COVID-19 Vaccination and Odds of Post–COVID-19 Condition Symptoms in Children Aged 5 to 17 Years, 2025, Yousaf et al.

[SNT Gatchaman]

COVID-19 Vaccination and Odds of Post–COVID-19 Condition Symptoms in Children Aged 5 to 17 Years
Anna R. Yousaf; Josephine Mak; Lisa Gwynn; Karen Lutrick; Robin F. Bloodworth; Ramona P. Rai; Zuha Jeddy; Lindsay B. LeClair; Laura J. Edwards; Lauren E.W. Olsho; Gabriella Newes-Adeyi; Alexandra F. Dalton; Alberto J. Caban-Martinez; Manjusha Gaglani; Sarang K. Yoon; Kurt T. Hegmann; Andrew L. Phillips; Jefferey L. Burgess; Katherine D. Ellingson; Patrick Rivers; Jennifer K. Meece; Leora R. Feldstein; Harmony L. Tyner; Allison Naleway; Angela P. Campbell; Amadea Britton; Sharon Saydah

IMPORTANCE
An estimated 1% to 3% of children with SARS-CoV-2 infection will develop post–COVID-19 condition (PCC).

OBJECTIVE
To evaluate the odds of PCC among children with COVID-19 vaccination prior to SARS-CoV-2 infection compared with odds among unvaccinated children.

DESIGN, SETTING, AND PARTICIPANTS
In this case-control study, children were enrolled in a multisite longitudinal pediatric cohort from July 27, 2021, to September 1, 2022, and followed up through May 2023. Analysis used a case (PCC reported)–control (no PCC reported) design and included children aged 5 to 17 years whose first real time–polymerase chain reaction (RT-PCR)–confirmed SARS-CoV-2 infection occurred during the study period, who were COVID-19 vaccine age-eligible at the time of infection, and who completed a PCC survey at least 60 days after infection. From December 1, 2022, to May 31, 2023, children had weekly SARS-CoV-2 testing and were surveyed regarding PCC (≥1 new or ongoing symptom lasting ≥1 month after infection).

EXPOSURES
COVID-19 mRNA vaccination status at time of infection was the exposure of interest; participants were categorized as vaccinated (≥2-dose series completed ≥14 days before infection) or unvaccinated. Vaccination status was verified through vaccination cards or vaccine registry and/or medical records when available.

MAIN OUTCOME AND MEASURES
Main outcomes were estimates of the odds of PCC symptoms. Multivariate logistic regression was performed to estimate the odds of PCC among vaccinated children compared with odds of PCC among unvaccinated children.

RESULTS
A total of 622 participants were included, with 28 (5%) case participants and 594 (95%) control participants. Median (IQR) age was 10.0 (7.0-11.9) years for case participants and 10.3 (7.8-12.7) years for control participants (P = .37). Approximately half of both groups reported female sex (13 case participants [46%] and 287 control participants [48%]). Overall, 57% of case participants (16 children) and 77% of control participants (458 children) were vaccinated (P = .05). After adjusting for demographic characteristics, number of acute COVID-19 symptoms, and baseline health, COVID-19 vaccination was associated with decreased odds of 1 or more PCC symptom (adjusted odds ratio [aOR], 0.43; 95% CI, 0.19-0.98) and 2 or more PCC symptoms (aOR, 0.27; 95% CI, 0.10-0.69).

CONCLUSIONS AND RELEVANCE
In this study, mRNA COVID-19 vaccination was associated with reduced odds of PCC in children. The aORs correspond to an estimated 57% and 73% reduced likelihood of 1 or more and 2 or more PCC symptoms, respectively, among vaccinated vs unvaccinated children. These findings suggest benefits of COVID-19 vaccination beyond those associated with protection against acute COVID-19 and may encourage increased pediatric uptake.


