MMWR Morb Mortal Wkly Rep. 2023 Feb 17;72(7):177-182. doi: 10.15585/mmwr.mm7207a3.
On June 18, 2022, the Advisory Committee on Immunization Practices (ACIP) issued interim recommendations for use of the 2-dose monovalent Moderna COVID-19 vaccine as a primary series for children aged 6 months-5 years* and the 3-dose monovalent Pfizer-BioNTech COVID-19 vaccine as a primary series for children aged 6 months-4 years, based on safety, immunobridging, and limited efficacy data from clinical trials (1-3). Monovalent mRNA vaccine effectiveness (VE) against symptomatic SARS-CoV-2 infection was evaluated using the Increasing Community Access to Testing (ICATT) program, which provides SARS-CoV-2 testing to persons aged ≥3 years at pharmacy and community-based testing sites nationwide (4,5). Among children aged 3-5 years with one or more COVID-19-like illness symptoms for whom a nucleic acid amplification test (NAAT) was performed during August 1, 2022-February 5, 2023, VE of 2 monovalent Moderna doses (complete primary series) against symptomatic infection was 60% (95% CI = 49% to 68%) 2 weeks-2 months after receipt of the second dose and 36% (95% CI = 15% to 52%) 3-4 months after receipt of the second dose. Among symptomatic children aged 3-4 years with NAATs performed during September 19, 2022-February 5, 2023, VE of 3 monovalent Pfizer-BioNTech doses (complete primary series) against symptomatic infection was 31% (95% CI = 7% to 49%) 2 weeks-4 months after receipt of the third dose; statistical power was not sufficient to estimate VE stratified by time since receipt of the third dose. Complete monovalent Moderna and Pfizer-BioNTech primary series vaccination provides protection for children aged 3-5 and 3-4 years, respectively, against symptomatic infection for at least the first 4 months after vaccination. CDC expanded recommendations for use of updated bivalent vaccines to children aged ≥6 months on December 9, 2022 (6), which might provide increased protection against currently circulating SARS-CoV-2 variants (7,8). Children should stay up to date with recommended COVID-19 vaccines, including completing the primary series; those who are eligible should receive a bivalent vaccine dose.
2022 年 6 月 18 日，免疫实践咨询委员会（ACIP）根据安全性、免疫桥接和临床试验的有限疗效数据，发布了 2 剂单价 Moderna COVID-19 疫苗作为 6 个月至 5 岁儿童基础系列疫苗、3 剂单价辉瑞-BioNTech COVID-19 疫苗作为 6 个月至 4 岁儿童基础系列疫苗的临时建议（1-3）。使用全国范围内的药店和社区检测点向年龄≥3 岁的人提供 SARS-CoV-2 检测的社区扩大检测机会（ICATT）计划评估单价 mRNA 疫苗对有症状的 SARS-CoV-2 感染的疫苗有效性（VE）（4,5）。在 2022 年 8 月 1 日至 2023 年 2 月 5 日期间，因出现一个或多个 COVID-19 样症状而接受核酸扩增试验（NAAT）的 3-5 岁儿童中，2 剂单价 Moderna 疫苗（完整基础系列）对有症状感染的 VE 为 60%（95%CI=49%至 68%），在第二剂接种后 2 周到 2 个月，在第二剂接种后 3 到 4 个月时为 36%（95%CI=15%至 52%）。在 2022 年 9 月 19 日至 2023 年 2 月 5 日期间因出现症状而接受 NAAT 的 3-4 岁儿童中，3 剂单价辉瑞-BioNTech 疫苗（完整基础系列）对有症状感染的 VE 为 31%（95%CI=7%至 49%），在第三剂接种后 2 周到 4 个月；由于时间因素，估计 VE 的统计能力不足。完整的单价 Moderna 和辉瑞-BioNTech 基础系列疫苗接种分别为 3-5 岁和 3-4 岁儿童提供了针对有症状感染的保护，至少在接种疫苗后的头 4 个月内是有效的。2022 年 12 月 9 日，CDC 扩大了更新的二价疫苗在≥6 个月儿童中的使用建议（6），这可能会提高对当前流行的 SARS-CoV-2 变体的保护（7,8）。儿童应及时接种推荐的 COVID-19 疫苗，包括完成基础系列疫苗接种；符合条件者应接种一剂二价疫苗。
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