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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

2025-02-27Journal article Open access
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datacite.subject.fosCiências Médicas::Ciências da Saúde
datacite.subject.sdg03:Saúde de Qualidade
dc.contributor.authorSoares, Patricia
dc.contributor.authorMachado, Ausenda
dc.contributor.authorNicolay, Nathalie
dc.contributor.authorMonge, Susana
dc.contributor.authorSacco, Chiara
dc.contributor.authorHansen, Christian Holm
dc.contributor.authorMeijerink, Hinta
dc.contributor.authorMartínez-Baz, Iván
dc.contributor.authorSchmitz, Susanne
dc.contributor.authorHumphreys, James
dc.contributor.authorFabiani, Massimo
dc.contributor.authorEcheverria, Aitziber
dc.contributor.authorAlKerwi, Ala'a
dc.contributor.authorNardone, Anthony
dc.contributor.authorMateo-Urdiales, Alberto
dc.contributor.authorCastilla, Jesús
dc.contributor.authorKissling, Esther
dc.contributor.authorNunes, Baltazar
dc.contributor.authorVEBIS-Lot 4 working group
dc.date.accessioned2025-07-01T12:01:23Z
dc.date.available2025-07-01T12:01:23Z
dc.date.issued2025-02-27
dc.description.abstractBackground: 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.eng
dc.description.abstractKey public health message: - What did you want to address in this study and why? Vaccination programmes were launched in the first year of the pandemic including for children and adolescents to prevent severe outcomes of SARS-CoV-2 infection, despite being rare in younger age groups. We assessed vaccine effectiveness (VE) of COVID-19 vaccines across six European countries in 5–17-years-olds with and without previous SARS-CoV-2 infection. Our 12-month study period allowed examination of VE against Delta and Omicron variants. ; - What have we learnt from this study? Overall, vaccines recommended for 5–17-year-olds prevented two thirds of COVID-19 hospitalisations, regardless of a previously documented infection of SARS-CoV-2. The level of protection was the highest 3 months following vaccination. Although VE declined over time, vaccinees remained at lower risk of hospitalisation during the 12-month study period vs those unvaccinated. Vaccine effectiveness tended to be lower during Omicron variant circulation.; - What are the implications of your findings for public health? Monitoring COVID-19 VE in population subgroups, such as children and adolescents, is important to inform future vaccination strategies. Our results showed that vaccination protected children against severe COVID-19 during Delta- and Omicron-circulating periods. We also highlighted valuable use of electronic health registeries to conduct VE studies in specific subgroups where severe outcomes were rare, vs more complex approaches using primary data.por
dc.description.sponsorshipAll the public health organisations involved received funding from the European Centre for Disease Prevention and Control (ECDC) implementing Framework Contract ECDC/2021/018 ‘Vaccine effectiveness and impact of COVID-19 vaccines through routinely collected exposure and outcome using health registries’ (RS/2022/DTS/24104). In Portugal, this work was also supported by FCT – Fundação para a Ciência e Tecnologia, I.P. by project reference CEECINST/00049/2021/CP2817/CT0001 and DOI identifier 10.54499/CEECINST/00049/2021/CP2817/CT0001.
dc.identifier.citationEuro Surveill. 2025 Feb;30(8):2400450. doi: 10.2807/1560-7917.ES.2025.30.8.2400450
dc.identifier.doi10.2807/1560-7917.ES.2025.30.8.2400450
dc.identifier.issn1560-7917
dc.identifier.pmid40017392
dc.identifier.urihttp://hdl.handle.net/10400.18/10519
dc.language.isoeng
dc.peerreviewedyes
dc.publisherEuropean Centre for Disease Prevention and Control
dc.relationNot Available
dc.relation.hasversionhttps://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2025.30.8.2400450
dc.rights.urihttp://creativecommons.org/licenses/by-sa/4.0/
dc.subjectCOVID-19 Vaccines
dc.subjectElectronic Health Records
dc.subjectPaediatrics
dc.subjectVaccine Effectiveness
dc.subjectEurope
dc.subjectCuidados de Saúde
dc.subjectInfecções Respiratórias.
dc.subjectVEBIS-LOT 4
dc.titleCOVID-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 2022eng
dc.typejournal article
dspace.entity.typePublication
oaire.awardTitleNot Available
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/CEEC INST 2ed/CEECINST%2F00049%2F2021%2FCP2817%2FCT0001/PT
oaire.citation.issue8
oaire.citation.startPage2400450
oaire.citation.titleEurosurveillance: Europe's journal on infectious disease surveillance, epidemiology, prevention and control
oaire.citation.volume30
oaire.fundingStreamCEEC INST 2ed
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNameSoares
person.familyNameMachado
person.familyNameNunes
person.givenNamePatricia
person.givenNameAusenda
person.givenNameBaltazar
person.identifier1050496
person.identifier.ciencia-id0415-632D-8609
person.identifier.ciencia-id1217-6076-5D88
person.identifier.ciencia-idAB11-AD48-A8DF
person.identifier.orcid0000-0001-5033-9115
person.identifier.orcid0000-0002-1849-1499
person.identifier.orcid0000-0001-6230-7209
person.identifier.scopus-author-id52063758300
person.identifier.scopus-author-id9133723200
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.nameFundação para a Ciência e a Tecnologia
relation.isAuthorOfPublicationdf1b8bab-1e35-4561-92d0-8aeb17371a29
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