Real-world effectiveness and causal mediation study of BNT162b2 on long COVID risks in children and adolescents

作者：Qiong Wu, Bingyu Zhang, Jiayi Tong, L. Charles Bailey, H. Timothy Bunnell, Jiajie Chen, Elizabeth A. Chrischilles, Dimitri Christakis, Stephen M. Downs, Kathryn Hirabayashi, Aaron Mishkin, Abu Saleh Mohammad Mosa, Nathan M. Pajor, Suchitra Rao, Hanieh Razzaghi, Hayden T. Schwenk, Marion R. Sills, Huiyuan Wang, Linbo Wang, Yudong Wang, Dazheng Zhang, Ting Zhou, Ravi Jhaveri, Eric J. Tchetgen Tchetgen, Jeffrey S. Morris, Christopher B. Forrest, Yong Chen · 发表于：EClinicalMedicine · 年份：2024 · DOI：10.1016/j.eclinm.2024.102962 · 被引用次数：26 · 研究领域：Long-Term Effects of COVID-19、COVID-19 Clinical Research Studies、SARS-CoV-2 and COVID-19 Research

Background: The impact of pre-infection vaccination on the risk of long COVID remains unclear in the pediatric population. We aim to assess the effectiveness of BNT162b2 on long COVID risks with various strains of the SARS-CoV-2 virus in children and adolescents, using comparative effectiveness methods. We further explore if such pre-infection vaccination can mitigate the risk of long COVID beyond its established protective benefits against SARS-CoV-2 infection using causal mediation analysis. Methods: We conducted real-world vaccine effectiveness study and mediation analysis using data from twenty health systems in the RECOVER PCORnet electronic health record (EHR) Program. Three independent cohorts were constructed including adolescents (12-20 years) during the Delta phase (July 1-November 30, 2021), children (5-11 years) and adolescents (12-20 years) during the Omicron phase (January 1-November 30, 2022). The intervention is first dose of the BNT162b2 vaccine in comparison with no receipt of COVID-19 vaccine. The outcomes of interest include conclusive or probable diagnosis of long COVID following a documented SARS-CoV-2 infection, and body-system-specific condition clusters of post-acute sequelae of SARS-CoV-2 infection (PASC), such as cardiac, gastrointestinal, musculoskeletal, respiratory, and syndromic categories. The effectiveness was reported as (1-relative risk)∗100 and mediating effects were reported as relative risks. Findings: 112,590 adolescents (88,811 vaccinat...