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Lancet Reg Health Eur . Post-vaccination infection rates and modification of COVID-19 symptoms in vaccinated UK school-aged children and adolescent

tetano

Editor, Senior Moderator
Lancet Reg Health Eur


. 2022 Aug;19:100429.
doi: 10.1016/j.lanepe.2022.100429. Epub 2022 Jul 8.
Post-vaccination infection rates and modification of COVID-19 symptoms in vaccinated UK school-aged children and adolescents: A prospective longitudinal cohort study


Erika Molteni[SUP] 1 [/SUP], Liane S Canas[SUP] 1 [/SUP], Kerstin Kläser[SUP] 1 [/SUP], Jie Deng[SUP] 1 [/SUP], Sunil S Bhopal[SUP] 2 [/SUP], Robert C Hughes[SUP] 3 [/SUP], Liyuan Chen[SUP] 1 [/SUP], Benjamin Murray[SUP] 1 [/SUP], Eric Kerfoot[SUP] 1 [/SUP], Michela Antonelli[SUP] 1 [/SUP], Carole H Sudre[SUP] 1 4 [/SUP], Joan Capdevila Pujol[SUP] 5 [/SUP], Lorenzo Polidori[SUP] 5 [/SUP], Anna May[SUP] 5 [/SUP], Prof Alexander Hammers[SUP] 1 [/SUP], Jonathan Wolf[SUP] 5 [/SUP], Prof Tim D Spector[SUP] 6 [/SUP], Claire J Steves[SUP] 6 7 [/SUP], Prof Sebastien Ourselin[SUP] 1 [/SUP], Michael Absoud[SUP] 8 9 [/SUP], Marc Modat[SUP] 1 [/SUP], Prof Emma L Duncan[SUP] 6 10 [/SUP]



Affiliations

Abstract

Background: We aimed to explore the effectiveness of one-dose BNT162b2 vaccination upon SARS-CoV-2 infection, its effect on COVID-19 presentation, and post-vaccination symptoms in children and adolescents (CA) in the UK during periods of Delta and Omicron variant predominance.
Methods: In this prospective longitudinal cohort study, we analysed data from 115,775 CA aged 12-17 years, proxy-reported through the Covid Symptom Study (CSS) smartphone application. We calculated post-vaccination infection risk after one dose of BNT162b2, and described the illness profile of CA with post-vaccination SARS-CoV-2 infection, compared to unvaccinated CA, and post-vaccination side-effects.
Findings: Between August 5, 2021 and February 14, 2022, 25,971 UK CA aged 12-17 years received one dose of BNT162b2 vaccine. The probability of testing positive for infection diverged soon after vaccination, and was lower in CA with prior SARS-CoV-2 infection. Vaccination reduced proxy-reported infection risk (-80·4% (95% CI -0·82 -0·78) and -53·7% (95% CI -0·62 -0·43) at 14-30 days with Delta and Omicron variants respectively, and -61·5% (95% CI -0·74 -0·44) and -63·7% (95% CI -0·68 -0.59) after 61-90 days). Vaccinated CA who contracted SARS-CoV-2 during the Delta period had milder disease than unvaccinated CA; during the Omicron period this was only evident in children aged 12-15 years. Overall disease profile was similar in both vaccinated and unvaccinated CA. Post-vaccination local side-effects were common, systemic side-effects were uncommon, and both resolved within few days (3 days in most cases).
Interpretation: One dose of BNT162b2 vaccine reduced risk of SARS-CoV-2 infection for at least 90 days in CA aged 12-17 years. Vaccine protection varied for SARS-CoV-2 variant type (lower for Omicron than Delta variant), and was enhanced by pre-vaccination SARS-CoV-2 infection. Severity of COVID-19 presentation after vaccination was generally milder, although unvaccinated CA also had generally mild disease. Overall, vaccination was well-tolerated.
Funding: UK Government Department of Health and Social Care, Chronic Disease Research Foundation, The Wellcome Trust, UK Engineering and Physical Sciences Research Council, UK Research and Innovation London Medical Imaging & Artificial Intelligence Centre for Value Based Healthcare, UK National Institute for Health Research, UK Medical Research Council, British Heart Foundation and Alzheimer's Society, and ZOE Limited.

Keywords: BNT162b2 vaccine effectiveness; BNT162b2, Comirnaty SARS-CoV-2 vaccine (BioNTech, Pfizer); CA, Children and adolescents; COVID-19 vaccination; KCL, King's College London; LFAT, Lateral flow antigen test; OR, Odds Ratio; PCR, Polymerase chain reaction; Paediatrics; SARS-CoV-2 vaccination; SARS-CoV-2 vaccination in children; SARS-CoV-2, Severe acute respiratory syndrome‐related coronavirus 2; UK, United Kingdom of Great Britain and Northern Ireland.
 
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