Durability of Original Monovalent mRNA Vaccine Effectiveness Against COVID-19 Omicron-Associated Hospitalization in Children and Adolescents - United States, 2021-2023

Authors

Laura D. Zambrano, National Center for Immunization and Respiratory Diseases
Margaret M. Newhams, Boston Children's Hospital
Regina M. Simeone, National Center for Immunization and Respiratory Diseases
Amanda B. Payne, National Center for Immunization and Respiratory Diseases
Michael Wu, National Center for Immunization and Respiratory Diseases
Amber O. Orzel-Lockwood, Boston Children's Hospital
Natasha B. Halasa, Vanderbilt University Medical Center
Jemima M. Calixte, Boston Children's Hospital
Pia S. Pannaraj, Children's Hospital Los Angeles
Kanokporn Mongkolrattanothai, Children's Hospital Los Angeles
Julie A. Boom, Texas Children's Hospital
Leila C. Sahni, Texas Children's Hospital
Satoshi Kamidani, Children's Healthcare of Atlanta
Kathleen Chiotos, The Children's Hospital of Philadelphia
Melissa A. Cameron, Rady Children's Hospital
Aline B. Maddux, University of Colorado Department of Pediatrics
Katherine Irby, Arkansas Children's Hospital
Jennifer E. Schuster, Children's Mercy Kansas City
Elizabeth H. MacK, Medical University of South Carolina
Austin Biggs, Medical University of South Carolina
Bria M. Coates, Northwestern University Feinberg School of Medicine
Kelly N. Michelson, Northwestern University Feinberg School of Medicine
Katherine E. Bline, Nationwide Children’s Hospital
Ryan A. Nofziger, Akron Children's Hospital
Hillary Crandall, University of Utah School of Medicine
Charlotte V. Hobbs, University of Mississippi School of Medicine
Shira J. Gertz, Cooperman Barnabas Medical Center
Sabrina M. Heidemann, Central Michigan University
Tamara T. Bradford, LSU Health Sciences Center - New OrleansFollow
et al

Document Type

Article

Publication Date

4-18-2024

Publication Title

Morbidity and Mortality Weekly Report

Abstract

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.

First Page

330

Last Page

338

PubMed ID

38635481

Volume

73

Issue

15

Comments

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