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OpenSAFELY: Effectiveness of COVID-19 Vaccination in Children and Adolescents.

Title: OpenSAFELY: Effectiveness of COVID-19 Vaccination in Children and Adolescents.
Authors: Andrews, Colm D; Parker, Edward PK; Horne, Elsie; Walker, Venexia; Palmer, Tom; Schaffer, Andrea L; Green, Amelia CA; Curtis, Helen J; Walker, Alex J; Bridges, Lucy; Wood, Christopher; Speed, Victoria; Bates, Christopher; Cockburn, Jonathan; Parry, John; Mehrkar, Amir; MacKenna, Brian; Bacon, Sebastian CJ; Goldacre, Ben; Hernan, Miguel A; Sterne, Jonathan AC; Hulme, William J; OpenSAFELY Collaborative
Publisher Information: Ovid Technologies (Wolters Kluwer Health)
Publication Year: 2026
Collection: London School of Hygiene & Tropical Medicine: LSHTM Research Online
Description: BACKGROUND: We assessed the safety and effectiveness of the first- and second-dose BNT162b2 COVID-19 vaccination, offered as part of the national COVID-19 vaccine roll-out from September 2021, in children and adolescents in England. METHODS: Our observational study using OpenSAFELY-TPP, included adolescents aged 12-15 years and children aged 5-11 years. It compared individuals receiving (1) the first vaccination to unvaccinated controls and (2) the second vaccination to single-vaccinated controls. We matched vaccinated individuals with controls on age, sex, and other important characteristics. Outcomes were positive SARS-CoV-2 test (adolescents only), COVID-19 accident and emergency (A&E) attendance, COVID-19 hospitalization, COVID-19 critical care admission, and COVID-19 death; with safety outcomes, A&E attendance, unplanned hospitalization, pericarditis, and myocarditis. RESULTS: Among 820,926 previously unvaccinated adolescents, 20-week incidence rate ratios (IRRs) comparing vaccination with no vaccination were 0.74 for positive SARS-CoV-2 test, 0.60 for COVID-19 A&E attendance, and 0.58 for COVID-19 hospitalization. Among 441,858 adolescents who had received the first vaccination, IRRs comparing second dose with single-vaccination were 0.67 for positive SARS-CoV-2 test, 1.00 for COVID-19 A&E attendance, and 0.60 for COVID-19 hospitalization. In both children groups, COVID-19-related outcomes were too rare to allow IRRs to be estimated precisely. Across all analyses, there were no COVID-19-related deaths, and fewer than seven COVID-19-related critical care admissions. Myocarditis and pericarditis were documented only in the vaccinated groups, with rates of 27 and 10 cases/million after the first and second doses, respectively. CONCLUSIONS: BNT162b2 vaccination in adolescents reduced COVID-19 A&E attendance and hospitalization, although these outcomes were rare. Protection against positive SARS-CoV-2 tests was transient.
Document Type: article in journal/newspaper
File Description: text
Language: English
ISSN: 1044-3983
Relation: https://researchonline.lshtm.ac.uk/id/eprint/4678053/1/Andrews-etal-2025-Opensafely-effectiveness-of-covid-19-vaccination.pdf; Andrews, Colm DORCID logo; Parker, Edward PK ORCID logo; Horne, Elsie; Walker, Venexia; Palmer, Tom; Schaffer, Andrea L; Green, Amelia CA; Curtis, Helen J; Walker, Alex J; Bridges, Lucy; +13 more.Wood, Christopher; Speed, Victoria; Bates, Christopher; Cockburn, Jonathan; Parry, John; Mehrkar, Amir; MacKenna, Brian; Bacon, Sebastian CJ; Goldacre, Ben; Hernan, Miguel A; Sterne, Jonathan AC; Hulme, William J; and OpenSAFELY Collaborative (2026) OpenSAFELY: Effectiveness of COVID-19 Vaccination in Children and Adolescents. Epidemiology (Cambridge, Mass.), 37. pp. 141-151. ISSN 1044-3983 DOI:10.1097/EDE.0000000000001908
DOI: 10.1097/ede.0000000000001908
Availability: https://researchonline.lshtm.ac.uk/id/eprint/4678053/; https://doi.org/10.1097/ede.0000000000001908
Rights: cc_by_4
Accession Number: edsbas.68073EA4
Database: BASE