{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:48:11Z","timestamp":1785545291317,"version":"3.56.0"},"reference-count":42,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>We assessed BNT162b2 vaccine effectiveness (VE) against mild to moderate and severe coronavirus disease 2019 (COVID-19) in children and adolescents through the Omicron BA.4\/BA.5 period.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Using VISION Network records from April 2021 to September 2022, we conducted a test-negative, case-control study assessing VE against COVID-19-associated emergency department\/urgent care (ED\/UC) encounters and hospitalizations using logistic regression, conditioned on month and site, adjusted for covariates.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>We compared 9800 ED\/UC cases with 70\u2009232 controls, and 305 hospitalized cases with 2612 controls. During Delta, 2-dose VE against ED\/UC encounters at 12 to 15 years was initially 93% (95% confidence interval 89 to 95), waning to 77% (69% to 84%) after \u2265150 days. At ages 16 to 17, VE was initially 93% (86% to 97%), waning to 72% (63% to 79%) after \u2265150 days. During Omicron, VE at ages 12 to 15 was initially 64% (44% to 77%), waning to 13% (3% to 23%) after \u2265150 days; at ages 16 to 17 VE was 31% (10% to 47%) during days 60 to 149, waning to 7% (\u22128 to 20%) after 150 days. A monovalent booster increased VE to 54% (40% to 65%) at ages 12 to 15 and 46% (30% to 58%) at ages 16 to 17. At ages 5 to 11, 2-dose VE was 49% (33% to 61%) initially and 41% (29% to 51%) after 150 days. During Delta, VE against hospitalizations at ages 12 to 17 was high (&amp;gt;97%), and at ages 16 to 17 remained 98% (73% to 100%) beyond 150 days; during Omicron, hospitalizations were too infrequent to precisely estimate VE.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>BNT162b2 protected children and adolescents against mild to moderate and severe COVID-19. VE was lower during Omicron predominance including BA.4\/BA.5, waned after dose 2 but increased after a monovalent booster. Children and adolescents should receive all recommended COVID-19 vaccinations.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2022-060894","type":"journal-article","created":{"date-parts":[[2023,4,7]],"date-time":"2023-04-07T08:05:29Z","timestamp":1680854729000},"source":"Crossref","is-referenced-by-count":20,"title":["Effectiveness of BNT162b2 COVID-19 Vaccination in Children and Adolescents"],"prefix":"10.1542","volume":"151","author":[{"given":"Nicola P.","family":"Klein","sequence":"first","affiliation":[{"name":"aKaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California Division of Research, Oakland, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Demarco","sequence":"additional","affiliation":[{"name":"bWestat, Rockville, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine E.","family":"Fleming-Dutra","sequence":"additional","affiliation":[{"name":"cCenters for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa S.","family":"Stockwell","sequence":"additional","affiliation":[{"name":"dDivision of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York"},{"name":"eDepartment of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York"},{"name":"fNewYork-Presbyterian Hospital, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anupam B.","family":"Kharbanda","sequence":"additional","affiliation":[{"name":"gChildren\u2019s Minnesota, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manjusha","family":"Gaglani","sequence":"additional","affiliation":[{"name":"hDepartment of Pediatrics, Section of Pediatric Infectious Diseases, Baylor Scott & White Health, Temple, Texas"},{"name":"iDepartment of Medical Education, Texas A&M University College of Medicine, Temple, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suchitra","family":"Rao","sequence":"additional","affiliation":[{"name":"jDepartment of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ned","family":"Lewis","sequence":"additional","affiliation":[{"name":"aKaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California Division of Research, Oakland, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie A.","family":"Irving","sequence":"additional","affiliation":[{"name":"kKaiser Permanente Center for Health Research, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Hartmann","sequence":"additional","affiliation":[{"name":"bWestat, Rockville, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karthik","family":"Natarajan","sequence":"additional","affiliation":[{"name":"fNewYork-Presbyterian Hospital, New York, New York"},{"name":"mDepartment of Biomedical Informatics, Columbia University Irving Medical Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra F.","family":"Dalton","sequence":"additional","affiliation":[{"name":"cCenters for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ousseny","family":"Zerbo","sequence":"additional","affiliation":[{"name":"aKaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California Division of Research, Oakland, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malini B.","family":"DeSilva","sequence":"additional","affiliation":[{"name":"nHealthPartners