{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T12:12:04Z","timestamp":1793189524682,"version":"4.5.0"},"reference-count":40,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2024,2,6]]},"abstract":"<jats:sec id=\"ab-joi230161-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Bivalent mRNA COVID-19 vaccines were recommended in the US for children and adolescents aged 12 years or older on September 1, 2022, and for children aged 5 to 11 years on October 12, 2022; however, data demonstrating the effectiveness of bivalent COVID-19 vaccines are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-joi230161-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the effectiveness of bivalent COVID-19 vaccines against SARS-CoV-2 infection and symptomatic COVID-19 among children and adolescents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-joi230161-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>Data for the period September 4, 2022, to January 31, 2023, were combined from 3 prospective US cohort studies (6 sites total) and used to estimate COVID-19 vaccine effectiveness among children and adolescents aged 5 to 17 years. A total of 2959 participants completed periodic surveys (demographics, household characteristics, chronic medical conditions, and COVID-19 symptoms) and submitted weekly self-collected nasal swabs (irrespective of symptoms); participants submitted additional nasal swabs at the onset of any symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-joi230161-7\">\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>Vaccination status was captured from the periodic surveys and supplemented with data from state immunization information systems and electronic medical records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-joi230161-8\">\n                    <jats:title>Main Outcome and Measures<\/jats:title>\n                    <jats:p>\n                      Respiratory swabs were tested for the presence of the SARS-CoV-2 virus using reverse transcriptase\u2013polymerase chain reaction\n                      <jats:italic>.<\/jats:italic>\n                      SARS-CoV-2 infection was defined as a positive test regardless of symptoms. Symptomatic COVID-19 was defined as a positive test and 2 or more COVID-19 symptoms within 7 days of specimen collection. Cox proportional hazards models were used to estimate hazard ratios for SARS-CoV-2 infection and symptomatic COVID-19 among participants who received a bivalent COVID-19 vaccine dose vs participants who received no vaccine or monovalent vaccine doses only. Models were adjusted for age, sex, race, ethnicity, underlying health conditions, prior SARS-CoV-2 infection status, geographic site, proportion of circulating variants by site, and local virus prevalence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-joi230161-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 2959 participants (47.8% were female; median age, 10.6 years [IQR, 8.0-13.2 years]; 64.6% were non-Hispanic White) included in this analysis, 25.4% received a bivalent COVID-19 vaccine dose. During the study period, 426 participants (14.4%) had laboratory-confirmed SARS-CoV-2 infection. Among these 426 participants, 184 (43.2%) had symptomatic COVID-19, 383 (89.9%) were not vaccinated or had received only monovalent COVID-19 vaccine doses (1.38 SARS-CoV-2 infections per 1000 person-days), and 43 (10.1%) had received a bivalent COVID-19 vaccine dose (0.84 SARS-CoV-2 infections per 1000 person-days). Bivalent vaccine effectiveness against SARS-CoV-2 infection was 54.0% (95% CI, 36.6%-69.1%) and vaccine effectiveness against symptomatic COVID-19 was 49.4% (95% CI, 22.2%-70.7%). The median observation time after vaccination was 276 days (IQR, 142-350 days) for participants who received only monovalent COVID-19 vaccine doses vs 50 days (IQR, 27-74 days) for those who received a bivalent COVID-19 vaccine dose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-joi230161-10\">\n                    <jats:title>Conclusion and Relevance<\/jats:title>\n                    <jats:p>The bivalent COVID-19 vaccines protected children and adolescents against SARS-CoV-2 infection and symptomatic COVID-19. These data demonstrate the benefit of COVID-19 vaccine in children and adolescents. All eligible children and adolescents should remain up to date with recommended COVID-19 vaccinations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jama.2023.27022","type":"journal-article","created":{"date-parts":[[2024,2,6]],"date-time":"2024-02-06T12:55:37Z","timestamp":1707224137000},"page":"408","source":"Crossref","is-referenced-by-count":40,"title":["Effectiveness of Bivalent mRNA COVID-19 Vaccines in Preventing SARS-CoV-2 Infection in Children and Adolescents Aged 5 to 17 Years"],"prefix":"10.1001","volume":"331","author":[{"given":"Leora R.","family":"Feldstein","sequence":"first","affiliation":[{"name":"Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amadea","family":"Britton","sequence":"additional","affiliation":[{"name":"Coronavirus and Other Respiratory Viruses 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