COVID-19 vaccine reduces long COVID in children
Vaccination associated with moderate protection in large, diverse cohort
Peer-Reviewed PublicationPhiladelphia, January 16, 2024 – Vaccination against SARS-CoV-2, the virus that causes COVID-19, reduces the risk of serious acute illness in children and adolescents. However, its role in protecting against persistent health problems in the months after COVID-19, or “long COVID,” was less clear. Now, researchers from 17 health systems in the U.S., in work led by investigators at the Children’s Hospital of Philadelphia (CHOP), have found that vaccination provides moderate protection against long COVID. Vaccination also has a stronger effect in adolescents, who have a higher risk of developing long COVID than young children.
The findings of the large retrospective study, based on electronic health records analyzed as part of the National Institutes of Health’s Researching COVID to Enhance Recovery (RECOVER) initiative, were published today in the journal Pediatrics.
While overall severity of COVID-19 has been lower in children than adults, the burden of long COVID has been difficult to accurately describe since the symptoms can vary widely and the exact ways the virus causes them are unknown. Some symptoms include brain fog, dyspnea, gastrointestinal dysfunction, generalized pain and fatigue, while others are more acute, like inflammatory reaction or heart problems.
“To date, no studies have assessed clinical data for large, diverse groups of children to address this important question,” said lead study author Hanieh Razzaghi, PhD, MPH, Director of Analytics in the PEDSnet and RECOVER/PCORnet EHR Coordinating Centers in the Applied Clinical Research Center at Children’s Hospital of Philadelphia. “Using clinical data from across health care networks allowed us to have a large enough sample of patients to identify rare effects of the virus and its impact on children.”
The researchers analyzed results from a large-scale collaboration of health systems from PCORnet® as part of the National Institutes of Health’s Researching COVID to Enhance Recovery (RECOVER) initiative, which was created to learn about the long-term effects of COVID-19. Data from 17 health systems were used to assess vaccine effectiveness against long COVID in two groups of patients between 5 and 11 years old and 12 and 17 years old, respectively, as well as the time period in which patients were impacted. The vaccination rate was 56% in the cohort of 1,037,936 children.
The incidence of probable long COVID was 4.5% among patients with COVID-19, though only 0.7% of patients were clinically diagnosed with long COVID. The study estimated effectiveness of the vaccine within 12 months of administration as 35.4% against probable long COVID and 41.7% against diagnosed long COVID. The estimate was higher in adolescents compared with younger children (50.3% vs. 23.8%), and higher at six months (61.4%) but decreased to 10.6% at 18 months. Children who were vaccinated after recovering from COVID-19 also appeared to benefit, with vaccine effectiveness of 46% against probable long COVID after a subsequent episode of COVID-19.
“This study provides us with important data showing the protective effects of the vaccine against long-haul COVID and suggests that this protection is mostly from preventing visible infections. We hope this means that as vaccines are improved to be more effective against current strains of SARS-CoV-2, their protection against long COVID will get better, too,” said senior study author Charles Bailey, MD, PhD, Associate Professor of Pediatrics and co-principal investigator for the PEDSnet and RECOVER/PCORnet EHR Coordinating Centers in the Applied Clinical Research Center at CHOP. “These retrospective data provide guidance for additional research into the ways long COVID develops, and how we can better protect children and adolescents.”
This study was supported by the National Institutes of Health (NIH) Agreement OT2HL161847-01 as part of the Researching COVID to Enhance Recovery (RECOVER) program of research.
Razzaghi et al, “Vaccine Effectiveness Against Long COVID in Children.” Pediatrics. Online January 16, 2024. DOI: 10.1542/peds.2023-064446.
About Children’s Hospital of Philadelphia:
A non-profit, charitable organization, Children’s Hospital of Philadelphia was founded in 1855 as the nation’s first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals, and pioneering major research initiatives, the hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country. The institution has a well-established history of providing advanced pediatric care close to home through its CHOP Care Network, which includes more than 50 primary care practices, specialty care and surgical centers, urgent care centers, and community hospital alliances throughout Pennsylvania and New Jersey, as well as the Middleman Family Pavilion and its dedicated pediatric emergency department in King of Prussia. In addition, its unique family-centered care and public service programs have brought Children’s Hospital of Philadelphia recognition as a leading advocate for children and adolescents. For more information, visit https://www.chop.edu.
JOURNAL
PEDIATRICS
METHOD OF RESEARCH
Data/statistical analysis
SUBJECT OF RESEARCH
People
ARTICLE TITLE
Vaccine Effectiveness Against Long COVID in Children
ARTICLE PUBLICATION DATE
16-Jan-2024
First all-UK study of 67 million people reveals consequences of missed COVID-19 vaccines
The first research study of the entire UK population highlights gaps in COVID-19 vaccine coverage. Between a third and a half of the populations of the four UK nations had not had the recommended number of COVID vaccinations and boosters by summer 2022.
Findings suggest that more than 7,000 hospitalisations and deaths might have been averted in summer 2022 if the UK had had better vaccine coverage, according to the paper, published today in The Lancet.
With COVID-19 cases on the rise and a new variant strain recently identified, this research provides a timely insight into vaccine uptake and hesitancy and could inform policy-makers.
The findings – led by Health Data Research UK (HDR UK) and the University of Edinburgh – relied on secure access to anonymised health data for everyone in all four nations of the UK, an advance which has only become possible during the pandemic. The researchers say that this approach could be extended to many other areas of medicine with great potential for new discoveries in the understanding and treatment of disease.
