Protection against symptomatic disease with the delta and omicron BA.1/BA.2 variants of SARS-CoV-2 after infection and vaccination in adolescents: national observational test-negative case control study, August 2021 to March 2022, England

Powell, Annabel A; Kirsebom, Freja; Stowe, Julia; Lopez-Bernal, Jamie; Ramsay, Mary; Andrews, Nick; Ladhani, Shamez

doi:10.1101/2022.08.19.22278987

Cited by 5 publications

(4 citation statements)

References 33 publications

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“…Risk factor associations early in the pandemic, such as older age, non-White ethnicity, and lower socioeconomic status, tended to attenuate across later variants. These findings may reflect differences between variants, higher levels of immunity due to prior infection in those at greater risk, or the impact of vaccination . Vaccination is only likely to have impacted those aged 12 to 17 years in our study, as this age group was eligible for vaccination in the UK from September 2021 onward, while younger children were considered eligible after January 2022.…”

Section: Discussionmentioning

confidence: 92%

“…These findings may reflect differences between variants, higher levels of immunity due to prior infection in those at greater risk, or the impact of vaccination. [23][24][25] Vaccination is only likely to have impacted those 12 to 17 years in our study, as this age group was eligible for vaccination in the UK from September 2021 onward, while younger children were considered eligible after January 2022. Of note, almost all hospitalized children and adolescents included in our study had no prior exposure to SARS-CoV-2 infection or vaccination.…”

Section: Discussionmentioning

confidence: 99%

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Pediatric Hospitalizations and ICU Admissions Due to COVID-19 and Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2 in England

et al. 2023

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ImportanceInvestigating how the risk of serious illness after SARS-CoV-2 infection in children and adolescents has changed as new variants have emerged is essential to inform public health interventions and clinical guidance.ObjectiveTo examine risk factors associated with hospitalization for COVID-19 or pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) among children and adolescents during the first 2 years of the COVID-19 pandemic and change in risk factors over time.Design, Setting, and ParticipantsThis population-level analysis of hospitalizations after SARS-CoV-2 infection in England among children and adolescents aged 0 to 17 years was conducted from February 1, 2020, to January 31, 2022. National data on hospital activity were linked with data on SARS-CoV-2 testing, SARS-CoV-2 vaccination, pediatric intensive care unit (PICU) admissions, and mortality. Children and adolescents hospitalized with COVID-19 or PIMS-TS during this time were included. Maternal, elective, and injury-related hospitalizations were excluded.ExposuresPrevious medical comorbidities, sociodemographic factors, and timing of hospitalization when different SARS-CoV-2 variants (ie, wild type, Alpha, Delta, and Omicron) were dominant in England.Main OutcomesPICU admission and death within 28 days of hospitalization with COVID-19 or PIMS-TS.ResultsA total of 10 540 hospitalizations due to COVID-19 and 997 due to PIMS-TS were identified within 1 125 010 emergency hospitalizations for other causes. The number of hospitalizations due to COVID-19 and PIMS-TS per new SARS-CoV-2 infections in England declined during the second year of the COVID-19 pandemic. Among 10 540 hospitalized children and adolescents, 448 (4.3%) required PICU admission due to COVID-19, declining from 162 of 1635 (9.9%) with wild type, 98 of 1616 (6.1%) with Alpha, and 129 of 3789 (3.4%) with Delta to 59 of 3500 (1.7%) with Omicron. Forty-eight children and adolescents died within 28 days of hospitalization due to COVID-19, and no children died of PIMS-TS (PIMS-S data were limited to November 2020 onward). Risk of severe COVID-19 in children and adolescents was associated with medical comorbidities and neurodisability regardless of SARS-CoV-2 variant. Results were similar when children and adolescents with prior SARS-CoV-2 exposure or vaccination were excluded.ConclusionsIn this study of data across the first 2 years of the COVID-19 pandemic, risk of severe disease from SARS-CoV-2 infection in children and adolescents in England remained low. Children and adolescents with multiple medical problems, particularly neurodisability, were at increased risk and should be central to public health measures as further variants emerge.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Pediatric Hospitalizations and ICU Admissions Due to COVID-19 and Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2 in England

et al. 2023

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“…We have summarized the vaccine effectiveness of the COVID‐19 vaccine at different time intervals after full vaccination (Table 4). 164,195–202 These results showed that the vaccine effectiveness began to decline 6 months after the completion of vaccination 164,195–197,201 . This decline occurs more frequently in older people 198 .…”

