Safety, Immunogenicity, and Efficacy of COVID-19 Vaccines in Adolescents, Children, and Infants: A Systematic Review and Meta-Analysis
BackgroundAs the epidemic progresses, universal vaccination against COVID-19 has been the trend, but there are still some doubts about the efficacy and safety of COVID-19 vaccines in adolescents, children, and even infants.PurposeTo evaluate the safety, immunogenicity, and efficacy of COVID-19 vacci...
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Frontiers Media S.A.
2022-04-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2022.829176/full |
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| author | Yuxuan Du Yuxuan Du Yuxuan Du Yuxuan Du Yuxuan Du Long Chen Long Chen Long Chen Long Chen Long Chen Yuan Shi Yuan Shi Yuan Shi Yuan Shi Yuan Shi |
| author_facet | Yuxuan Du Yuxuan Du Yuxuan Du Yuxuan Du Yuxuan Du Long Chen Long Chen Long Chen Long Chen Long Chen Yuan Shi Yuan Shi Yuan Shi Yuan Shi Yuan Shi |
| author_sort | Yuxuan Du |
| collection | DOAJ |
| description | BackgroundAs the epidemic progresses, universal vaccination against COVID-19 has been the trend, but there are still some doubts about the efficacy and safety of COVID-19 vaccines in adolescents, children, and even infants.PurposeTo evaluate the safety, immunogenicity, and efficacy of COVID-19 vaccines in the population aged 0–17 years.MethodA comprehensive search for relevant randomized controlled trials (RCTs) was conducted in PubMed, Embase, and the Cochrane Library from inception to November 9, 2021. All data were pooled by RevMan 5.3 statistical software, with risk ratio (RR) and its 95% confidence interval as the effect measure. This study protocol was registered on PROSPERO (CRD42021290205).ResultsThere was a total of six randomized controlled trials included in this systematic review and meta-analysis, enrolling participants in the age range of 3–17 years, and containing three types of COVID-19 vaccines. Compared with mRNA vaccines and adenovirus vector vaccines, inactivated vaccines have a more satisfactory safety profile, both after initial (RR 1.40, 95% CI 1.04–1.90, P = 0.03) and booster (RR 1.84, 95% CI 1.20–2.81, P = 0.005) vaccination. The risk of adverse reactions was significantly increased after the first and second doses, but there was no significant difference between the first two doses (RR 1.00, 95%CI 0.99–1.02, P = 0.60). Nevertheless, the two-dose regimen is obviously superior to the single-dose schedule for immunogenicity and efficacy. After booster vaccination, both neutralizing antibodies (RR 144.80, 95%CI 44.97–466.24, P < 0.00001) and RBD-binding antibodies (RR 101.50, 95%CI 6.44–1,600.76, P = 0.001) reach optimal levels, but the cellular immune response seemed not to be further enhanced. In addition, compared with younger children, older children and adolescents were at significantly increased risk of adverse reactions after vaccination, with either mRNA or inactivated vaccines, accompanied by a stronger immune response.ConclusionThe available evidence suggests that the safety, immunogenicity and efficacy of COVID-19 vaccines are acceptable in people aged 3–17 years. However, there is an urgent need for additional multicenter, large-sample studies, especially in younger children under 3 years of age and even in infants, with long-term follow-up data.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021290205, identifier: CRD42021290205. |
| first_indexed | 2024-12-10T17:16:54Z |
| format | Article |
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| language | English |
| last_indexed | 2024-12-10T17:16:54Z |
| publishDate | 2022-04-01 |
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| series | Frontiers in Public Health |
| spelling | doaj.art-633fc96bf6464c528bb4a22743be8fd52022-12-22T01:40:07ZengFrontiers Media S.A.Frontiers in Public Health2296-25652022-04-011010.3389/fpubh.2022.829176829176Safety, Immunogenicity, and Efficacy of COVID-19 Vaccines in Adolescents, Children, and Infants: A Systematic Review and Meta-AnalysisYuxuan Du0Yuxuan Du1Yuxuan Du2Yuxuan Du3Yuxuan Du4Long Chen5Long Chen6Long Chen7Long Chen8Long Chen9Yuan Shi10Yuan Shi11Yuan Shi12Yuan Shi13Yuan Shi14Department of Neonatology, Children's Hospital of Chongqing Medical University, Chongqing, ChinaNational Clinical Research Center for Child Health and Disorders, Chongqing, ChinaMinistry of Education Key Laboratory of Child Development and Disorders, Chongqing, ChinaChina International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, ChinaChongqing Key Laboratory of Pediatrics, Chongqing, ChinaDepartment of Neonatology, Children's Hospital of Chongqing Medical University, Chongqing, ChinaNational Clinical Research Center for Child