Target trial emulation of vaccine effectiveness in 5- to 17-years-olds with prior SARS-CoV-2 infection
Lei, Y; Chen, J; Wu, Q; et al., Nature Communications, April 2026
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Publication Details
DOI: 10.1038/s41467-026-71820-2
Abstract
The effectiveness of COVID-19 vaccination in children and adolescents with prior SARS-CoV-2 infection remains unclear, particularly for Omicron subvariants. We evaluate vaccine effectiveness against reinfection with Omicron BA.1/BA.2, BA.4/BA.5, XBB, and later subvariants among 5- to 17-year-olds using data from the RECOVER initiative, a national electronic health record database covering 37 U.S. children's hospitals and health institutions. We emulate target trials by age group and variant period, comparing previously infected participants between January 2022 and August 2023. During the BA.1/BA.2 period, vaccination reduces the risk of reinfection, with effectiveness rates of 62% in children and 65% in adolescents. During the BA.4/BA.5 period, protection effectiveness in children was 57%, whereas no statistically significant protection is observed in adolescents. During the XBB and later period, no significant protection is observed in either group. In summary, COVID-19 vaccination provides protection against reinfection during the early and mid-Omicron periods in previously infected pediatric populations, but effectiveness declines for later variants.Authors
Yuqing Lei, Jiajie Chen, Qiong Wu, Ting Zhou, Bingyu Zhang, Michael J Becich, Yuriy Bisyuk, Saul Blecker, Elizabeth A Chrischilles, Dimitri A Christakis, Lindsay G Cowell, Mollie R Cummins, Soledad A Fernandez, Daniel Fort, Sandy L Gonzalez, Sharon J Herring, Benjamin D Horne, Carol Horowitz, Mei Liu, Susan Kim, Parsa Mirhaji, Abu Saleh Mohammad Mosa, Jennifer A Muszynski, Catharine I Paules, Alice I Sato, Hayden T Schwenk, Soumitra Sengupta, Srinivasan Suresh, Bradley W Taylor, David A Williams, Yongqun He, Jeffrey S Morris, Ravi Jhaveri, Christopher B Forrest, Yong Chen, RECOVER Consortium
Keywords
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