CDC report shows COVID vaccines are safe for children, serious side effects are rare


In a recent study published in the US Centers for Disease Control and Prevention (CDC) Weekly report on morbidity and mortality, the researchers determined the characteristics and clinical outcomes of coronavirus disease 2019 (COVID-19) in children and adolescents 18 years of age or younger.

Study: Characteristics and clinical outcomes of children and adolescents under 18 years of age hospitalized with COVID-19 - six hospitals, United States, July – August 2021. Image credit: FarmVeld / Shutterstock.com

study: Characteristics and clinical outcomes of children and adolescents <18 years of age hospitalized with COVID-19 - six hospitals, USA, July-August 2021 Image credit: FarmVeld / Shutterstock.com

Background

In July 2021, infections with severe acute coronavirus 2 syndrome (SARS-CoV-2) increased with the arrival of the Delta variant (B.1.617.2). The incidence of Delta variant infections peaked in September 2021, along with an increased hospitalization rate for children 18 years of age or younger. However, the clinical signs and symptoms, the course of the disease and the factors contributing to hospitalization in pediatric patients are still not well understood.

About the study

In the current study, researchers reviewed medical records of children and adolescents hospitalized with COVID-19 from six children’s hospitals in the United States between July and August 2021. A total of 915 pediatric patients were identified, of whom 713 (77.9%) were acute COVID-19, 177 (19.3%) had asymptomatic or mild COVID-19, and 25 (2.7%) had multisystemic inflammatory syndrome in children (MIS-C).

Demographic characteristics

The researchers determined the age distribution among 713 hospitalized pediatric patients and found that 24.7% of patients were under one year old, 17.1% were between one and four years old, 20.1% were between five and 11 years old, and 38.1% are aged between 12-17 years.

Among the 713 hospitalized patients with COVID-19, 373 (52.3%) were male, 210 (29.5%) were non-Hispanic, 202 (28.3%) were black or African American, and 211 (29.6%) ) are Spaniards.

Clinical features and results

About 83% of patients between the ages of five and 11 and 88% of patients between the ages of 12 and 17 had one or more underlying conditions. The number of patients admitted to the intensive care unit (ICU) with any underlying medical conditions is higher (34.7%) than those without a basic condition (18.5%).

About 32.4% were obese and needed longer care than those without obesity. In addition, approximately 33.9% of patients five years of age or younger had a viral coinfection.

Among the 713 hospitalized patients with COVID-19, 385 (54%) needed oxygen support, 210 (29.5%) were admitted to the intensive care unit, eight received (1.1%) extracorporeal membrane oxygenation (ECMO) and 11 1.5%) started. Of the patients in need of respiratory support, 142 (36.9%) patients received a high-flow nasal cannula, and 56 patients (14.5%) required invasive mechanical ventilation (IMV).

Compared to other age groups, adolescents between the ages of 12 and 17 are more likely to need intensive care, oxygen maintenance, and the longest average IMV duration (9.5 days). In all age groups, the mean length of hospital stay and the mean duration of invasive mechanical ventilation (IMV) were three and seven days, respectively.

Many hospitalized patients with COVID-19 had severe illness and viral coinfections. About 32.4% of patients under one year of age and 36.1% of patients between one and four years of age had viral coinfection. About 15.8% of viral coinfection is associated with respiratory syncytial virus (RSV).

272 adolescents aged 12 to 17 years were eligible for vaccination, of which 12 (4.4%) were partially vaccinated with ribonucleic acid (mRNA) vaccine against COVID-19 and only 0.4 %) was fully vaccinated during the hospitalization period, which shows a low vaccination rate among them.

Restrictions and conclusion

The current study had several limitations. First, five of the six hospitals are located in the southern region of the United States, where the proportion of adolescents with obesity is higher, which may be the reason for the increased levels of obesity observed in the study population. Second, during the study, adolescents aged 12-15 years were eligible for vaccination in only 2-3 months, which indicates the reason for the low levels of vaccination.

Overall, the results of the study show that underlying medical conditions and obesity are risk factors for COVID-19 in children and adolescents under 18 years of age. The number of vaccinated people is also lower, indicating the need for vaccination and other prevention strategies for children aged five and over to protect them from COVID-19, especially those with concomitant medical conditions.

In addition, research and monitoring of viral coinfections with SARS-CoV-2 in pediatrics may help to manage COVID-19 in this population.



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