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COVID-19 vaccine moderately effective (48%) at preventing symptomatic infection in children 5 to 11 years old
Clinical Question
How effective is the Pfizer-BioNTech COVID-19 vaccine against symptomatic infection with the omicron variant in children aged 5 to 11 years?
Bottom line
The Pfizer-BioNTech vaccine provides moderate protection against symptomatic infection in children 5 to 11 years. The decreasing level of protection in older children suggests that older children may benefit from a higher dose, but this requires further study. There were too few complications to provide meaningful information, and data on severity of illness were not available. 3b
Reference
Study design: Cohort (retrospective)
Funding: Government
Setting: Population-based
Synopsis
Although hospitalization and death are rare sequelae of COVID-19 infection in children, it is important to remember that while the flu typically kills 50 to 150 children per year in the United States, COVID-19 caused more than 600 pediatric deaths (and numerous hospitalizations) in 2021. This study from Israel is a population-based observational study in which researchers matched 94,728 children vaccinated after November 23, 2021, with the same number of otherwise similar unvaccinated children, and then looked at the number of infections in each group through January 7, 2022. A further 15,280 in the unvaccinated got vaccinated during the study period and were rematched as now being members of the vaccinated group. Matching was on the basis of age, sex, population sector (Jewish, Arab, or ultra-Orthodox Jewish), residence, weight, and number of comorbidities. Children received 2 doses of the Pfizer-BioNTech vaccine, and effectiveness overall was 48% at 7 to 21 days after the second dose. Effectiveness was greater for younger children: 69% for ages 5 to 6 years, 49% for ages 7 to 9 years, and 36% for ages 10 to 11 years. Effectiveness after the first dose was only 18%. There were only 3 hospitalizations (2 in the unvaccinated group and 1 in the vaccinated group). The study was supported by the European Union, the United Kingdom's Medical Research Council, and the Morris-Singer Fund.
Reviewer
Mark H. Ebell, MD, MS
Professor
University of Georgia
Athens, GA
Comments
Vaccination in children
Only 45% effectiveness in children. Disappointing.