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. 2022 Dec 9;17(12):e0276409.
doi: 10.1371/journal.pone.0276409. eCollection 2022.

Impact of the COVID-19 Vaccination Program on case incidence, emergency department visits, and hospital admissions among children aged 5-17 Years during the Delta and Omicron Periods-United States, December 2020 to April 2022

Katherine G Topf  1 , Michael Sheppard  2 , Grace E Marx  2   3 , Ryan E Wiegand  2 , Ruth Link-Gelles  2   3 , Alison M Binder  2 , Andrea J Cool  1 , B Casey Lyons  2 , Sohyun Park  2 , Hannah E Fast  2 , Arthur Presnetsov  1 , G Roseric Azondekon  2 , Karl A Soetebier  2 , Jennifer Adjemian  2   3 , Kamil E Barbour  2   3
Affiliations

Impact of the COVID-19 Vaccination Program on case incidence, emergency department visits, and hospital admissions among children aged 5-17 Years during the Delta and Omicron Periods-United States, December 2020 to April 2022

Katherine G Topf et al. PLoS One. .

Abstract

Background: In the United States, national ecological studies suggest a positive impact of COVID-19 vaccination coverage on outcomes in adults. However, the national impact of the vaccination program on COVID-19 in children remains unknown. To determine the association of COVID-19 vaccination with U.S. case incidence, emergency department visits, and hospital admissions for pediatric populations during the Delta and Omicron periods.

Methods: We conducted an ecological analysis among children aged 5-17 and compared incidence rate ratios (RRs) of COVID-19 cases, emergency department visits, and hospital admissions by pediatric vaccine coverage, with jurisdictions in the highest vaccine coverage quartile as the reference.

Results: RRs comparing states with lowest pediatric vaccination coverage to the highest pediatric vaccination coverage were 2.00 and 0.64 for cases, 2.96 and 1.11 for emergency department visits, and 2.76 and 1.01 for hospital admissions among all children during the Delta and Omicron periods, respectively. During the 3-week peak period of the Omicron wave, only children aged 12-15 and 16-17 years in the states with the lowest versus highest coverage, had a significantly higher rate of emergency department visits (RR = 1.39 and RR = 1.34, respectively).

Conclusions: COVID-19 vaccines were associated with lower case incidence, emergency department visits and hospital admissions among children during the Delta period but the association was weaker during the Omicron period. Pediatric COVID-19 vaccination should be promoted as part of a program to decrease COVID-19 impact among children; however, vaccine effectiveness may be limited when available vaccines do not match circulating viral variants.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Weekly “fully vaccinated” pediatric vaccination coverage rates by age group among children aged 5–17 years, U.S., from December 13, 2020, through April 30, 2022.
Fig 2
Fig 2. Weekly rate ratios among children aged 5–17 comparing lowest COVID-19 vaccination coverage quartile states to highest coverage quartile states by outcome: December 13, 2020–April 30, 2022.
Vaccine coverage estimates for children aged 5–17 years during the first and last week of the Delta and Omicron periods of predominance in the US: (Delta: 9.21% as of the week of June 20th, 2021, 22.57% the week of October 31, 2021); (Omicron: 29.19% the week of December 19, 2021, 40.03% the week of April 24, 2022). Full vaccination coverage ranges for bottom and top quartile states as of the week of April 24, 2022: Bottom quartile: 20.14%–28.46%, Top quartile: 47.24%–59.42%.
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References

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