Vaccine · 2026
Estimates of SARS-CoV-2 vaccine effectiveness against COVID-19-associated hospitalisation in paediatric patients in Hong Kong during two successive SARS-CoV-2 epidemic waves dominated by the Omicron variant: A test-negative design study.
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Okoli George N, Kwan Mike Y W, Chan Eunice L Y, Murphy Caitriona, Wong Joshua S C, Chua Huiying, Peiris Malik, Cowling Benjamin J, Lee So-Lun
Аннотация
BACKGROUND: We assessed the effectiveness of SARS-CoV-2 vaccines against COVID-19-associated hospitalisation in paediatric patients in Hong Kong.
METHODS: We conducted a test-negative design study in hospitalised children 1-17 years old admitted with recent-onset (≤5 days) acute respiratory illness in two large public hospitals in Hong Kong during successive SARS-CoV-2 epidemic waves between April 2022 and February 2024 dominated by the Omicron variant. We defined having been vaccinated as receipt of ≥1 SARS-CoV-2 vaccine dose within six months prior to hospitalisation, and for a sensitivity analysis, within twelve months of hospitalisation. Children who had only received one dose of vaccine and had no prior infection were excluded. We estimated VE against laboratory-confirmed SARS-CoV-2 infection separately for 1-4-year-olds and 5-17-year-olds, by conditional logistic regression stratified by calendar time (week) and adjusted for potential confounders.
RESULTS: There were 6308 patients. The proportion of the vaccinated within six months of hospitalisation differed significantly between cases and controls in all strata of the assessed individual sociodemographic/health-related characteristics in the 5-17-year-olds, and in 1-4-year-olds who had a chronic medical condition. Overall, VE was moderate for 1-4-year-olds [41% (23-56%)] and for 5-17-year-olds [54% (10-66%)]. VE was higher in those who had received a mRNA vaccine: 87% (0-98%) and 82% (59-92%) compared with a lower VE for those who had received an inactivated vaccine: 39% (17-54%) and 30% (-19-58%), respectively for 1-4-year-olds and 5-17-year-olds although with a higher degree of imprecision in the VE for mRNA in 1-4-year-olds. In both age groups, VE was higher for those who had had no previous SARS-CoV-2 infection compared with for those who had had a previous infection.
CONCLUSIONS: SARS-CoV-2 vaccines, particularly mRNA vaccines, provided substantial protection against paediatric COVID-19-associated hospitalisations in Hong Kong during two successive SARS-CoV-2 epidemic waves dominated by the Omicron variant.
METHODS: We conducted a test-negative design study in hospitalised children 1-17 years old admitted with recent-onset (≤5 days) acute respiratory illness in two large public hospitals in Hong Kong during successive SARS-CoV-2 epidemic waves between April 2022 and February 2024 dominated by the Omicron variant. We defined having been vaccinated as receipt of ≥1 SARS-CoV-2 vaccine dose within six months prior to hospitalisation, and for a sensitivity analysis, within twelve months of hospitalisation. Children who had only received one dose of vaccine and had no prior infection were excluded. We estimated VE against laboratory-confirmed SARS-CoV-2 infection separately for 1-4-year-olds and 5-17-year-olds, by conditional logistic regression stratified by calendar time (week) and adjusted for potential confounders.
RESULTS: There were 6308 patients. The proportion of the vaccinated within six months of hospitalisation differed significantly between cases and controls in all strata of the assessed individual sociodemographic/health-related characteristics in the 5-17-year-olds, and in 1-4-year-olds who had a chronic medical condition. Overall, VE was moderate for 1-4-year-olds [41% (23-56%)] and for 5-17-year-olds [54% (10-66%)]. VE was higher in those who had received a mRNA vaccine: 87% (0-98%) and 82% (59-92%) compared with a lower VE for those who had received an inactivated vaccine: 39% (17-54%) and 30% (-19-58%), respectively for 1-4-year-olds and 5-17-year-olds although with a higher degree of imprecision in the VE for mRNA in 1-4-year-olds. In both age groups, VE was higher for those who had had no previous SARS-CoV-2 infection compared with for those who had had a previous infection.
CONCLUSIONS: SARS-CoV-2 vaccines, particularly mRNA vaccines, provided substantial protection against paediatric COVID-19-associated hospitalisations in Hong Kong during two successive SARS-CoV-2 epidemic waves dominated by the Omicron variant.