Immunologic response, Efficacy, and Safety of Vaccines Against COVID-19 Infection in Children and Adolescents Aged 2 – 21 years old: A Systematic Review

  1. Sara Sadeghi
  2. Yasamin Kalantari
  3. Sima Shokri
  4. Morteza Fallahpour
  5. Nahid Nafisi
  6. Azadeh Goodarzi

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Abstract

Backgrounds

Children and adolescents form a large proportion of societies and play an important role in the transmission of COVID-19. On the other hand, their education, mental and physical wellness, and safety are compromised which makes vaccination a crucial step to return to normal life.

Aims and objectives

To collect and summarize all data about the immune response, effectiveness, and safety of available COVID-19 vaccines for people aged 2 – 21 years old.

Methods

A thorough systematic review was performed on available publications in English language regarding immunogenicity, efficacy, and safety of COVID-19 vaccines in individuals aged 2 – 21 years old. Types of selected studies were clinical trials, observational studies, and cohort. Searched databases comprised Ovid Medline, Cochrane Library, Embase, Scopus, Web of Sciences, Google Scholar, and ClinicalTrials.gov website. Data extraction and analysis were performed in Microsoft Word software, version 16.56.

Results

The COVID-19 vaccination was evaluated in a total of 50,148 children and adolescents in 22 published studies and 5,279 participants in two ongoing clinical trials. Data were collected about multiple vaccines including BNT162b2 (Pfizer), mRNA-1273 (Moderna), JNJ-78436735 (Johnson and Johnson), CoronaVac (Sinovac), BBIBP-CorV (Sinopharm), adenovirus type-5-vectored vaccine, ZyCov-D, and BBV152 (COVAXIN). The immune response and efficacy of such vaccines were 96% – 100% in healthy children and adolescents and were also acceptable in those with underlying diseases and suppressed immune systems. The current systematic review revealed favorable safety profiles of employed vaccines in children and adolescents; however, adverse reactions such as myocarditis and myopericarditis were reported which were transient and resolved entirely.

Conclusion

Vaccinating children and adolescents aged 2 – 21 years old is beneficial to abort the COVID-19 pandemic. Moreover, the risk-benefit assessments revealed favorable results for vaccinating children and adolescents, especially those with underlying disease, alongside adults to prevent transmission, severe infection, negative outcomes, and new variants formation.

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  1. ScreenIT

    SciScore for 10.1101/2022.01.11.22269113: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Search Strategy: A systematic search was performed on databases including Ovid Medline, Cochrane Library, Scopus, Web of Sciences, Embase, Google Scholar, and ClinicalTrials.gov website until December 7th, 2021.
    Cochrane Library
    suggested: (Cochrane Library, RRID:SCR_013000)
    Embase
    suggested: (EMBASE, RRID:SCR_001650)
    Google Scholar
    suggested: (Google Scholar, RRID:SCR_008878)
    The combination of employed keywords and MeSH terms is attached in the supplementary data (Table S1).
    MeSH
    suggested: (MeSH, RRID:SCR_004750)
    Literature Screening: For the entire screening process, EndNote software, version 20, was utilized.
    EndNote
    suggested: (EndNote, RRID:SCR_014001)
    Data Analysis: We systematically reviewed and described all the information about immunogenicity, efficacy, and safety of all available vaccines for healthy children and adolescents or those with underlying diseases in Microsoft Word software, version 16.56.
    Microsoft Word
    suggested: None

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: We found the following clinical trial numbers in your paper:

    IdentifierStatusTitle
    NCT04918797RecruitingCOVAXIN in a Pediatric Cohort
    NCT04796896RecruitingA Study to Evaluate Safety and Effectiveness of mRNA-1273 CO…

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2022.01.11.22269113v1 on medRxiv