BNT162b2 Protection against the Omicron Variant in Children and Adolescents

被引：3

作者：

Price, A. M. ^{[1
]}

Olson, S. M. ^{[1
]}

Newhams, M. M. ^{[1
,5
]}

Halasa, N. B. ^{[8
]}

Boom, J. A. ^{[9
]}

Sahni, L. C. ^{[9
]}

Pannaraj, P. S. ^{[11
,12
,13
]}

Irby, K. ^{[19
]}

Bline, K. E. ^{[20
]}

Maddux, A. B. ^{[23
,24
]}

Nofziger, R. A. ^{[21
]}

Cameron, M. A. ^{[14
]}

Walker, T. C. ^{[25
]}

Schwartz, S. P. ^{[25
]}

Mack, E. H. ^{[26
]}

Smallcomb, L. ^{[27
]}

Schuster, J. E. ^{[28
]}

Hobbs, C., V ^{[29
,30
]}

Kamidani, S. ^{[2
,3
]}

Tarquinio, K. M. ^{[4
]}

Bradford, T. T. ^{[31
,32
]}

Levy, E. R. ^{[33
,34
]}

Chiotos, K. ^{[36
]}

Bhumbra, S. S. ^{[37
]}

Cvijanovich, N. Z. ^{[15
]}

Heidemann, S. M. ^{[38
]}

Cullimore, M. L. ^{[41
]}

Gertz, S. J. ^{[42
]}

Coates, B. M. ^{[43
]}

Staat, M. A. ^{[22
]}

Zinter, M. S. ^{[16
,17
,18
]}

Kong, M. ^{[44
]}

Chatani, B. M. ^{[45
]}

Hume, J. R. ^{[35
]}

Typpo, K., V ^{[46
,47
]}

Maamari, M. ^{[10
]}

Flori, H. R. ^{[39
,40
]}

Tenforde, M. W. ^{[1
]}

Zambrano, L. D. ^{[1
]}

Campbell, A. P. ^{[1
]}

Patel, M. M. ^{[1
]}

Randolph, A. G. ^{[5
,6
,7
]}

机构：

[1] Ctr Dis Control & Prevent, Covid 19 Response Team, Atlanta, GA 30329 USA

[2] Childrens Healthcare Atlanta, Ctr Childhood Infect & Vaccines, Atlanta, GA USA

[3] Emory Univ, Sch Med, Dept Pediat, Atlanta, GA USA

[4] Emory Univ, Sch Med, Childrens Healthcare Atlanta, Div Crit Care Med,Dept Pediat, Atlanta, GA USA

[5] Boston Childrens Hosp, Dept Anesthesiol Crit Care & Pain Med, Boston, MA USA

[6] Harvard Med Sch, Dept Anaesthesia, Boston, MA 02115 USA

[7] Harvard Med Sch, Dept Pediat, Boston, MA 02115 USA

[8] Vanderbilt Univ Sch Med, Dept Pediat, Div Pediat Infect Dis, Nashville, TN USA

[9] Texas Childrens Hosp, Immunizat Project, Dept Pediat, Baylor Coll Med, Houston, TX 77030 USA

[10] Univ Texas Southwestern, Childrens Med Ctr, Div Crit Care Med, Dept Pediat, Dallas, TX USA

[11] Childrens Hosp Los Angeles, Div Infect Dis, Los Angeles, CA 90027 USA

[12] Univ Southern Calif, Dept Pediat, Los Angeles, CA USA

[13] Univ Southern Calif, Dept Mol Microbiol & Immunol, Los Angeles, CA USA

[14] UC San Diego Rady Childrens Hosp, Div Pediat Hosp Med, San Diego, CA USA

[15] UCSF Benioff Childrens Hosp, Div Crit Care Med, Oakland, CA USA

[16] Univ Calif San Francisco, Dept Pediat, Div Crit Care Med, San Francisco, CA USA

[17] Univ Calif San Francisco, Dept Pediat, Div Immunol, San Francisco, CA USA

[18] Univ Calif San Francisco, Dept Pediat, Div Bone Marrow Transplant, San Francisco, CA USA

[19] Arkansas Childrens Hosp, Sect Pediat Crit Care, Dept Pediat, Little Rock, AR 72202 USA

[20] Nationwide Childrens Hosp Columbus, Div Pediat Crit Care Med, Akron, OH USA

[21] Akron Childrens Hosp, Dept Pediat, Div Crit Care Med, Akron, OH 44308 USA

[22] Univ Cincinnati, Coll Med, Cincinnati Childrens Hosp Med Ctr, Dept Pediat, Cincinnati, OH USA

[23] Univ Colorado, Sch Med, Dept Pediat, Sect Crit Care Med, Aurora, CO USA

[24] Childrens Hosp Colorado, Aurora, CO USA

[25] Univ North Carolina Chapel Hill, Childrens Hosp, Dept Pediat, Chapel Hill, NC USA

[26] Med Univ South Carolina, Div Pediat Crit Care Med, Charleston, SC 29425 USA

[27] Med Univ South Carolina, Dept Pediat, Charleston, SC 29425 USA

[28] Childrens Mercy Kansas City, Dept Pediat, Div Pediat Infect Dis, Kansas City, MO USA