Professor Sir Aziz Sheikh, Director of the Usher Institute at the University of Edinburgh, HDR UK Research Director and study co-lead, said: “Large-scale data studies have been critical to pandemic management, allowing scientists to make policy-relevant findings at speed. COVID-19 vaccines save lives. As new variants emerge, this study will help to pinpoint groups of our society and areas of the country where public health campaigns should be focused and tailored for those communities.”
Early COVID-19 vaccine rollout began strongly in the UK, with over 90% of the population over the age of 12 vaccinated with at least one dose by January 2022. However, rates of subsequent booster doses across the UK were not fully understood until now.
Scientists from England, Scotland, Northern Ireland and Wales studied securely-held, routinely collected NHS data from everyone over 5 years of age during June 1 to September 30 2022. All data was de-identified and available only to approved researchers.
Data from across the four countries was then pooled and harmonised – or made more uniform – a feat that was not possible until now. People were grouped by vaccine status, with under-vaccination defined as not having had all doses of a vaccine for which that a person was eligible.
The findings reveal that the proportion of people who were under-vaccinated on June 1st 2022 ranged between one third and one half of the population – 45.7% for England, 49.8% for Northern Ireland, 34.2% for Scotland and 32.8% Wales.
Mathematical modelling indicated that 7,180 hospitalisations and deaths out of around 40,400 severe COVID-19 outcomes during four months in summer 2022 might have been averted, if the UK population was fully vaccinated.
Under-vaccination was related to significantly more hospitalisations and deaths across all age groups studied, with under-vaccinated people over 75 more than twice as likely to have a severe COVID-19 outcome than those who were fully protected.
The highest rates of under-vaccination were found in younger people, men, people in areas of higher deprivation, and people of non-white ethnicity.
Researchers say the study – the largest ever study carried out in the UK – also ushers in a new era for UK science by overcoming challenges in uniting NHS data that is gathered and stored in different ways between devolved nations.
Professor Cathie Sudlow, Chief Scientist at Health Data Research UK and Director of the British Heart Foundation (BHF) Data Science Centre, said: “The infrastructure now exists to make full use of the potential of routinely collected data in the NHS across the four nations of the UK. We believe that we could and should extend these approaches to many other areas of medicine, such as cancer, heart disease and diabetes to search for better understanding, prevention and treatment of disease."
The study was set up to provide UK and devolved governments with data-driven insights into COVID-19 vaccination coverage and establish data pooling methods and infrastructure to pave the way for future UK-wide studies. It is led by HDR UK and the University of Edinburgh, in collaboration with research teams from across the four nations.
Alan Keys, a public contributor at the British Heart Foundation (BHF) Data Science Centre at HDR UK who sat on the steering group of the study and is a co-author on the paper, said: “The research outcome is a powerful validation of the benefits of vaccination.”
Ends
Notes to Editors:
- For further information, copies of the paper or to request an interview with the researchers, contact the HDR UK Communications team at media@hdruk.ac.uk or +44 7594 514007
- Once published, the study will be available at https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02467-4/fulltext
- Health Data Research UK is the national institute for health data that includes England, Wales, Scotland and Northern Ireland. Its mission is to unite the UK’s health data to enable discoveries that improve people’s lives. It is a charity funded by UK Research and Innovation, the Department of Health and Social Care in England and equivalents in Northern Ireland, Wales and Scotland, and leading medical research charities. www.hdruk.ac.uk
- The British Heart Foundation (BHF) Data Science Centre is a partnership between Health Data Research UK (HDR UK) and the British Heart Foundation. We work closely with patients, the public, NHS organisations, researchers, and clinicians to promote the safe and ethical use of data for research into the causes, prevention and treatment of all diseases of the heart and circulation. https://bhfdatasciencecentre.org/
- Read more about the HDR UK COALESCE study here: https://www.ed.ac.uk/usher/eave-ii/connected-projects/coalesce
JOURNAL
The Lancet
METHOD OF RESEARCH
Observational study
SUBJECT OF RESEARCH
People
ARTICLE TITLE
Undervaccination and severe COVID-19 outcomes: meta-analysis of national cohort studies in England, Northern Ireland, Scotland, and Wales
ARTICLE PUBLICATION DATE
15-Jan-2024
COI STATEMENT
Aziz Sheikh (ASh) reports being a member of the Scottish Government Chief Medical Officer’s COVID-19 Advisory Group, the Scottish Government’s Standing Committee on Pandemic Preparedness, the UK Government’s New and Emerging Respiratory Virus Threats Advisory Group Risk Stratification Subgroup, the Department of Health and Social Care’s COVID-19 Therapeutics Modelling Group, and AstraZeneca’s COVID-19 Strategic Thrombocytopenia Taskforce (all unfunded). Prof C Robertson (CR) reports being a member of the Scottish Government Chief Medical Officer’s COVID-19 Advisory Group, the Scientific Pandemic Influenza Group on Modelling, and the Medicines and Healthcare Products Regulatory Agency’s Vaccine Benefit and Risk Working Group. Declan T Bradley (DTB) reports being a member of the Scientific Pandemic Influenza Group on Modelling and the COVID-19 Scientific Advisory Group for Emergencies and its subgroups. Kamlesh Khunti (KK) reports being chair of the ethnicity subgroup of, and a member of, the UK Scientific Advisory Group for Emergencies. RAL reports being a member of the Welsh Government COVID-19 Technical Advisory Group. All other authors declare no competing interests.
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