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

2024; Centers for Disease Control and Prevention; Volume: 73; Issue: 15 Linguagem: Inglês

10.15585/mmwr.mm7315a2

1545-861X

Laura D. Zambrano, Margaret M. Newhams, Regina M. Simeone, Amanda B. Payne, Michael Wu, Amber O. Orzel-Lockwood, Natasha Halasa, Jemima M. Calixte, Pia S. Pannaraj, Kanokporn Mongkolrattanothai, Julie A. Boom, Leila C. Sahni, Satoshi Kamidani, Kathleen Chiotos, Melissa A. Cameron, Aline B. Maddux, Katherine Irby, Jennifer E. Schuster, Elizabeth H. Mack, Austin Biggs, Bria M. Coates, Kelly Michelson, Katherine Bline, Ryan A. Nofziger, Hillary Crandall, Charlotte V. Hobbs, Shira J. Gertz, Sabrina M. Heidemann, Tamara T. Bradford, Tracie C. Walker, Stephanie P. Schwartz, Mary Allen Staat, Samina Bhumbra, Janet R. Hume, Michele Kong, Melissa S. Stockwell, Thomas J. Connors, Melissa L. Cullimore, Heidi R. Flori, Emily R. Levy, Natalie Z. Cvijanovich, Matt S. Zinter, Mia Maamari, Cindy Bowens, Danielle M. Zerr, Judith A. Guzman‐Cottrill, Iván González, Angela P. Campbell, Adrienne G. Randolph, Meghan Murdock, Heather M. Kelley, Candice Colston, Ronald C. Sanders, Laura Miron, Masson Yates, Ashlyn Madding, Alexa Dixon, Michael Henne, Kathleen Sun, Jazmin Baez Maidana, Natalie Triester, Jaycee Jumarang, Daniel Hakimi, Kennis-Grace Mrotek, L. Niell, Natasha Baig, Elizabeth Temte, Lexi Petruccelli, Heidi Sauceda, Nicolette Gomez, Mark D. Gonzalez, Caroline Ciric, Jong-Ha C. Choi, Elizabeth G. Taylor, G. Li, Nadine Baida, Heather E. Price, Mary Stumpf, Suden Kücükak, Eve Listerud, Maya Clark, Rylie Dittrich, Allison Zaff, Patrick Moran, Jessica C. Peterson, Noelle M. Drapeau, Lora Martin, Lacy Malloch, Maygan Martin, Cameron Sanders, Kayla Patterson, Melissa Sullivan, Shannon Pruitt, Elizabeth Ricciardi, Celibell Vargas, Raul A. Silverio Francisco, Ana Valdez de Romero, Sheila Joshi, Merry Tomcany, Nicole A. Twinem, Chelsea C. Rohlfs, Amber Wolfe, Rebecca Douglas, Kathlyn Phengchomphet, Jenny Bush, Alanah Mckelvey, Mickael Boustany, Fatima A. Mohammed, Laura S Stewart, Kailee N Fernandez, Leenah Abojaib, Molly J. Kyles, Amanda Adler,

COVID-19 Clinical Research Studies

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 * These senior authors contributed equally to this report.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.