{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T01:29:16Z","timestamp":1776216556503,"version":"3.50.1"},"reference-count":45,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003593","name":"CNPq (Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["405731\/2023-0"],"award-info":[{"award-number":["405731\/2023-0"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003593","name":"CNPq (Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["301522\/2025-1"],"award-info":[{"award-number":["301522\/2025-1"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"name":"FAPEMIG (Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de Minas Gerais","award":["APQ-03205-24"],"award-info":[{"award-number":["APQ-03205-24"]}]},{"name":"FAPEMIG (Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de Minas Gerais","award":["APQ-04839-24"],"award-info":[{"award-number":["APQ-04839-24"]}]},{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Pediatric patients with SARS-CoV-2 infection are at an increased risk of severe disease and adverse outcomes. Nevertheless, comprehensive data on COVID-19 vaccine effectiveness (VE) in children with diabetes during the post-pandemic period remain limited. This study assessed the VE against severe COVID-19 outcomes during both the pandemic and post-pandemic phases in children with and without diabetes mellitus (DM). A cohort study based on population data was carried out, including all patients under 18 years of age with symptomatic SARS-CoV-2 infection as registered in the Brazilian national surveillance systems from February 2020 to June 2025. The main outcomes were hospitalization due to COVID-19 and severe illness, which included admission to the intensive care unit (ICU), need for invasive ventilation, and death. Utilizing a propensity score-matched cohort, we estimated the VE and the number needed to vaccinate (NNV) for a booster dose against these outcomes by comparing vaccinated and unvaccinated individuals, employing conditional logistic regression adjusted for confounding variables. The cohort comprised 3,730,007 pediatric patients with COVID-19, of whom 7675 (0.2%) had DM. At baseline, children with DM exhibited a significantly higher prevalence of hospitalization (11.2% vs. 2.0%), severe COVID-19 (6.4% vs. 0.6%), and mortality (1.9% vs. 0.1%) than those without DM (all p &lt; 0.001). During the pandemic period, the adjusted VE was consistently higher in children with DM. Against severe disease, the VE was 72.8% (95% CI: 12.3\u201393.2) in the DM cohort compared with 45.7% (28.1\u201359.0) in the non-DM cohort. This increased effectiveness corresponded to a more favorable NNV; the NNV to prevent one severe case was 24 (95% CI: 12\u2013232) for children with DM versus 243 (168\u2013440) for those without DM. In the post-pandemic period, the VE remained significantly higher in the DM cohort. Against severe disease, the VE was 76.2% (11.5\u201393.5) for children with DM and 52.9% (32.7\u201367.1) for those without. The NNV to prevent one severe case was consistently lower in the DM cohort (8 vs. 591). In conclusion, a complete vaccination regimen, including a booster dose, substantially mitigated severe COVID-19 outcomes in children with DM in the pandemic and post-pandemic periods.<\/jats:p>","DOI":"10.3390\/microorganisms14020501","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T10:32:37Z","timestamp":1771583557000},"page":"501","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effectiveness of COVID-19 Vaccines Against Hospitalization and Severe Disease in Children with Diabetes Mellitus During Pandemic and Post-Pandemic Eras"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2479-4429","authenticated-orcid":false,"given":"Laura G.","family":"Coelho","sequence":"first","affiliation":[{"name":"Health Sciences Postgraduate Program, Department of Pediatrics, School of Medicine, Federal University of Minas Gerais (UFMG), R. Engenheiro Amaro Lanari 389\/501, Belo Horizonte 30310-580, MG, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lilian M.","family":"Diniz","sequence":"additional","affiliation":[{"name":"Health Sciences Postgraduate Program, Department of Pediatrics, School of Medicine, Federal University of Minas Gerais (UFMG), R. Engenheiro Amaro Lanari 389\/501, Belo Horizonte 30310-580, MG, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5790-1136","authenticated-orcid":false,"given":"Stella C.","family":"Galante","sequence":"additional","affiliation":[{"name":"Health Sciences Postgraduate Program, Department of Pediatrics, School of Medicine, Federal University of Minas Gerais (UFMG), R. Engenheiro Amaro Lanari 389\/501, Belo Horizonte 30310-580, MG, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6559-3300","authenticated-orcid":false,"given":"Cristiane S.","family":"Dias","sequence":"additional","affiliation":[{"name":"Health Sciences Postgraduate Program, Department of Pediatrics, School of Medicine, Federal University of Minas Gerais (UFMG), R. Engenheiro Amaro Lanari 389\/501, Belo Horizonte 30310-580, MG, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2511-6769","authenticated-orcid":false,"given":"Maria Christina L.","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Health Sciences Postgraduate Program, Department of Pediatrics, School of Medicine, Federal University of Minas Gerais (UFMG), R. Engenheiro Amaro Lanari 389\/501, Belo Horizonte 30310-580, MG, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrico A.","family":"Colosimo","sequence":"additional","affiliation":[{"name":"Department of Statistics, Federal University of Minas Gerais (UFMG), Belo Horizonte 31270-901, MG, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9222-3882","authenticated-orcid":false,"given":"Ana Cristina","family":"Sim\u00f5es e Silva","sequence":"additional","affiliation":[{"name":"Health Sciences Postgraduate Program, Department of Pediatrics, School of Medicine, Federal University of Minas Gerais (UFMG), R. Engenheiro Amaro Lanari 389\/501, Belo Horizonte 30310-580, MG, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0981-4843","authenticated-orcid":false,"given":"Fernanda N.","family":"Duelis","sequence":"additional","affiliation":[{"name":"Health Sciences Postgraduate Program, Department of Pediatrics, School of Medicine, Federal University of Minas Gerais (UFMG), R. Engenheiro Amaro Lanari 389\/501, Belo Horizonte 30310-580, MG, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4790-1955","authenticated-orcid":false,"given":"Maria Eduarda T.","family":"Bernardes","sequence":"additional","affiliation":[{"name":"Health Sciences Postgraduate Program, Department of Pediatrics, School of Medicine, Federal University of Minas Gerais (UFMG), R. Engenheiro Amaro Lanari 389\/501, Belo Horizonte 30310-580, MG, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3979-7497","authenticated-orcid":false,"given":"Daniela R.","family":"Martelli","sequence":"additional","affiliation":[{"name":"Health Science\/Primary Care Postgraduate Program, State University of Montes Claros (Unimontes), Montes Claros 39401-089,  MG, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0164-1179","authenticated-orcid":false,"given":"Fabr\u00edcio Emanuel S.","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Health Science\/Primary Care Postgraduate Program, State University of Montes Claros (Unimontes), Montes Claros 39401-089,  MG, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herc\u00edlio","family":"Martelli-Junior","sequence":"additional","affiliation":[{"name":"Health Science\/Primary Care Postgraduate Program, State University of Montes Claros (Unimontes), Montes Claros 39401-089,  MG, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert H.","family":"Mak","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Nephrology, University of California, San Diego, CA 92123, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5642-7164","authenticated-orcid":false,"given":"Eduardo A.","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Health Sciences Postgraduate Program, Department of Pediatrics, School of Medicine, Federal University of Minas Gerais (UFMG), R. 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