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Efficacy and Safety of COVID-19 Vaccines in Children Aged 5 to 11 Years: A Systematic Review

5-11세 소아에서 코로나19 백신의 효능 및 안전성에 대한 체계적 문헌고찰

  • Choi, Miyoung (Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency) ;
  • Yu, Su-Yeon (Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency) ;
  • Cheong, Chelim (Healthcare Insights Research) ;
  • Choe, Young June (Department of Pediatrics, Korea University Anam Hospital) ;
  • Choi, Soo-Han (Department of Pediatrics, Pusan National University School of Medicine)
  • 최미영 (한국보건의료연구원 임상근거연구팀) ;
  • 유수연 (한국보건의료연구원 임상근거연구팀) ;
  • 정채림 (HIC 리서치) ;
  • 최영준 (고려대학교 의과대학 소아청소년과) ;
  • 최수한 (부산대학교 의과대학 소아청소년과)
  • Received : 2022.04.20
  • Accepted : 2022.04.26
  • Published : 2022.04.25

Abstract

Purpose: To evaluate the efficacy and safety of coronavirus disease 2019 (COVID-19) vaccines in children aged 5-11 years, a rapid systematic review was conducted on published clinical trials of COVID-19 vaccines and studies that analyzed real-world data on adverse events after COVID-19 vaccination. Methods: A systematic search was conducted on medical literature in international (Ovid-MEDLINE) and pre-published literature databases (medRxiv), followed by handsearching up to January 4, 2022. We used terms including COVID-19, severe acute respiratory syndrome coronavirus 2, and vaccines, and the certainty of evidence was graded using the GRADE approach. Results: A total of 1,675 studies were identified, of which five were finally selected. Among the five studies, four consisted of data from clinical trials of each of the four types of COVID-19 vaccines (BNT162b2, mRNA-1273, CoronaVac, and BBIBP-CorV). The remaining study consisted of real-world data on the safety of the BNT162b2 vaccine in children aged 5-11 years. This systematic review identified that COVID-19 vaccines in recipients aged 5-11 years produced a favorable immune response, and were vaccines were effective against COVID-19. The safety findings for the BNT162b2 vaccine in children and early adolescents aged 5-11 years were similar to those data noted in the clinical trial. Conclusions: There is limited data on COVID-19 vaccines in children aged 5-11 years. Consequently continuous and comprehensive monitoring is necessary for the evaluation of the safety and effectiveness of the COVID-19 vaccines.

목적: 5-11세 소아에서 코로나19 백신의 효능과 안전성을 평가하기 위해서 체계적 문헌고찰을 시행하였다. 방법: 2022년 1월 4일까지 Ovid-MEDLINE 및 medRxiv를 검색하여 문헌을 선정하고 자료를 추출하였다. 근거 수준을 평가하기 위해 GRADE 도구를 사용하였다. 결과: 총 1,675 건의 연구가 일차적으로 검색되었고 최종적으로 5편의 연구가 포함되었다. 서로 다른 4개의 코로나19 백신(BNT162b2, mRNA-1273, CoronaVac, BBIBP-CorV)에 대한 무작위 대조군 연구 결과들은 5-11세 연령에서 각 백신의 양호한 면역원성과 안전성을 보여주었다. 미국에서 5-11세 소아 연령에서 BNT162b2 백신 접종 후 이상사례 모니터링 연구에서는 승인 전 임상시험을 통해 예상되었던 국소반응 및 전신반응이 보고되었으나 중대한 이상사례는 거의 보고되지 않았다. 결론: 5-11세 연령에서 코로나19 백신 접종에 대한 데이터는 제한적이다. 이 연령에서 코로나19 백신의 안전성과 효과에 대한 체계적인 평가를 위해 지속적이고 포괄적인 모니터링이 필요할 것으로 보인다.

Keywords

Acknowledgement

This study was supported by Policy Research Grant from Korea Disease Control and Prevention Agency, titled: [Coronavirus Disease 2019 Immunization in Children Aged 5-11 years: Validation and Policy Assessment (11-1790387-00055-01)].

