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Pediatrics . Effectiveness of BNT162b2 COVID-19 Vaccination in Children and Adolescents

tetano

Editor, Senior Moderator
Pediatrics


. 2023 Apr 7;e2022060894.
doi: 10.1542/peds.2022-060894. Online ahead of print.
Effectiveness of BNT162b2 COVID-19 Vaccination in Children and Adolescents


Nicola P Klein[SUP] 1 [/SUP], Maria Demarco[SUP] 2 [/SUP], Katherine E Fleming-Dutra[SUP] 3 [/SUP], Melissa S Stockwell[SUP] 4 5 6 [/SUP], Anupam B Kharbanda[SUP] 7 [/SUP], Manjusha Gaglani[SUP] 8 9 [/SUP], Suchitra Rao[SUP] 10 [/SUP], Ned Lewis[SUP] 1 [/SUP], Stephanie A Irving[SUP] 11 [/SUP], Emily Hartmann[SUP] 12 [/SUP], Karthik Natarajan[SUP] 6 13 [/SUP], Alexandra F Dalton[SUP] 3 [/SUP], Ousseny Zerbo[SUP] 1 [/SUP], Malini B DeSilva[SUP] 14 [/SUP], Deepika Konatham[SUP] 8 [/SUP], Edward Stenehjem[SUP] 15 [/SUP], Elizabeth A K Rowley[SUP] 2 [/SUP], Toan C Ong[SUP] 10 [/SUP], Shaun J Grannis[SUP] 16 17 [/SUP], Chantel Sloan-Aagard[SUP] 12 18 [/SUP], Jungmi Han[SUP] 12 [/SUP], Jennifer R Verani[SUP] 3 [/SUP], Chandni Raiyani[SUP] 8 [/SUP], Kristin Dascomb[SUP] 15 [/SUP], Sarah E Reese[SUP] 2 [/SUP], Michelle A Barron[SUP] 10 [/SUP], William F Fadel[SUP] 16 19 [/SUP], Allison L Naleway[SUP] 11 [/SUP], Juan Nanez[SUP] 12 [/SUP], Monica Dickerson[SUP] 3 [/SUP], Kristin Goddard[SUP] 1 [/SUP], Kempapura Murthy[SUP] 8 [/SUP], Nancy Grisel[SUP] 15 [/SUP], Zacharay A Weber[SUP] 2 [/SUP], Brian E Dixon[SUP] 16 19 [/SUP], Palak Patel[SUP] 3 [/SUP], Bruce Fireman[SUP] 1 [/SUP], Julie Arndorfer[SUP] 15 [/SUP], Nimish R Valvi[SUP] 16 [/SUP], Eric P Griggs[SUP] 3 [/SUP], Carly Hallowell[SUP] 2 [/SUP], Peter J Embi[SUP] 16 20 [/SUP], Sarah W Ball[SUP] 2 [/SUP], Mark G Thompson[SUP] 3 [/SUP], Mark W Tenforde[SUP] 3 [/SUP], Ruth Link-Gelles[SUP] 3 [/SUP]



Affiliations

Abstract

Objectives: We assessed BNT162b2 vaccine effectiveness (VE) against mild to moderate and severe coronavirus disease 2019 (COVID-19) in children and adolescents through the Omicron BA.4/BA.5 period.
Methods: Using VISION Network records from April 2021 to September 2022, we conducted a test-negative, case-control study assessing VE against COVID-19-associated emergency department/urgent care (ED/UC) encounters and hospitalizations using logistic regression, conditioned on month and site, adjusted for covariates.
Results: We compared 9800 ED/UC cases with 70 232 controls, and 305 hospitalized cases with 2612 controls. During Delta, 2-dose VE against ED/UC encounters at 12 to 15 years was initially 93% (95% confidence interval 89 to 95), waning to 77% (69% to 84%) after ≥150 days. At ages 16 to 17, VE was initially 93% (86% to 97%), waning to 72% (63% to 79%) after ≥150 days. During Omicron, VE at ages 12 to 15 was initially 64% (44% to 77%), waning to 13% (3% to 23%) after 60 days; at ages 16 to 17 VE was 31% (10% to 47%) during days 60 to 149, waning to 7% (-8 to 20%) after 150 days. A monovalent booster increased VE to 54% (40% to 65%) at ages 12 to 15 and 46% (30% to 58%) at ages 16 to 17. At ages 5 to 11, 2-dose VE was 49% (33% to 61%) initially and 41% (29% to 51%) after 150 days. During Delta, VE against hospitalizations at ages 12 to 17 was high (>97%), and at ages 16 to 17 remained 98% (73% to 100%) beyond 150 days; during Omicron, hospitalizations were too infrequent to precisely estimate VE.
Conclusions: BNT162b2 protected children and adolescents against mild to moderate and severe COVID-19. VE was lower during Omicron predominance including BA.4/BA.5, waned after dose 2 but increased after a monovalent booster. Children and adolescents should receive all recommended COVID-19 vaccinations.
 
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