MMWR. Morbidity and mortality weekly report · 2024
Durability of Original Monovalent mRNA Vaccine Effectiveness Against COVID-19 Omicron-Associated Hospitalization in Children and Adolescents - United States, 2021-2023.
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Zambrano Laura D, Newhams Margaret M, Simeone Regina M, Payne Amanda B, Wu Michael, Orzel-Lockwood Amber O, Halasa Natasha B, Calixte Jemima M, Pannaraj Pia S, Mongkolrattanothai Kanokporn, Boom Julie A, Sahni Leila C, Kamidani Satoshi, Chiotos Kathleen, Cameron Melissa A, Maddux Aline B, Irby Katherine, Schuster Jennifer E, Mack Elizabeth H, Biggs Austin, Coates Bria M, Michelson Kelly N, Bline Katherine E, Nofziger Ryan A, Crandall Hillary, Hobbs Charlotte V, Gertz Shira J, Heidemann Sabrina M, Bradford Tamara T, Walker Tracie C, Schwartz Stephanie P, Staat Mary Allen, Bhumbra Samina S, Hume Janet R, Kong Michele, Stockwell Melissa S, Connors Thomas J, Cullimore Melissa L, Flori Heidi R, Levy Emily R, Cvijanovich Natalie Z, Zinter Matt S, Maamari Mia, Bowens Cindy, Zerr Danielle M, Guzman-Cottrill Judith A, Gonzalez Ivan, Campbell Angela P, Randolph Adrienne G, Overcoming COVID-19 Investigators
Аннотация
Pediatric COVID-19 vaccination is effective in preventing COVID-19-related hospitalization, but duration of protection of the original monovalent vaccine during SARS-CoV-2 Omicron predominance merits evaluation, particularly given low coverage with updated COVID-19 vaccines. During December 19, 2021-October 29, 2023, the Overcoming COVID-19 Network evaluated vaccine effectiveness (VE) of ≥2 original monovalent COVID-19 mRNA vaccine doses against COVID-19-related hospitalization and critical illness among U.S. children and adolescents aged 5-18 years, using a case-control design. Too few children and adolescents received bivalent or updated monovalent vaccines to separately evaluate their effectiveness. Most case-patients (persons with a positive SARS-CoV-2 test result) were unvaccinated, despite the high frequency of reported underlying conditions associated with severe COVID-19. VE of the original monovalent vaccine against COVID-19-related hospitalizations was 52% (95% CI = 33%-66%) when the most recent dose was administered <120 days before hospitalization and 19% (95% CI = 2%-32%) if the interval was 120-364 days. VE of the original monovalent vaccine against COVID-19-related hospitalization was 31% (95% CI = 18%-43%) if the last dose was received any time within the previous year. VE against critical COVID-19-related illness, defined as receipt of noninvasive or invasive mechanical ventilation, vasoactive infusions, extracorporeal membrane oxygenation, and illness resulting in death, was 57% (95% CI = 21%-76%) when the most recent dose was received <120 days before hospitalization, 25% (95% CI = -9% to 49%) if it was received 120-364 days before hospitalization, and 38% (95% CI = 15%-55%) if the last dose was received any time within the previous year. VE was similar after excluding children and adolescents with documented immunocompromising conditions. Because of the low frequency of children who received updated COVID-19 vaccines and waning effectiveness of original monovalent doses, these data support CDC recommendations that all children and adolescents receive updated COVID-19 vaccines to protect against severe COVID-19.