Global COVID-19 Vaccination in Infants and Children: Effectiveness, Safety, and Challenges

Watsamon Jantarabenjakul1,2,3, Napaporn Chantasrisawad1,2,3, Rapisa Nantanee1

  • 1Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.

Insights

COVID-19 vaccines are safe and effective for children over six months, reducing severe illness. Real-world effectiveness against infection is lower due to variants, and vaccine uptake remains a challenge.

Area of Science:

  • Pediatric Infectious Diseases
  • Vaccinology
  • Public Health

Background:

  • COVID-19 vaccines (mRNA and inactivated) are approved for infants and children over six months, demonstrating efficacy in preventing severe disease, hospitalization, multisystem inflammatory syndrome in children (MIS-C), and death.
  • Real-world vaccine effectiveness against infection is diminished by emerging SARS-CoV-2 variants, particularly Omicron strains, compared to initial clinical trial findings.
  • Despite established vaccine availability for pediatric populations, global vaccine uptake remains suboptimal, exacerbated by parental vaccine hesitancy.

Approach:

  • This review synthesizes data from clinical trials and real-world studies on COVID-19 vaccine safety and efficacy in children aged 6 months to under 12 years.
  • It examines current 2023-2024 COVID-19 vaccine recommendations for this age group.
  • The review discusses vaccine implementation progress, real-world effectiveness, and identifies knowledge gaps and future research directions.

Key Points:

  • COVID-19 vaccines significantly reduce severe outcomes in children, including hospitalization and MIS-C.
  • Emerging variants like Omicron impact vaccine effectiveness against infection, necessitating ongoing surveillance and potential strategy adjustments.
  • Addressing parental hesitancy and improving vaccine accessibility are crucial for enhancing pediatric COVID-19 vaccine uptake.

Conclusions:

  • COVID-19 vaccines offer substantial protection against severe disease in infants and children.
  • Continued research is vital to understand and mitigate the impact of viral evolution on vaccine effectiveness.
  • Strategies to boost vaccine confidence and uptake in pediatric populations are essential for public health.

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