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Does Measles, Mumps, and Rubella (MMR) Vaccination Protect against COVID-19 Outcomes: A Nationwide Cohort Study
Epiphane Kolla1,2, Alain Weill1, David Desplas1
1EPI-PHARE (Scientific Interest Group in Epidemiology of Health Products), French National Agency for the Safety of Medicines and Health Products, French National Health Insurance, CEDEX, 93285 Saint-Denis, France.
Insights
This study found that the measles, mumps, and rubella (MMR) vaccine did not reduce the risk of COVID-19 hospitalization in children. The live attenuated MMR vaccine showed no protective effect against severe COVID-19 outcomes in pediatric populations.
Area of Science:
- Pediatric Infectious Diseases
- Vaccinology
- Epidemiology
Background:
- The lower incidence of severe COVID-19 in children compared to adults has led to hypotheses about potential cross-protection from existing live attenuated vaccines.
- The measles, mumps, and rubella (MMR) vaccine, a widely administered live attenuated vaccine, has been investigated for potential non-specific immune effects.
Purpose of the Study:
- To evaluate whether prior exposure to the live attenuated MMR vaccine influences the risk of hospitalization due to COVID-19 in children.
- To investigate the association between MMR vaccination status and COVID-19 hospitalization rates in a large pediatric cohort.
Main Methods:
- A nationwide cohort study was conducted using the French National Health Data System (SNDS), including children born between 2009 and 2019.
- Exposure was defined as receiving at least one dose of the MMR vaccine. Hospitalization for COVID-19 was identified using ICD-10 codes.
- Multivariate logistic regression analysis was employed to calculate adjusted odds ratios (aORs), controlling for relevant covariates.
Main Results:
- The study included over 6.8 million children exposed to the MMR vaccine and over 384,000 unexposed children.
- MMR vaccine exposure was not associated with a reduced risk of COVID-19 hospitalization (aOR = 1.09; 95% CI [0.81–1.48]).
- Stratified analyses by age group (1-4, 5-9, 10-12 years) also revealed no significant protective effect of MMR vaccination against COVID-19 hospitalization.
Conclusions:
- The findings suggest that the live attenuated MMR vaccine does not provide protection against hospitalization for COVID-19 in children.
- The hypothesis of cross-protection from MMR vaccination against severe COVID-19 in pediatric populations is not supported by this study's results.
Abstract:
Cross-protection from previous live attenuated vaccines is proposed to explain the low impact of COVID-19 on children. This study aimed to evaluate the effect of live attenuated MMR vaccines on the risk of being hospitalized for COVID-19 in children. An exposed (MMR vaccine)-non-exposed cohort study was conducted using the nationwide French National Health Data System (SNDS). We included children born between 1 January 2009 and 31 December 2019. Exposure was defined as a claim of at least one dose of MMR vaccine since birth. Hospitalization for COVID-19 was defined using main diagnostic ICD10 codes. Non-conditional logistic regression was used to calculate the adjusted odds ratios (aORs) of the association between MMR exposure and hospitalization for COVID-19, controlling for socio-demographic and socio-economic factors, co-morbidities, and general health. In total, 6,800,542 (median age 6 IQR [3-8] years) children exposed to a MMR vaccine and 384,162 (6 [3-9] years) not exposed were followed up with for 18 months. Among them, 873 exposed to the MMR vaccine and 38 who were not exposed were hospitalized for COVID-19. In a multi-variate analysis, the exposure of children to MMR vaccination was not associated with a decreased risk of COVID-19 hospitalization versus non-exposure (aOR (95%CI) = 1.09 [0.81-1.48]). A stratified analysis by age showed an aOR = 1.03 [0.64-1.66] for children aged 1-4, an aOR = 1.38 [0.82-2.31] for those aged 5-9, and an aOR = 1.11 [0.54-2.29] for those aged 10-12. Our study suggests that the live attenuated MMR vaccine does not protect children against COVID-19 hospitalization.
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