Effectiveness of an inactivated SARS-CoV-2 vaccine in children and adolescents: a large-scale observational study.

Autor:	Jara A; Ministry of Health, Santiago, Chile.; Facultad de Matemáticas, Pontificia Universidad Católica de Chile, Santiago, Chile.; Center for the Discovery of Structures in Complex Data (MiDaS), Santiago, Chile., Undurraga EA; Escuela de Gobierno, Pontificia Universidad Católica de Chile, Santiago, RM, Chile.; Initiative for Collaborative Research in Bacterial Resistance (MICROB-R), Santiago, Chile.; Research Center for Integrated Disaster Risk Management (CIGIDEN), Santiago, Chile.; CIFAR Azrieli Global Scholars Program, CIFAR, Toronto, Canada., Flores JC; Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile., Zubizarreta JR; Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.; Department of Biostatistics, Harvard T.H. School of Public Health, Boston, MA, USA.; Department of Statistics, Harvard T.H. School of Public Health, Boston, MA, USA., González C; Ministry of Health, Santiago, Chile., Pizarro A; Ministry of Health, Santiago, Chile.; Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile., Ortuño-Borroto D; Ministry of Health, Santiago, Chile., Acevedo J; Ministry of Health, Santiago, Chile., Leo K; Ministry of Health, Santiago, Chile., Paredes F; Ministry of Health, Santiago, Chile., Bralic T; Ministry of Health, Santiago, Chile., Vergara V; Ministry of Health, Santiago, Chile., Leon F; Ministry of Health, Santiago, Chile., Parot I; Ministry of Health, Santiago, Chile., Leighton P; Ministry of Health, Santiago, Chile., Suárez P; Ministry of Health, Santiago, Chile., Rios JC; Ministry of Health, Santiago, Chile.; Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile., García-Escorza H; Ministry of Health, Santiago, Chile., Araos R; Ministry of Health, Santiago, Chile.; Initiative for Collaborative Research in Bacterial Resistance (MICROB-R), Santiago, Chile.; Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile.; Advanced Center for Chronic Diseases (ACCDiS), Santiago, Chile.
Jazyk:	angličtina
Zdroj:	Lancet regional health. Americas [Lancet Reg Health Am] 2023 May; Vol. 21, pp. 100487. Date of Electronic Publication: 2023 Apr 20.
DOI:	10.1016/j.lana.2023.100487
Abstrakt:	Background: Policymakers urgently need evidence to adequately balance the costs and benefits of mass vaccination against COVID-19 across all age groups, including children and adolescents. In this study, we aim to assess the effectiveness of CoronaVac's primary series among children and adolescents in Chile. Methods: We used a large prospective national cohort of about two million children and adolescents 6-16 years to estimate the effectiveness of an inactivated SARS-CoV-2 vaccine (CoronaVac) in preventing laboratory-confirmed symptomatic SARS-CoV-2 infection (COVID-19), hospitalisation, and admission to an intensive care unit (ICU) associated with COVID-19. We compared the risk of individuals treated with a complete primary immunization schedule (two doses, 28 days apart) with the risk of unvaccinated individuals during the follow-up period. The study was conducted in Chile from June 27, 2021, to January 12, 2022, when the SARS-CoV-2 Delta variant was predominant but other variants of concern were co-circulating, including Omicron. We used inverse probability-weighted survival regression models to estimate hazard ratios of complete immunization over the unvaccinated status, accounting for time-varying vaccination exposure and adjusting for relevant demographic, socioeconomic, and clinical confounders. Findings: The estimated adjusted vaccine effectiveness for the inactivated SARS-CoV-2 vaccine in children aged 6-16 years was 74.5% (95% CI, 73.8-75.2), 91.0% (95% CI, 87.8-93.4), 93.8% (95% CI, 87.8-93.4) for the prevention of COVID-19, hospitalisation, and ICU admission, respectively. For the subgroup of children 6-11 years, the vaccine effectiveness was 75.8% (95% CI, 74.7-76.8) for the prevention of COVID-19 and 77.9% (95% CI, 61.5-87.3) for the prevention of hospitalisation. Interpretation: Our results suggest that a complete primary immunization schedule with the inactivated SARS-CoV-2 vaccine provides effective protection against severe COVID-19 disease for children 6-16 years. Funding: Agencia Nacional de Investigación y Desarrollo (ANID) Millennium Science Initiative Program and Fondo de Financiamiento de Centros de Investigación en Áreas Prioritarias (FONDAP). Competing Interests: R. Araos has received consulting fees from AstraZeneca, Pfizer and research support from Sinovac. This support is not related to this article and was received after its acceptance. J.C. Flores is a non-paid member of the Servicio de Salud Metropolitano Sur Oriente's Ethics Committee, Santiago, Chile. The remaining authors have no conflicts of interest to declare. (© 2023 Published by Elsevier Ltd.)
Databáze:	MEDLINE
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