Department of Biostatistics, University of Michigan, Ann Arbor, Michigan.
Huron High School, Ann Arbor, Michigan.
J Adolesc Health. 2023 Jan;72(1):147-152. doi: 10.1016/j.jadohealth.2022.09.006. Epub 2022 Oct 8.
The BNT162b2 (Pfizer-BioNTech) is approved for adolescents aged 12-17 years. We estimated BNT162b2 vaccine effectiveness (VE) and a booster dose effectiveness in adolescents aged 12-17 years and the impact of opening schools and the Omicron variant on risk of SARS-CoV-2 infection in adolescents.
We used logistic regression with a test-negative design controlling for gender and race to estimate BNT162b2 VE and the effectiveness of a booster dose in adolescents aged 12-17 years. To evaluate the effect of school opening on Omicron transmission, we used Cox proportional hazards regression to compare adolescents to a reference group of adults aged 22-33 or aged 65+ years, investigating whether risk for adolescents increased relative to the reference group after school opened.
We found that adolescents who received two BNT162b2 doses had significant protection against Omicron infection in the first three months following their second dose (VE = 54.5%, confidence interval [CI]: [17.8%-76.9%], p = .014) but no protection afterwards. Receiving a booster dose was associated with lower risk of infection (odds ratio = 0.48, CI: [0.33-0.69], p < .0001) and restored efficacy to a similar level (VE = 56.3%, CI: [36.5%-70.6%], p < .0001). We observed a statistically significant increase (p = .04) in adolescent infection risk relative to adults in the period of Omicron predominance.
The BNT162b2 vaccine is effective at preventing SARS-CoV-2 infection in adolescents but immunity against Omicron wanes rapidly and booster doses are needed to retain protection. More research is needed to determine the effect of school reopening on spread in the Omicron-dominant period.
BNT162b2（辉瑞-生物科技）已获批准用于 12-17 岁青少年。我们评估了 BNT162b2 疫苗在 12-17 岁青少年中的有效性（VE）和加强针的有效性，以及学校开放和奥密克戎变体对青少年感染 SARS-CoV-2 的风险的影响。
我们使用逻辑回归和阴性测试设计，控制性别和种族，以评估 BNT162b2 在 12-17 岁青少年中的 VE 和加强针的有效性。为了评估学校开放对奥密克戎传播的影响，我们使用 Cox 比例风险回归比较了青少年与 22-33 岁或 65 岁以上的成年人参考组，调查学校开放后青少年的风险相对于参考组是否增加。
我们发现，接受两剂 BNT162b2 的青少年在第二剂接种后三个月内对奥密克戎感染有显著的保护作用（VE=54.5%，置信区间[17.8%-76.9%]，p=0.014），但之后没有保护作用。加强针接种与感染风险降低相关（比值比=0.48，置信区间[0.33-0.69]，p<0.0001），并恢复了类似水平的疗效（VE=56.3%，置信区间[36.5%-70.6%]，p<0.0001）。我们观察到，在奥密克戎流行期间，青少年感染风险相对成年人显著增加（p=0.04）。
BNT162b2 疫苗在预防 SARS-CoV-2 感染方面对青少年有效，但对奥密克戎的免疫力迅速减弱，需要加强针来保持保护。需要进一步研究以确定学校重新开放对奥密克戎主导期间传播的影响。