References

  1. Yang S, Jang J, Park SY, Ahn SH, Kim SS, Ryu B, et al. COVID-19 outbreak report from January 20, 2020 to January 19, 2022 in the Republic of Korea. Public Health Wkly Rep 2022;15:796-805.
  2. Woodworth KR, Moulia D, Collins JP, Hadler SC, Jones JM, Reddy SC, et al. The Advisory Committee on immunization practices' interim recommendation for use of Pfizer-BioNTech COVID-19 vaccine in children aged 5-11 years: United States, November 2021. MMWR Morb Mortal Wkly Rep 2021;70:1579-83. https://doi.org/10.15585/mmwr.mm7045e1
  3. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;6:e1000097. https://doi.org/10.1371/journal.pmed.1000097
  4. National Institute for Health and Care Excellence. Methods for the development of NICE public health guidance. London: NICE, 2012.
  5. Cumpston M, Li T, Page MJ, Chandler J, Welch VA, Higgins JP, et al. Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Database Syst Rev 2019;10:ED000142.
  6. Health Insurance Review and Assessment Service. Methods for the development of NICE public health guidance. Wonju: HIRA 2013.
  7. Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol 2011;64:383-94. https://doi.org/10.1016/j.jclinepi.2010.04.026
  8. Guyatt GH, Thorlund K, Oxman AD, Walter SD, Patrick D, Furukawa TA, et al. GRADE guidelines: 13. Preparing summary of findings tables and evidence profiles-continuous outcomes. J Clin Epidemiol 2013;66:173-83. https://doi.org/10.1016/j.jclinepi.2012.08.001
  9. Santesso N, Carrasco-Labra A, Langendam M, Brignardello-Petersen R, Mustafa RA, Heus P, et al. Improving GRADE evidence tables part 3: detailed guidance for explanatory footnotes supports creating and understanding GRADE certainty in the evidence judgments. J Clin Epidemiol 2016;74:28-39. https://doi.org/10.1016/j.jclinepi.2015.12.006
  10. Moderna. Moderna announces positive top line data from phase 2/3 study of COVID-19 vaccine in children 6 to 11 years of age 2021 [Internet]. Cambridge: Moderna; 2021 [cited 2021 Dec 30] Available from: https://investors.modernatx.com/news/news-details/2021/Moderna-Announces-Positive-Top-Line-Data-from-Phase-23-Study-of-COVID-19-Vaccine-in-Children-6-to-11-Years-of-Age-10-25-2021/default.aspx.
  11. Han B, Song Y, Li C, Yang W, Ma Q, Jiang Z, et al. Safety, tolerability, and immunogenicity of an inactivated SARS-CoV-2 vaccine (CoronaVac) in healthy children and adolescents: a double-blind, randomised, controlled, phase 1/2 clinical trial. Lancet Infect Dis 2021;21:1645-53. https://doi.org/10.1016/S1473-3099(21)00319-4
  12. Xia S, Zhang Y, Wang Y, Wang H, Yang Y, Gao GF, et al. Safety and immunogenicity of an inactivated COVID-19 vaccine, BBIBP-CorV, in people younger than 18 years: a randomised, double-blind, controlled, phase 1/2 trial. Lancet Infect Dis 2022;22:196-208. https://doi.org/10.1016/S1473-3099(21)00462-X
  13. Hause AM, Baggs J, Marquez P, Myers TR, Gee J, Su JR, et al. COVID-19 vaccine safety in children aged 5-11 years - United States, November 3-December 19, 2021. MMWR Morb Mortal Wkly Rep 2021;70:1755-60. https://doi.org/10.15585/mmwr.mm705152a1
  14. Walter EB, Talaat KR, Sabharwal C, Gurtman A, Lockhart S, Paulsen GC, et al. Evaluation of the BNT162b2 Covid-19 vaccine in children 5 to 11 years of age. N Engl J Med 2022;386:35-46. https://doi.org/10.1056/NEJMoa2116298
  15. Klein NP, Stockwell MS, Demarco M, Gaglani M, Kharbanda AB, Irving SA, et al. Effectiveness of COVID-19 Pfizer-BioNTech BNT162b2 mRNA vaccination in preventing COVID-19-associated emergency department and urgent care encounters and hospitalizations among nonimmunocompromised children and adolescents aged 5-17 years - VISION Network, 10 States, April 2021-January 2022. MMWR Morb Mortal Wkly Rep 2022;71:352-8. https://doi.org/10.15585/mmwr.mm7109e3
  16. Fowlkes AL, Yoon SK, Lutrick K, Gwynn L, Burns J, Grant L, et al. Effectiveness of 2-dose BNT162b2 (Pfizer BioNTech) mRNA vaccine in preventing SARS-CoV-2 infection among children aged 5-11 years and adolescents aged 12-15 years - PROTECT Cohort, July 2021-February 2022. MMWR Morb Mortal Wkly Rep 2022;71:422-8. https://doi.org/10.15585/mmwr.mm7111e1
  17. Price AM, Olson SM, Newhams MM, Halasa NB, Boom JA, Sahni LC, et al. BNT162b2 protection against the omicron variant in children and adolescents. N Engl J Med, in press 2022.