Characteristics and Clinical Outcomes of Vaccine-Eligible US Children Under-5 Years Hospitalized for Acute COVID-19 in a National Network

Authors

Laura D. Zambrano, Centers for Disease Control and Prevention, Atlanta, GA
Margaret M. Newhams, Boston Children's Hospital, Boston, MA
Regina M. Simeone, Centers for Disease Control and Prevention, Atlanta, GA
Katherine E. Fleming-Dutra, Centers for Disease Control and Prevention, Atlanta, GA
Natasha Halasa, Vanderbilt University Medical Center, Nashville, TN
Michael Wu, Centers for Disease Control and Prevention, Atlanta, GA
Amber O. Orzel-Lockwood, Boston Children's Hospital, Boston, MA
Satoshi Kamidani, Emory University School of Medicine, Atlanta, GA
Pia S. Pannaraj, University of Southern California, Children's Hospital Los Angeles, Los Angeles, CA
Kathleen Chiotos, Children's Hospital of Philadelphia, Philadelphia, PA
Melissa A. Cameron, UC San Diego-Rady Children's Hospital, San Diego, CA
Aline B. Maddux, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO
Jennifer E. Schuster, Children's Mercy Kansas City, Kansas City, MO
Hillary Crandall, University of Utah and Primary Children's Hospital, Salt Lake City, UT
Michele Kong, University of Alabama at Birmingham, Birmingham, AL
Ryan A. Nofziger, Akron Children's Hospital, Akron, OH
Mary A. Staat, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
Samina S. Bhumbra, Indiana University School of Medicine, Indianapolis, IN
Katherine Irby, Arkansas Children's Hospital, Little Rock, AR
Julie A. Boom, Texas Children's Hospital, Houston, TX
Leila C. Sahni, Texas Children's Hospital, Houston, TX
Janet R. Hume, University of Minnesota Masonic Children's Hospital, Minneapolis, MN
Shira J. Gertz, Cooperman Barnabas Medical Center, Livingston, NJ
Mia Maamari, University of Texas Southwestern, Children's Medical Center Dallas, TX
Cindy Bowens, University of Texas Southwestern, Children's Medical Center Dallas, TX
Emily R. Levy, Mayo Clinic, Rochester, MN
Tamara T. Bradford, LSU Health Sciences Center - New OrleansFollow
Tracie C. Walker, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill, NC
Stephanie P. Schwartz, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill, NC
Elizabeth H. Mack, Medical University of South Carolina, Charleston, SC

Document Type

Article

Publication Date

12-25-2023

Publication Title

The Pediatric infectious disease journal

Abstract

BACKGROUND AND OBJECTIVES: In June 2022, the mRNA COVID-19 vaccination was recommended for young children. We examined clinical characteristics and factors associated with vaccination status among vaccine-eligible young children hospitalized for acute COVID-19. METHODS: We enrolled inpatients aged 8 months to 20, 2022 to May 31, 2023. We assessed demographic and clinical factors, including the highest level of respiratory support, and vaccination status defined as unvaccinated, incomplete, or complete primary series [at least 2 (Moderna) or 3 (Pfizer-BioNTech) mRNA vaccine doses ≥14 days before hospitalization]. RESULTS: Among 597 children, 174 (29.1%) patients were admitted to the intensive care unit and 75 (12.6%) had a life-threatening illness, including 51 (8.5%) requiring invasive mechanical ventilation. Children with underlying respiratory and neurologic/neuromuscular conditions more frequently received higher respiratory support. Only 4.5% of children hospitalized for COVID-19 (n = 27) had completed their primary COVID-19 vaccination series and 7.0% (n = 42) of children initiated but did not complete their primary series. Among 528 unvaccinated children, nearly half (n = 251) were previously healthy, 3 of them required extracorporeal membrane oxygenation for acute COVID-19 and 1 died. CONCLUSIONS: Most young children hospitalized for acute COVID-19, including most children admitted to the intensive care unit and with life-threatening illness, had not initiated COVID-19 vaccination despite being eligible. Nearly half of these children had no underlying conditions. Of the small percentage of children who initiated a COVID-19 primary series, most had not completed it before hospitalization.

PubMed ID

38145397

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