Section: Perspective Of Vaccination Optimization and Future Vaccine D...mentioning

confidence: 83%

Research progress in spike mutations of SARS‐CoV‐2 variants and vaccine development

Hong

et al. 2023

Medicinal Research Reviews

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The coronavirus disease 2019 (COVID‐19) pandemic can hardly end with the emergence of different variants over time. In the past 2 years, several variants of severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2), such as the Delta and Omicron variants, have emerged with higher transmissibility, immune evasion and drug resistance, leading to higher morbidity and mortality in the population. The prevalent variants of concern (VOCs) share several mutations on the spike that can affect virus characteristics, including transmissibility, antigenicity, and immune evasion. Increasing evidence has demonstrated that the neutralization capacity of sera from COVID‐19 convalescent or vaccinated individuals is decreased against SARS‐CoV‐2 variants. Moreover, the vaccine effectiveness of current COVID‐19 vaccines against SARS‐CoV‐2 VOCs is not as high as that against wild‐type SARS‐CoV‐2. Therefore, more attention might be paid to how the mutations impact vaccine effectiveness. In this review, we summarized the current studies on the mutations of the SARS‐CoV‐2 spike, particularly of the receptor binding domain, to elaborate on how the mutations impact the infectivity, transmissibility and immune evasion of the virus. The effects of mutations in the SARS‐CoV‐2 spike on the current therapeutics were highlighted, and potential strategies for future vaccine development were suggested.

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“…A recent systematic review and meta-analysis synthesized evidence on the waning of protection against infection and severe disease from exposure to the Omicron variants 9,10,21 . We used this evidence to specify waning curves for different combinations of prior infection and vaccination.…”

Section: Initial Levels Of Protection and Subsequent Waningmentioning

confidence: 99%

Changes in population immunity against infection and severe disease from SARS-CoV-2 Omicron variants in the United States between December 2021 and November 2022

Klaassen

Chitwood

Cohen

et al. 2022

Preprint

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Importance: While a substantial fraction of the US population was infected with SARS-CoV-2 during December 2021-February 2022, the subsequent evolution of population immunity against SARS-CoV-2 Omicron variants reflects the competing influences of waning protection over time and acquisition or restoration of immunity through additional infections and vaccinations. Objective: To estimate changes in population immunity against infection and severe disease due to circulating SARS-CoV-2 Omicron variants in the United States from December 2021 to October 2022, and to quantify the protection against a potential 2022-2023 winter SARS-CoV-2 wave. Design, setting, participants: Bayesian evidence synthesis of reported COVID-19 data (diagnoses, hospitalizations), vaccinations, and waning patterns for vaccine- and infection-acquired immunity, using a mathematical model of COVID-19 natural history. Main Outcomes and Measures: Population immunity against infection and severe disease from SARS-CoV-2 Omicron variants in the United States, by location (national, state, county) and week. Results: By November 10, 2022, 94% (95% CrI, 79%-99%) of the US population were estimated to have been infected by SARS-CoV-2 at least once. Combined with vaccination, 97% (95%-99%) were estimated to have some prior immunological exposure to SARS-CoV-2. Between December 1, 2021 and November 10, 2022, protection against a new Omicron infection rose from 22% (21%-23%) to 63% (51%-75%) nationally, and protection against an Omicron infection leading to severe disease increased from 61% (59%-64%) to 89% (83%-92%). Increasing first booster uptake to 55% in all states (current US coverage: 34%) and second booster uptake to 22% (current US coverage: 11%) would increase protection against infection by 4.5 percentage points (2.4-7.2) and protection against severe disease by 1.1 percentage points (1.0-1.5). Conclusions and Relevance: Effective protection against SARS-CoV-2 infection and severe disease in October 2022 was substantially higher than in December 2021. Despite this high level of protection, a more transmissible or immune evading (sub)variant, changes in behavior, or ongoing waning of immunity could lead to a new SARS-CoV-2 wave.

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Protection against symptomatic disease with the delta and omicron BA.1/BA.2 variants of SARS-CoV-2 after infection and vaccination in adolescents: national observational test-negative case control study, August 2021 to March 2022, England

Cited by 5 publications

References 33 publications

Pediatric Hospitalizations and ICU Admissions Due to COVID-19 and Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2 in England

Pediatric Hospitalizations and ICU Admissions Due to COVID-19 and Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2 in England

Research progress in spike mutations of SARS‐CoV‐2 variants and vaccine development

Changes in population immunity against infection and severe disease from SARS-CoV-2 Omicron variants in the United States between December 2021 and November 2022

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