دورية أكاديمية
Effectiveness of Bivalent mRNA COVID-19 Vaccines in Preventing SARS-CoV-2 Infection in Children and Adolescents Aged 5 to 17 Years.
| العنوان: | Effectiveness of Bivalent mRNA COVID-19 Vaccines in Preventing SARS-CoV-2 Infection in Children and Adolescents Aged 5 to 17 Years. |
|---|---|
| المؤلفون: | Feldstein LR; Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia., Britton A; Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia., Grant L; Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia., Wiegand R; Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia., Ruffin J; Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia., Babu TM; Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle., Briggs Hagen M; Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia., Burgess JL; University of Arizona, Tucson., Caban-Martinez AJ; Department of Public Health Science, University of Miami, Miami, Florida., Chu HY; Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle., Ellingson KD; University of Arizona, Tucson., Englund JA; Children's Research Institute, Seattle, Washington., Hegmann KT; University of Utah Health, Salt Lake City., Jeddy Z; Abt Associates Inc, Rockville, Maryland., Lauring AS; Division of Infectious Diseases, Department of Internal Medicine, University of Michigan, Ann Arbor., Lutrick K; University of Arizona, Tucson., Martin ET; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor., Mathenge C; Baylor Scott and White Health, Temple, Texas., Meece J; Marshfield Clinic Research Institute, Marshfield, Wisconsin., Midgley CM; Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia., Monto AS; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor., Newes-Adeyi G; Abt Associates Inc, Rockville, Maryland., Odame-Bamfo L; Baylor Scott and White Health, Temple, Texas., Olsho LEW; Abt Associates Inc, Rockville, Maryland., Phillips AL; University of Utah Health, Salt Lake City., Rai RP; Abt Associates Inc, Rockville, Maryland., Saydah S; Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia., Smith N; Kaiser Permanente Center for Health Research, Portland, Oregon., Steinhardt L; Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia., Tyner H; St Luke's Regional Health Care System, Duluth, Minnesota., Vandermeer M; Kaiser Permanente Center for Health Research, Portland, Oregon., Vaughan M; Abt Associates Inc, Rockville, Maryland., Yoon SK; University of Utah Health, Salt Lake City., Gaglani M; Baylor Scott and White Health, Temple, Texas., Naleway AL; Kaiser Permanente Center for Health Research, Portland, Oregon. |
| المصدر: | JAMA [JAMA] 2024 Feb 06; Vol. 331 (5), pp. 408-416. |
| نوع المنشور: | Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S. |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Medical Association Country of Publication: United States NLM ID: 7501160 Publication Model: Print Cited Medium: Internet ISSN: 1538-3598 (Electronic) Linking ISSN: 00987484 NLM ISO Abbreviation: JAMA Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Chicago : American Medical Association, 1960- |
| مواضيع طبية MeSH: | COVID-19*/diagnosis , COVID-19*/prevention & control , COVID-19 Vaccines*/therapeutic use, Adolescent ; Child ; Female ; Humans ; Male ; Prospective Studies ; SARS-CoV-2 ; mRNA Vaccines/therapeutic use ; Vaccines, Combined/therapeutic use ; Child, Preschool ; Vaccine Efficacy ; United States |
| مستخلص: | 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. |
| References: | BMJ. 2022 Mar 9;376:e069761. (PMID: 35264324) Eur J Pediatr. 2022 Apr;181(4):1597-1607. (PMID: 35000003) JAMA Pediatr. 2022 Oct 1;176(10):1000-1009. (PMID: 35994282) Nat Commun. 2022 Sep 6;13(1):5240. (PMID: 36068236) MMWR Morb Mortal Wkly Rep. 2022 Dec 30;71(5152):1625-1630. (PMID: 36580424) Lancet Infect Dis. 2023 Dec;23(12):1343-1348. (PMID: 37543042) Lancet Infect Dis. 2023 Nov;23(11):1257-1265. (PMID: 37336222) MMWR Morb Mortal Wkly Rep. 2022 Nov 11;71(45):1436-1441. (PMID: 36355612) N Engl J Med. 2022 Jul 7;387(1):86-88. (PMID: 35731894) Cell. 2021 May 13;184(10):2595-2604.e13. (PMID: 33891875) Stat Med. 2010 Mar 30;29(7-8):915-23. (PMID: 20213705) BMJ Open. 2023 Jul 14;13(7):e071446. (PMID: 37451722) Lancet Child Adolesc Health. 2023 Jul;7(7):463-470. (PMID: 37201540) N Engl J Med. 2020 Jul 23;383(4):334-346. (PMID: 32598831) PLoS Pathog. 2021 Apr 7;17(4):e1009499. (PMID: 33826681) JAMA. 2022 Feb 15;327(7):639-651. (PMID: 35060999) MMWR Morb Mortal Wkly Rep. 2023 Mar 17;71(53):1637-1646. (PMID: 36921274) MMWR Morb Mortal Wkly Rep. 2022 Dec 02;71(48):1526-1530. (PMID: 36454688) J Infect Dis. 2023 Oct 31;:. (PMID: 37925630) JMIR Res Protoc. 2022 Jul 28;11(7):e37929. (PMID: 35635842) Influenza Other Respir Viruses. 2023 Mar 01;17(3):e13106. (PMID: 36875204) Sci Rep. 2022 Jun 23;12(1):9950. (PMID: 35739136) Lancet Respir Med. 2023 Dec;11(12):1089-1100. (PMID: 37898148) Clin Infect Dis. 2022 Aug 24;75(1):e361-e367. (PMID: 35404391) JAMA Pediatr. 2020 Sep 01;174(9):882-889. (PMID: 32320004) Nat Microbiol. 2020 Nov;5(11):1403-1407. (PMID: 32669681) MMWR Morb Mortal Wkly Rep. 2023 May 26;72(21):579-588. (PMID: 37227984) N Engl J Med. 2021 Jul 1;385(1):23-34. (PMID: 34133855) |
| معلومات مُعتمدة: | 75N93021C00015 United States AI NIAID NIH HHS |
| المشرفين على المادة: | 0 (COVID-19 Vaccines) 0 (mRNA Vaccines) 0 (Vaccines, Combined) |
| تواريخ الأحداث: | Date Created: 20240206 Date Completed: 20240207 Latest Revision: 20240210 |
| رمز التحديث: | 20240210 |
| مُعرف محوري في PubMed: | PMC10848053 |
| DOI: | 10.1001/jama.2023.27022 |
| PMID: | 38319331 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1538-3598 |
|---|---|
| DOI: | 10.1001/jama.2023.27022 |