Institute, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepika","family":"Konatham","sequence":"additional","affiliation":[{"name":"hDepartment of Pediatrics, Section of Pediatric Infectious Diseases, Baylor Scott & White Health, Temple, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Stenehjem","sequence":"additional","affiliation":[{"name":"oDivision of Infectious Diseases and Clinical Epidemiology, Intermountain Healthcare, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A. K.","family":"Rowley","sequence":"additional","affiliation":[{"name":"bWestat, Rockville, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toan C.","family":"Ong","sequence":"additional","affiliation":[{"name":"bWestat, Rockville, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaun J.","family":"Grannis","sequence":"additional","affiliation":[{"name":"pCenter for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana"},{"name":"qSchool of Medicine, Indiana University, Indianapolis, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chantel","family":"Sloan-Aagard","sequence":"additional","affiliation":[{"name":"lPaso del Norte Health Information Exchange (PHIX), El Paso, Texas"},{"name":"rBrigham Young University Department of Public Health, Provo, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jungmi","family":"Han","sequence":"additional","affiliation":[{"name":"lPaso del Norte Health Information Exchange (PHIX), El Paso, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer R","family":"Verani","sequence":"additional","affiliation":[{"name":"cCenters for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chandni","family":"Raiyani","sequence":"additional","affiliation":[{"name":"hDepartment of Pediatrics, Section of Pediatric Infectious Diseases, Baylor Scott & White Health, Temple, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Dascomb","sequence":"additional","affiliation":[{"name":"oDivision of Infectious Diseases and Clinical Epidemiology, Intermountain Healthcare, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah E.","family":"Reese","sequence":"additional","affiliation":[{"name":"bWestat, Rockville, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle A.","family":"Barron","sequence":"additional","affiliation":[{"name":"jDepartment of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William F.","family":"Fadel","sequence":"additional","affiliation":[{"name":"pCenter for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana"},{"name":"sFairbanks School of Public Health, Indiana University, Indianapolis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison L.","family":"Naleway","sequence":"additional","affiliation":[{"name":"kKaiser Permanente Center for Health Research, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Nanez","sequence":"additional","affiliation":[{"name":"lPaso del Norte Health Information Exchange (PHIX), El Paso, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Dickerson","sequence":"additional","affiliation":[{"name":"cCenters for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Goddard","sequence":"additional","affiliation":[{"name":"aKaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California Division of Research, Oakland, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kempapura","family":"Murthy","sequence":"additional","affiliation":[{"name":"hDepartment of Pediatrics, Section of Pediatric Infectious Diseases, Baylor Scott & White Health, Temple, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Grisel","sequence":"additional","affiliation":[{"name":"oDivision of Infectious Diseases and Clinical Epidemiology, Intermountain Healthcare, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zacharay A.","family":"Weber","sequence":"additional","affiliation":[{"name":"bWestat, Rockville, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian E.","family":"Dixon","sequence":"additional","affiliation":[{"name":"pCenter for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana"},{"name":"sFairbanks School of Public Health, Indiana University, Indianapolis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Palak","family":"Patel","sequence":"additional","affiliation":[{"name":"cCenters for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Fireman","sequence":"additional","affiliation":[{"name":"aKaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California Division of Research, Oakland, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Arndorfer","sequence":"additional","affiliation":[{"name":"oDivision of Infectious Diseases and Clinical Epidemiology, Intermountain Healthcare, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nimish R.","family":"Valvi","sequence":"additional","affiliation":[{"name":"pCenter for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric P.","family":"Griggs","sequence":"additional","affiliation":[{"name":"cCenters for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carly","family":"Hallowell","sequence":"additional","affiliation":[{"name":"bWestat, Rockville, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J.","family":"Embi","sequence":"additional","affiliation":[{"name":"pCenter for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana"},{"name":"tVanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah W.","family":"Ball","sequence":"additional","affiliation":[{"name":"bWestat, Rockville, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark G.","family":"Thompson","sequence":"additional","affiliation":[{"name":"cCenters for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark W.","family":"Tenforde","sequence":"additional","affiliation":[{"name":"cCenters for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Link-Gelles","sequence":"additional","affiliation":[{"name":"cCenters for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2023,4,7]]},"reference":[{"issue":"4","key":"2023111014151341600_B1","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1016\/j.vaccine.2020.11.078","article-title":"Epidemiology of COVID-19 infection in young children under five years: a systematic review and meta-analysis","volume":"39","author":"Bhuiyan","year":"2021","journal-title":"Vaccine"},{"issue":"4","key":"2023111014151341600_B2","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1056\/NEJMoa2021680","article-title":"Multisystem inflammatory syndrome in U.S. children and adolescents","volume":"383","author":"Feldstein","year":"2020","journal-title":"N Engl J Med"},{"issue":"23","key":"2023111014151341600_B3","doi-asserted-by":"crossref","first-page":"851","DOI":"10.15585\/mmwr.mm7023e1","article-title":"Hospitalization of adolescents aged 12-17 years with laboratory-confirmed COVID-19 - COVID-NET, 14 states, March 1, 2020-April 24, 2021","volume":"70","author":"Havers","year":"2021","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"32","key":"2023111014151341600_B4","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.15585\/mmwr.mm6932e3","article-title":"Hospitalization rates and characteristics of children aged &lt;18 years hospitalized with laboratory-confirmed COVID-19 - COVID-NET, 14 states, March 1-July 25, 2020","volume":"69","author":"Kim","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2023111014151341600_B5","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.puhe.2020.10.012","article-title":"Predictors of laboratory-positive COVID-19 in children and teenagers","volume":"189","author":"Murillo-Zamora","year":"2020","journal-title":"Public 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VISION network, 10 states, April 2021-January 2022","volume":"71","author":"Klein","year":"2022","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"7","key":"2023111014151341600_B26","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1016\/S1473-3099(20)30375-3","article-title":"New WHO guidelines on the management of pregnancy and breastfeeding in the context of Ebola","volume":"20","author":"Thorson","year":"2020","journal-title":"Lancet Infect Dis"},{"issue":"4","key":"2023111014151341600_B27","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1037\/1082-989X.9.4.403","article-title":"Propensity score estimation with boosted regression for evaluating causal effects in observational studies","volume":"9","author":"McCaffrey","year":"2004","journal-title":"Psychol Methods"},{"issue":"1","key":"2023111014151341600_B28","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1186\/s12874-017-0338-0","article-title":"Double-adjustment in propensity score matching analysis: choosing a threshold for considering residual imbalance","volume":"17","author":"Nguyen","year":"2017","journal-title":"BMC Med Res Methodol"},{"issue":"6","key":"2023111014151341600_B29","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1056\/NEJMoa2203209","article-title":"Effectiveness of BNT162b2 vaccine against omicron in children 5 to 11 years of age","volume":"387","author":"Tan","year":"2022","journal-title":"N Engl J Med"},{"issue":"7","key":"2023111014151341600_B30","doi-asserted-by":"crossref","first-page":"255","DOI":"10.15585\/mmwr.mm7107e2","article-title":"Waning 2-dose and 3-dose effectiveness of mRNA vaccines against COVID-19- associated emergency department and urgent care encounters and hospitalizations among adults during periods of delta and omicron variant predominance - VISION network, 10 states, August 2021-January 2022","volume":"71","author":"Ferdinands","year":"2022","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"1","key":"2023111014151341600_B31","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1056\/NEJMc2206576","article-title":"Neutralization escape by SARS-CoV-2 omicron subvariants BA.2.12.1, BA.4, and BA.5","volume":"387","author":"Hachmann","year":"2022","journal-title":"N Engl J Med"},{"issue":"8","key":"2023111014151341600_B32","doi-asserted-by":"crossref","first-page":"e2225162","DOI":"10.1001\/jamanetworkopen.2022.25162","article-title":"Effectiveness associated with BNT162b2 vaccine against emergency department and urgent care encounters for delta and omicron SARS-CoV-2 infection among adolescents aged 12 to 17 years","volume":"5","author":"Tartof","year":"2022","journal-title":"JAMA Netw Open"},{"issue":"29","key":"2023111014151341600_B33","doi-asserted-by":"crossref","first-page":"931","DOI":"10.15585\/mmwr.mm7129e1","article-title":"Effectiveness of 2, 3, and 4 COVID-19 mRNA vaccine doses among immunocompetent adults during periods when SARS-CoV-2 omicron BA.1 and BA.2\/BA.2.12.1 sublineages predominated - 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