Effectiveness of Bivalent mRNA COVID-19 Vaccines in Preventing SARS-CoV-2 Infection in Children and Adolescents Aged 5 to 17 Years

被引：17

作者：

Feldstein, Leora R. ^{[1
,14
]}

Britton, Amadea ^{[1
]}

Grant, Lauren ^{[1
]}

Wiegand, Ryan ^{[1
]}

Ruffin, Jasmine ^{[1
]}

Babu, Tara M. ^{[2
]}

Hagen, Melissa Briggs ^{[1
]}

Burgess, Jefferey L. ^{[3
]}

Caban-Martinez, Alberto J. ^{[4
]}

Chu, Helen Y. ^{[2
]}

Ellingson, Katherine D. ^{[3
]}

Englund, Janet A. ^{[5
]}

Hegmann, Kurt T. ^{[6
]}

Jeddy, Zuha ^{[7
]}

Lauring, Adam S. ^{[8
]}

Lutrick, Karen ^{[3
]}

Martin, Emily T. ^{[9
]}

Mathenge, Clare ^{[10
]}

Meece, Jennifer ^{[11
]}

Midgley, Claire M. ^{[1
]}

Monto, Arnold S. ^{[9
]}

Newes-Adeyi, Gabriella ^{[7
]}

Odame-Bamfo, Leah ^{[10
]}

Olsho, Lauren E. W. ^{[7
]}

Phillips, Andrew L. ^{[6
]}

Rai, Ramona P. ^{[7
]}

Saydah, Sharon ^{[1
]}

Smith, Ning ^{[12
]}

Steinhardt, Laura ^{[1
]}

Tyner, Harmony ^{[13
]}

Vandermeer, Meredith ^{[12
]}

Vaughan, Molly ^{[7
]}

Yoon, Sarang K. ^{[6
]}

Gaglani, Manjusha ^{[10
]}

Naleway, Allison L. ^{[12
]}

机构：

[1] US Ctr Dis Control & Prevent, Natl Ctr Immunizat & Resp Dis, Coronavirus & Other Resp Viruses Div, Atlanta, GA USA

[2] Univ Washington, Dept Med, Div Allergy & Infect Dis, Seattle, WA USA

[3] Univ Arizona, Tucson, AZ USA

[4] Univ Miami, Dept Publ Hlth Sci, Miami, FL USA

[5] Seattle Childrens Res Inst, Seattle, WA USA

[6] Univ Utah Hlth, Salt Lake City, UT USA

[7] Abt Associates Inc, Rockville, MD USA

[8] Univ Michigan, Dept Internal Med, Div Infect Dis, Ann Arbor, MI USA

[9] Univ Michigan, Dept Epidemiol, Sch Publ Hlth, Ann Arbor, MI USA

[10] Baylor Scott & White Hlth, Temple, TX USA

[11] Marshfield Clin Res Inst, Marshfield, WI USA

[12] Kaiser Permanente Ctr Hlth Res, Portland, OR USA

[13] St Lukes Reg Hlth Care Syst, Duluth, MN USA

[14] US Ctr Dis Control & Prevent, 1600 Clifton Rd NE, Atlanta, GA 30329 USA

来源：

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION | 2024年 / 331卷 / 05期

关键词：

REGRESSION; VACCINATION; VARIANT; OMICRON;

D O I：

10.1001/jama.2023.27022

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Importance Bivalent mRNA COVID-19 vaccines were recommended in the US for children and adolescents aged 12 years or older on September 1, 2022, and for children aged 5 to 11 years on October 12, 2022; however, data demonstrating the effectiveness of bivalent COVID-19 vaccines are limited. Objective To assess the effectiveness of bivalent COVID-19 vaccines against SARS-CoV-2 infection and symptomatic COVID-19 among children and adolescents. Design, Setting, and Participants Data for the period September 4, 2022, to January 31, 2023, were combined from 3 prospective US cohort studies (6 sites total) and used to estimate COVID-19 vaccine effectiveness among children and adolescents aged 5 to 17 years. A total of 2959 participants completed periodic surveys (demographics, household characteristics, chronic medical conditions, and COVID-19 symptoms) and submitted weekly self-collected nasal swabs (irrespective of symptoms); participants submitted additional nasal swabs at the onset of any symptoms. Exposure Vaccination status was captured from the periodic surveys and supplemented with data from state immunization information systems and electronic medical records. Main Outcome and Measures Respiratory swabs were tested for the presence of the SARS-CoV-2 virus using reverse transcriptase-polymerase chain reaction. SARS-CoV-2 infection was defined as a positive test regardless of symptoms. Symptomatic COVID-19 was defined as a positive test and 2 or more COVID-19 symptoms within 7 days of specimen collection. Cox proportional hazards models were used to estimate hazard ratios for SARS-CoV-2 infection and symptomatic COVID-19 among participants who received a bivalent COVID-19 vaccine dose vs participants who received no vaccine or monovalent vaccine doses only. Models were adjusted for age, sex, race, ethnicity, underlying health conditions, prior SARS-CoV-2 infection status, geographic site, proportion of circulating variants by site, and local virus prevalence. Results Of the 2959 participants (47.8% were female; median age, 10.6 years [IQR, 8.0-13.2 years]; 64.6% were non-Hispanic White) included in this analysis, 25.4% received a bivalent COVID-19 vaccine dose. During the study period, 426 participants (14.4%) had laboratory-confirmed SARS-CoV-2 infection. Among these 426 participants, 184 (43.2%) had symptomatic COVID-19, 383 (89.9%) were not vaccinated or had received only monovalent COVID-19 vaccine doses (1.38 SARS-CoV-2 infections per 1000 person-days), and 43 (10.1%) had received a bivalent COVID-19 vaccine dose (0.84 SARS-CoV-2 infections per 1000 person-days). Bivalent vaccine effectiveness against SARS-CoV-2 infection was 54.0% (95% CI, 36.6%-69.1%) and vaccine effectiveness against symptomatic COVID-19 was 49.4% (95% CI, 22.2%-70.7%). The median observation time after vaccination was 276 days (IQR, 142-350 days) for participants who received only monovalent COVID-19 vaccine doses vs 50 days (IQR, 27-74 days) for those who received a bivalent COVID-19 vaccine dose. Conclusion and Relevance The bivalent COVID-19 vaccines protected children and adolescents against SARS-CoV-2 infection and symptomatic COVID-19. These data demonstrate the benefit of COVID-19 vaccine in children and adolescents. All eligible children and adolescents should remain up to date with recommended COVID-19 vaccinations.

引用

页码：408 / 416

页数：9

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