Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China.
Institute for Global Health and Development, Peking University, No. 5, Yiheyuan Road, Haidian District, Beijing, 100871, China.
World J Pediatr. 2023 Nov;19(11):1041-1054. doi: 10.1007/s12519-022-00680-9. Epub 2023 Feb 1.
During the coronavirus disease 2019 (COVID-19) pandemic, there is an urgent need for safe and effective COVID-19 vaccines to protect children and adolescents. This study aims to provide scientific evidence and recommendations for the application of COVID-19 vaccines in children and adolescents by analyzing the latest studies.
We systematically searched MEDLINE (accessed through PubMed), Embase, and Web of Science from January 1, 2020, to October 8, 2022. Eligible clinical trials, cohort studies, case‒control studies, and cross-sectional studies with extractable data were included in immunogenicity, effectiveness, and safety analyses. According to the heterogeneity, we chose a fixed-effect model (when I ≤ 50) or a random-effects model (when I > 50) to pool effect values.
A total of 88 articles were included. The seroconversion rates after the first, second, and third doses of the vaccines were 86.10%, 96.52%, and 99.87%, respectively. After the first and second doses, vaccine effectiveness (VE) against severe acute respiratory syndrome coronavirus 2 infection was 42.87% [95% confidence interval (CI) = 27.09%-58.65%] and 63.33% (95% CI = 52.09%-74.56%), respectively. After the first and second doses, VE against COVID-19 was 60.65% (95% CI = 44.80%-76.50%) and 75.77% (95% CI = 63.99%-87.56%), respectively. VE against hospitalization due to COVID-19 after the first and second doses was 72.74% (95% CI = 51.48%-94.01%) and 82.78% (95% CI = 75.78%-89.78%), respectively. The most common adverse events were injection site pain, fatigue/asthenia/tiredness, headache, myalgia/muscle pain, and chills. The incidence rate of myocarditis or pericarditis was 2.42/100,000 people. In addition, the subgroup analysis showed that children aged ≤ 5 years had the lowest incidence of adverse events, and the incidence rate of adverse events was higher for mRNA vaccines than for inactivated vaccines.
COVID-19 vaccines have good immunogenicity, effectiveness, and safety among children and adolescents. We recommend that children and adolescents be vaccinated as soon as possible to protect them and slow the spread of COVID-19.
在 2019 年冠状病毒病（COVID-19）大流行期间，迫切需要安全有效的 COVID-19 疫苗来保护儿童和青少年。本研究旨在通过分析最新研究，为 COVID-19 疫苗在儿童和青少年中的应用提供科学依据和建议。
我们系统地检索了 2020 年 1 月 1 日至 2022 年 10 月 8 日期间 MEDLINE（通过 PubMed 访问）、Embase 和 Web of Science 中的数据。纳入了具有可提取数据的免疫原性、有效性和安全性分析的合格临床试验、队列研究、病例对照研究和横断面研究。根据异质性，我们选择固定效应模型（当 I≤50 时）或随机效应模型（当 I＞50 时）来合并效应值。
共纳入 88 篇文章。疫苗接种后第一、二、三剂的血清转化率分别为 86.10%、96.52%和 99.87%。第一剂和第二剂后，疫苗对严重急性呼吸综合征冠状病毒 2 感染的有效性（VE）分别为 42.87%（95%置信区间[CI]：27.09%-58.65%）和 63.33%（95% CI：52.09%-74.56%）。第一剂和第二剂后，COVID-19 的 VE 分别为 60.65%（95% CI：44.80%-76.50%）和 75.77%（95% CI：63.99%-87.56%）。第一剂和第二剂后，因 COVID-19 住院的 VE 分别为 72.74%（95% CI：51.48%-94.01%）和 82.78%（95% CI：75.78%-89.78%）。最常见的不良反应是注射部位疼痛、疲劳/乏力/疲倦、头痛、肌痛/肌肉疼痛和寒战。心肌炎或心包炎的发生率为 2.42/100,000 人。此外，亚组分析显示，≤5 岁的儿童不良反应发生率最低，mRNA 疫苗的不良反应发生率高于灭活疫苗。
COVID-19 疫苗在儿童和青少年中具有良好的免疫原性、有效性和安全性。我们建议尽快为儿童和青少年接种疫苗，以保护他们并减缓 COVID-19 的传播。