[29] Univ Mississippi Med Ctr, Div Infect Dis, Dept Pediat, Jackson, MS USA

[30] Univ Mississippi Med Ctr, Div Infect Dis, Dept Microbiol, Jackson, MS USA

[31] Louisiana State Univ, Hlth Sci Ctr, Div Cardiol, Dept Pediat, New Orleans, LA USA

[32] Childrens Hosp New Orleans, New Orleans, LA USA

[33] Mayo Clin, Div Pediat Infect Dis, Dept Pediat & Adolescent Med, Rochester, NY USA

[34] Mayo Clin, Div Pediat Crit Care Med, Dept Pediat & Adolescent Med, Rochester, NY USA

[35] Univ Minnesota, Masonic Childrens Hosp, Div Pediat Crit Care, Minneapolis, MN USA

[36] Childrens Hosp Philadelphia, Dept Anesthesiol & Crit Care, Div Crit Care Med, Philadelphia, PA 19104 USA

[37] Indiana Univ Sch Med, Dept Pediat, Ryan White Ctr Pediat Infect Dis & Global Hlth, Indianapolis, IN 46202 USA

[38] Cent Michigan Univ, Childrens Hosp Michigan, Div Pediat Crit Care Med, Detroit, MI USA

[39] Mott Childrens Hosp, Dept Pediat, Div Pediat Crit Care Med, Ann Arbor, MI USA

[40] Univ Michigan, Ann Arbor, MI 48109 USA

[41] Childrens Hosp & Med Ctr, Dept Pediat, Div Pediat Crit Care, Omaha, NE USA

[42] Cooperman Barnabas Med Ctr, Dept Pediat, Div Pediat Crit Care, Livingston, NJ USA

[43] Northwestern Univ, Feinberg Sch Med, Ann & Robert H Lurie Childrens Hosp Chicago, Div Crit Care Med,Dept Pediat, Chicago, IL 60611 USA

[44] Univ Alabama Birmingham, Dept Pediat, Div Pediat Crit Care Med, Birmingham, AL USA

[45] UHlth Holtz Childrens Hosp, Dept Pediat, Div Pediat Infect Dis, Miami, FL USA

[46] Univ Arizona, Dept Pediat, Tucson, AZ 85721 USA

[47] Univ Arizona, Banner Childrens, Diamond Childrens Med Ctr, Tucson, AZ USA

来源：

NEW ENGLAND JOURNAL OF MEDICINE | 2022年 / 386卷 / 20期

关键词：

MESSENGER-RNA VACCINATION; COVID-19; VACCINE; STATES;

D O I：

10.1056/NEJMoa2202826

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BackgroundSpread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) B.1.1.529 (omicron) variant, which led to increased U.S. hospitalizations for coronavirus disease 2019 (Covid-19), generated concern about immune evasion and the duration of protection from vaccines in children and adolescents. MethodsUsing a case-control, test-negative design, we assessed vaccine effectiveness against laboratory-confirmed Covid-19 leading to hospitalization and against critical Covid-19 (i.e., leading to receipt of life support or to death). From July 1, 2021, to February 17, 2022, we enrolled case patients with Covid-19 and controls without Covid-19 at 31 hospitals in 23 states. We estimated vaccine effectiveness by comparing the odds of antecedent full vaccination (two doses of BNT162b2 messenger RNA vaccine) at least 14 days before illness among case patients and controls, according to time since vaccination for patients 12 to 18 years of age and in periods coinciding with circulation of B.1.617.2 (delta) (July 1, 2021, to December 18, 2021) and omicron (December 19, 2021, to February 17, 2022) among patients 5 to 11 and 12 to 18 years of age. ResultsWe enrolled 1185 case patients (1043 [88%] of whom were unvaccinated, 291 [25%] of whom received life support, and 14 of whom died) and 1627 controls. During the delta-predominant period, vaccine effectiveness against hospitalization for Covid-19 among adolescents 12 to 18 years of age was 93% (95% confidence interval [CI], 89 to 95) 2 to 22 weeks after vaccination and was 92% (95% CI, 80 to 97) at 23 to 44 weeks. Among adolescents 12 to 18 years of age (median interval since vaccination, 162 days) during the omicron-predominant period, vaccine effectiveness was 40% (95% CI, 9 to 60) against hospitalization for Covid-19, 79% (95% CI, 51 to 91) against critical Covid-19, and 20% (95% CI, -25 to 49) against noncritical Covid-19. During the omicron period, vaccine effectiveness against hospitalization among children 5 to 11 years of age was 68% (95% CI, 42 to 82; median interval since vaccination, 34 days). ConclusionsBNT162b2 vaccination reduced the risk of omicron-associated hospitalization by two thirds among children 5 to 11 years of age. Although two doses provided lower protection against omicron-associated hospitalization than against delta-associated hospitalization among adolescents 12 to 18 years of age, vaccination prevented critical illness caused by either variant. (Funded by the Centers for Disease Control and Prevention.) Vaccine Effectiveness against Omicron in Children and AdolescentsIn this study evaluating BNT162b2, vaccine effectiveness against hospitalization for Covid-19 in the delta-predominant period among adolescents 12 to 18 years of age was more than 90%; during the omicron period, vaccine effectiveness was 40% against hospitalization and 79% against critical illness. Vaccine effectiveness against hospitalization was 68% among children 5 to 11 years of age.

引用

页码：1899 / 1909

页数：11

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