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. 2024 Apr 1;153(4):e2023064446.
doi: 10.1542/peds.2023-064446.

Vaccine Effectiveness Against Long COVID in Children

Hanieh Razzaghi  1 , Christopher B Forrest  1   2 , Kathryn Hirabayashi  1 , Qiong Wu  3 , Andrea J Allen  1 , Suchitra Rao  4 , Yong Chen  3 , H Timothy Bunnell  5 , Elizabeth A Chrischilles  6 , Lindsay G Cowell  7 , Mollie R Cummins  8 , David A Hanauer  9 , Miranda Higginbotham  1 , Benjamin D Horne  10 , Carol R Horowitz  11 , Ravi Jhaveri  12 , Susan Kim  13 , Aaron Mishkin  14 , Jennifer A Muszynski  15 , Susanna Naggie  16 , Nathan M Pajor  17 , Anuradha Paranjape  14 , Hayden T Schwenk  18 , Marion R Sills  19 , Yacob G Tedla  20 , David A Williams  21 , L Charles Bailey  1   2 ; RECOVER CONSORTIUM
Affiliations

Vaccine Effectiveness Against Long COVID in Children

Hanieh Razzaghi et al. Pediatrics. .

Abstract

Objectives: Vaccination reduces the risk of acute coronavirus disease 2019 (COVID-19) in children, but it is less clear whether it protects against long COVID. We estimated vaccine effectiveness (VE) against long COVID in children aged 5 to 17 years.

Methods: This retrospective cohort study used data from 17 health systems in the RECOVER PCORnet electronic health record program for visits after vaccine availability. We examined both probable (symptom-based) and diagnosed long COVID after vaccination.

Results: The vaccination rate was 67% in the cohort of 1 037 936 children. The incidence of probable long COVID was 4.5% among patients with COVID-19, whereas diagnosed long COVID was 0.8%. Adjusted vaccine effectiveness within 12 months was 35.4% (95 CI 24.5-44.7) against probable long COVID and 41.7% (15.0-60.0) against diagnosed long COVID. VE was higher for adolescents (50.3% [36.6-61.0]) than children aged 5 to 11 (23.8% [4.9-39.0]). VE was higher at 6 months (61.4% [51.0-69.6]) but decreased to 10.6% (-26.8% to 37.0%) at 18-months.

Conclusions: This large retrospective study shows moderate protective effect of severe acute respiratory coronavirus 2 vaccination against long COVID. The effect is stronger in adolescents, who have higher risk of long COVID, and wanes over time. Understanding VE mechanism against long COVID requires more study, including electronic health record sources and prospective data.

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Conflict of interest statement

CONFLICT OF INTEREST DISCLOSURES: Dr Cummins is employed by Doxy.me Inc, a commercial telemedicine platform provider; Dr Horne is a member of the advisory boards of Opsis Health and Lab Me Analytics, and a consultant to Pfizer (regarding clinical risk scores; funds paid to Intermountain); Dr Naggie reports research grants from Gilead Sciences and AbbVie, scientific advisor/stock options from Vir Biotechnologies, consulting with no financial payment from Pardes Biosciences and Silverback Therapeutics, DSMB fees from Personal Health Insights, Inc, event adjudication committee fees from BMS/PRA outside the submitted work; Dr Mishkin receives Grant support from Pfizer paid directly to Institution Advisory Board for Takeda; Dr Jhaveri is a consultant for AstraZeneca, Seqirus, Dynavax, receives an editorial stipend from Elsevier and Pediatric Infectious Diseases Society; Dr Rao reports prior grant support from GSK and Biofire and is a consultant for Sequiris; and the remaining authors have no disclosures.

Figures

FIGURE 1
FIGURE 1
Study sample selection. Steps in the construction of the overall study sample are shown, including demographic and vaccine-related eligibility criteria. At each step, the number of children satisfying all criteria to that point is shown, as is the percentage of children in the previous step who were retained. a Vaccination rates ≥60% of CDC regional estimate.
FIGURE 2
FIGURE 2
Vaccine effectiveness estimates for children receiving at least 2 doses of mRNA vaccine in their primary series. Analyses were otherwise structured identically to the main analysis.
FIGURE 3
FIGURE 3
Durability of vaccine effectiveness of SARS-CoV-2 vaccine against long COVID. Results are shown for long COVID occurring within 6, 12, or 18 months of vaccination. (Note that no value is shown for diagnosed long covid within 6 months in 5 to 11 year olds because too few cases exist to generate an estimate.)
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Update of

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