Health and Disorders, Chongqing, ChinaMinistry of Education Key Laboratory of Child Development and Disorders, Chongqing, ChinaChina International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, ChinaChongqing Key Laboratory of Pediatrics, Chongqing, ChinaDepartment of Neonatology, Children's Hospital of Chongqing Medical University, Chongqing, ChinaNational Clinical Research Center for Child Health and Disorders, Chongqing, ChinaMinistry of Education Key Laboratory of Child Development and Disorders, Chongqing, ChinaChina International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, ChinaChongqing Key Laboratory of Pediatrics, Chongqing, ChinaBackgroundAs the epidemic progresses, universal vaccination against COVID-19 has been the trend, but there are still some doubts about the efficacy and safety of COVID-19 vaccines in adolescents, children, and even infants.PurposeTo evaluate the safety, immunogenicity, and efficacy of COVID-19 vaccines in the population aged 0–17 years.MethodA comprehensive search for relevant randomized controlled trials (RCTs) was conducted in PubMed, Embase, and the Cochrane Library from inception to November 9, 2021. All data were pooled by RevMan 5.3 statistical software, with risk ratio (RR) and its 95% confidence interval as the effect measure. This study protocol was registered on PROSPERO (CRD42021290205).ResultsThere was a total of six randomized controlled trials included in this systematic review and meta-analysis, enrolling participants in the age range of 3–17 years, and containing three types of COVID-19 vaccines. Compared with mRNA vaccines and adenovirus vector vaccines, inactivated vaccines have a more satisfactory safety profile, both after initial (RR 1.40, 95% CI 1.04–1.90, P = 0.03) and booster (RR 1.84, 95% CI 1.20–2.81, P = 0.005) vaccination. The risk of adverse reactions was significantly increased after the first and second doses, but there was no significant difference between the first two doses (RR 1.00, 95%CI 0.99–1.02, P = 0.60). Nevertheless, the two-dose regimen is obviously superior to the single-dose schedule for immunogenicity and efficacy. After booster vaccination, both neutralizing antibodies (RR 144.80, 95%CI 44.97–466.24, P < 0.00001) and RBD-binding antibodies (RR 101.50, 95%CI 6.44–1,600.76, P = 0.001) reach optimal levels, but the cellular immune response seemed not to be further enhanced. In addition, compared with younger children, older children and adolescents were at significantly increased risk of adverse reactions after vaccination, with either mRNA or inactivated vaccines, accompanied by a stronger immune response.ConclusionThe available evidence suggests that the safety, immunogenicity and efficacy of COVID-19 vaccines are acceptable in people aged 3–17 years. However, there is an urgent need for additional multicenter, large-sample studies, especially in younger children under 3 years of age and even in infants, with long-term follow-up data.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021290205, identifier: CRD42021290205.https://www.frontiersin.org/articles/10.3389/fpubh.2022.829176/fullCOVID-19 vaccineadolescentschildinfantrandomized controlled trialmeta-analysis |
| spellingShingle | Yuxuan Du Yuxuan Du Yuxuan Du Yuxuan Du Yuxuan Du Long Chen Long Chen Long Chen Long Chen Long Chen Yuan Shi Yuan Shi Yuan Shi Yuan Shi Yuan Shi Safety, Immunogenicity, and Efficacy of COVID-19 Vaccines in Adolescents, Children, and Infants: A Systematic Review and Meta-Analysis Frontiers in Public Health COVID-19 vaccine adolescents child infant randomized controlled trial meta-analysis |
| title | Safety, Immunogenicity, and Efficacy of COVID-19 Vaccines in Adolescents, Children, and Infants: A Systematic Review and Meta-Analysis |
| title_full | Safety, Immunogenicity, and Efficacy of COVID-19 Vaccines in Adolescents, Children, and Infants: A Systematic Review and Meta-Analysis |
| title_fullStr | Safety, Immunogenicity, and Efficacy of COVID-19 Vaccines in Adolescents, Children, and Infants: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Safety, Immunogenicity, and Efficacy of COVID-19 Vaccines in Adolescents, Children, and Infants: A Systematic Review and Meta-Analysis |
| title_short | Safety, Immunogenicity, and Efficacy of COVID-19 Vaccines in Adolescents, Children, and Infants: A Systematic Review and Meta-Analysis |
| title_sort | safety immunogenicity and efficacy of covid 19 vaccines in adolescents children and infants a systematic review and meta analysis |
| topic | COVID-19 vaccine adolescents child infant randomized controlled trial meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2022.829176/full |
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