Link | PDF (JAMA Network Open) [Open Access]

 

[Hutan]

Case participants were defined as children reporting at least 1 new or ongoing symptom lasting for 1 month or more after infection.9 Control participants were defined as children not reporting PCC symptoms. Analysis was restricted to children aged 5 to 17 years whose first RT-PCR–confirmed SARS-CoV-2 infection occurred in-study (ie, no self-reported history of prior infection and serology negative, if serology at enrollment available), who completed their PCC survey 60 days or more from their positive SARS-CoV-2 test

During the study period, 1389 children had at least 1 positive SARS-CoV-2 test. After applying analytic sample restrictions described previously, 622 participants were eligible for inclusion (Figure). Of these, 28 (5%) were case participants and 594 (95%) were control participants.

Note - small number of cases. Less than 50% were female.

Although not statistically significant, 4 cases (14%) and 57 controls (10%) were asymptomatic at SARS-CoV-2 diagnosis

Case and control participants completed their PCC surveys a similar median (IQR) number of weeks after acute SARS-CoV-2 infection: 27 (16-44) weeks for case participants and 26 (17-42) weeks for control participants (P = .91).

 

[Hutan]

Vaccine as prevention against post-Covid-19 condition

In addition, COVID-19 vaccination prior to SARS-CoV-2 Omicron infection was associated with a 75% reduced likelihood of PCC symptoms impacting day-to-day function. Because both case and control participants had SARS-CoV-2 infection, the overall protection against PCC from vaccination is likely even higher, as these estimates do not account for prevention of SARS-CoV-2 infection by vaccination.30-32 These data showing reduced odds of PCC in children with vaccination are consistent with findings in adults and limited findings in children that show that COVID-19 vaccination is associated with lower risk of PCC.15,18-20,28

Makes me think that the big companies selling covid-19 vaccinations may be allies in getting post-Covid-19 condition accepted as not psychosomatic.

Symptomatic acute illness is not necessary for post-Covid-19 condition

Surveys have shown that one reason behind parental COVID-19 vaccine hesitancy is the idea that COVID-19 in children is usually a mild illness and therefore vaccination is not necessary.35,36 However, even mild or asymptomatic SARS-CoV-2 infection can result in postinfectious sequelae.37,38 Several children with PCC in this cohort had asymptomatic SARS-CoV-2 infections at diagnosis (although they may have gone on to develop symptoms), and none had an infection that resulted in hospitalization, suggesting that although severe SARS-CoV-2 illness is a risk factor for PCC,12,15,17 PCC may develop without severe or even symptomatic COVID-19 illness.

Symptoms

Symptomsinclude:respiratory(shortnessofbreath,runnynoseornasalcongestion,andcough)andnonrespiratory(fever,unexplainedweightloss,unexplainedweightgain, symptoms that get worse after physical activity, change in general physical levels, “brain fog,” fatigue, change in sleeping, leg swelling, hair loss, change in color of finger or toes, rash, bruising or bleeding easily, palpitations, chest pain or tightness, dizziness, numbness, headache, difficulty speaking or communicating, difficulty swallowing or chewing, problems with balance, memory loss, difficulty concentrating, nerve problems [tremors, shaking, abnormal movement, new seizures], problem with hearing loss or ears ringing, joint pain, joint swelling, muscle pain, loss of appetite, increased appetite, change in taste, change in smell, nausea, vomiting, abdominal or stomach pain, constipation, diarrhea, bloating, and bladder problems).

21/28 cases had two or more persisting symptoms.

 

[Turtle]

Vaccine as prevention against post-Covid-19 condition

Makes me think that the big companies selling covid-19 vaccinations may be allies in getting post-Covid-19 condition accepted as not psychosomatic.

Symptomatic acute illness is not necessary for post-Covid-19 condition


Symptoms

21/28 cases had two or more persisting symptoms.

Vaccine companies as allies to get LC accepted, wonderful thought.
Do you think it could turn around JFK and make him into a pro-vaccine LC advocate?

 

[Hutan]

Politicians come and go. But, if big drug companies have a financial reason to not see LC as psychosomatic, that could lead to them being more open to the development of drugs for treatment.

 

[hotblack]

Agree, those with the biggest financial incentives to do the right thing and follow the science and get people vaccinated (amongst loads of other preventive healthcare measures) are health insurers and drug companies. So they will.