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Abstract

Background

During the first year of the COVID-19 pandemic, vaccination programmes targeted children and adolescents to prevent severe outcomes of SARS-CoV-2 infection.

Aim

To estimate COVID-19 vaccine effectiveness (VE) against hospitalisation due to COVID-19 in the paediatric population, among those with and without previously documented SARS-CoV-2 infection.

Methods

We established a fixed cohort followed for 12 months in Denmark, Norway, Italy, Luxembourg, Navarre (Spain) and Portugal using routine electronic health registries. The study commenced with paediatric COVID-19 vaccination campaign at each site between June 2021 and January 2022. The outcome was hospitalisation with a laboratory-confirmed SARS-CoV-2 infection or COVID-19 as the main diagnosis. Using Cox proportional hazard models, VE was estimated as 1 minus the confounder-adjusted hazard ratio of COVID-19 hospitalisation between vaccinated and unvaccinated. A random-effects meta-analysis was used to pool VE estimates.

Results

We included 4,144,667 5–11-year-olds and 3,861,841 12–17-year-olds. In 12–17-year-olds without previous infection, overall VE was 69% (95% CI: 40 to 84). VE declined with time since vaccination from 77% ≤ 3 months to 48% 180–365 days after immunisation. VE was 94% (95% CI: 90 to 96), 56% (95% CI: 3 to 80) and 41% (95% CI: −14 to 69) in the Delta, Omicron BA.1/BA.2 and BA.4/BA.5 periods, respectively. In 12–17-year-olds with previous infection, one dose VE was 80% (95% CI: 18 to 95). VE estimates were similar for 5–11-year-olds but with lower precision.

Conclusion

Vaccines recommended for 5–17-year-olds provided protection against COVID-19 hospitalisation, regardless of a previously documented infection of SARS-CoV-2, with high levels of protection in the first 3 months of the vaccination.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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2025-02-27
2025-02-27
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COVID-19 vaccine effectiveness in the paediatric population aged 5–17 years: a multicentre cohort study using electronic health registries in six European countries, 2021 to 2022
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Patr%C3%ADcia+Soares&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Soares Patrícia</a>, <a href="/search?value1=Ausenda+Machado&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Machado Ausenda</a>, <a href="/search?value1=Nathalie+Nicolay&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Nicolay Nathalie</a>, <a href="/search?value1=Susana+Monge&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Monge Susana</a>, <a href="/search?value1=Chiara+Sacco&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sacco Chiara</a>, <a href="/search?value1=Christian+Holm+Hansen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hansen Christian Holm</a>, <a href="/search?value1=Hinta+Meijerink&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Meijerink Hinta</a>, <a href="/search?value1=Iv%C3%A1n+Mart%C3%ADnez-Baz&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Martínez-Baz Iván</a>, <a href="/search?value1=Susanne+Schmitz&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Schmitz Susanne</a>, <a href="/search?value1=James+Humphreys&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Humphreys James</a>, <a href="/search?value1=Massimo+Fabiani&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Fabiani Massimo</a>, <a href="/search?value1=Aitziber+Echeverria&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Echeverria Aitziber</a>, <a href="/search?value1=Ala%E2%80%99a+AlKerwi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">AlKerwi Ala’a</a>, <a href="/search?value1=Anthony+Nardone&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Nardone Anthony</a>, <a href="/search?value1=Alberto+Mateo-Urdiales&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mateo-Urdiales Alberto</a>, <a href="/search?value1=Jes%C3%BAs+Castilla&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Castilla Jesús</a>, <a href="/search?value1=Esther+Kissling&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kissling Esther</a>, <a href="/search?value1=Baltazar+Nunes&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Nunes Baltazar</a>, <a href="/search?value1=VEBIS-Lot+4+working+group&option1=author&noRedirect=true" class="nonDisambigAuthorLink">VEBIS-Lot 4 working group</a></span>. COVID-19 vaccine effectiveness in the paediatric population aged 5–17 years: a multicentre cohort study using electronic health registries in six European countries, 2021 to 2022. <a href="/content/ecdc">Euro Surveill.</a> 2025;30(8):pii=2400450. <a href="https://doi.org/10.2807/1560-7917.ES.2025.30.8.2400450" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2025.30.8.2400450</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 11 Jul 2024;&nbsp;&nbsp; <span class="generated">Accepted</span>: 08 Nov 2024 </span> </p>
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