateo-Urdiales⁵ , Jesús Castilla^4,8 , Esther Kissling¹⁰ , Baltazar Nunes^1,10 , VEBIS-Lot 4 working group¹¹

Background

During the first year of the COVID-19 pandemic, vaccination programmes targeted children and adolescents to prevent severe outcomes of SARS-CoV-2 infection.


Aim

To estimate COVID-19 vaccine effectiveness (VE) against hospitalisation due to COVID-19 in the paediatric population, among those with and without previously documented SARS-CoV-2 infection.


Methods

We established a fixed cohort followed for 12 months in Denmark, Norway, Italy, Luxembourg, Navarre (Spain) and Portugal using routine electronic health registries. The study commenced with paediatric COVID-19 vaccination campaign at each site between June 2021 and January 2022. The outcome was hospitalisation with a laboratory-confirmed SARS-CoV-2 infection or COVID-19 as the main diagnosis. Using Cox proportional hazard models, VE was estimated as 1 minus the confounder-adjusted hazard ratio of COVID-19 hospitalisation between vaccinated and unvaccinated. A random-effects meta-analysis was used to pool VE estimates.


Results

We included 4,144,667 5–11-year-olds and 3,861,841 12–17-year-olds. In 12–17-year-olds without previous infection, overall VE was 69% (95% CI: 40 to 84). VE declined with time since vaccination from 77% ≤ 3 months to 48% 180–365 days after immunisation. VE was 94% (95% CI: 90 to 96), 56% (95% CI: 3 to 80) and 41% (95% CI: −14 to 69) in the Delta, Omicron BA.1/BA.2 and BA.4/BA.5 periods, respectively. In 12–17-year-olds with previous infection, one dose VE was 80% (95% CI: 18 to 95). VE estimates were similar for 5–11-year-olds but with lower precision.


Conclusion

Vaccines recommended for 5–17-year-olds provided protection against COVID-19 hospitalisation, regardless of a previously documented infection of SARS-CoV-2, with high levels of protection in the first 3 months of the vaccination

https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2025.30.8.2400450