BNT162b2 Protection Against the Omicron Variant in Children and Adolescents

to the editor

Value and colleagues (revealed on-line March 30 at NEJM.org)one Describes the efficacy of the BNT162b2 vaccine (Pfizer-BioNTech) towards the B.1.1.529 (micron) variant of SARS-CoV-2 in youngsters and adolescents, findings with essential scientific relevance and coverage implications. Nonetheless, the examine was designed with out together with the earlier Covid-19 state of affairs as a confounding issue. It’s well-known that SARS-CoV-2 an infection supplies immune safety and additional safety towards extreme Covid-19.2nd Elements that will have an effect on the analysis of vaccine efficacy. For instance, the efficacy of the vaccine towards hospitalization for Covid-19 throughout the improve in variant B.1.617.2 (delta) didn’t lower over time, however research have proven that neutralizing antibody ranges lower over time after receiving the vaccine. BNT162b2 vaccine, neutralizing antibody, and T-cell responses had been maintained 12 months after preliminary an infection.3,4 Subsequently, the inclusion of the earlier Covid-19 state of affairs ought to have been explicitly mandated within the examine design.

Guangting Zeng, USA
Chenzhou First Folks’s Hospital, Chenzhou, China
[email protected]

No potential conflicts of curiosity had been reported concerning this letter.

This letter was revealed on NEJM.org on Might 11, 2022.

  1. one. Value AM, Olson SM, Newhams MM, et al. BNT162b2 safety towards the omicron variant in youngsters and adolescents. NEngl J Med. DOI: 10.1056/NEJMoa2202826.

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  2. 2nd. Leon TM, Dorabawila V., Nelson L., et al. COVID-19 instances and hospitalizations by COVID-19 vaccine standing and former COVID-19 prognosis — California and New York, Might-November 2021. MMWR Morb Mortal Wkly Rep 2022;71:125131.

  3. 3. Levin EG, sensual y, Cohen C., et al. Decreased immune humoral response to BNT162b2 Covid-19 vaccine over 6 months. N English J Med 2021;385(24):e84e84.

  4. 4. Guo L, Wang G, Wang Y, et al. Antibody and T-cell responses particular to SARS-CoV-2 1 yr after an infection in individuals recovering from COVID-19: a longitudinal cohort examine. lancet germ 2022;3(5):e348e356..

Response

The authors reply: Zeng notes that earlier SARS-CoV-2 an infection may confer protecting immunity towards subsequent an infection and, if not addressed, may deflect estimates of vaccine efficacy. Whereas it might be ideally suited to incorporate such information in our examine, we had been unable to evaluate whether or not vaccine efficacy had modified from earlier an infection as we didn’t have entry to previous Covid-19 check leads to most sufferers. As well as, serological testing for antibodies to SARS-CoV-2 can not precisely distinguish between prior and present an infection. Prior an infection, particularly when coupled with vaccination, could confer protecting immunity and subsequently alter vaccine efficacy.one Nonetheless, the presence of prior an infection solely causes a complicated bias in vaccine efficacy, because it differentially influences vaccination selections in these with out prior an infection. If prior an infection had diminished the probability of each subsequent an infection and vaccination, the controls in our examine would have been enriched with unvaccinated contributors, driving the vaccine efficacy downward.2nd In actuality, most SARS-CoV-2 infections in youngsters go undiagnosed as they’re asymptomatic or end in gentle signs and are subsequently unlikely to straight affect subsequent vaccination selections.2.3 Subsequently, we conclude that our examine is unlikely to have considerably confounding bias from prior an infection.

Ashley M. Value, MPH
Samantha M. Olson, MPH
Manish M. Patel, MD
Facilities for Illness Management and Prevention, Atlanta, GA
[email protected]

Because the publication of their article, the authors haven’t declared some other potential conflicts of curiosity.

This letter was revealed on NEJM.org on Might 11, 2022.

  1. one. Corridor V, Foulkes S, Insalata F, et al. Covid-19 vaccine and safety towards SARS-CoV-2 after earlier an infection. N English J Med 2022;386:12071220.

  2. 2nd. Patel MK, Bergeri I, Bresee JS, et al. Analysis of post-entry COVID-19 vaccine efficacy: abstract of World Well being Group interim steerage. Vaccine 2021;39:40134024.

  3. 3. Hobbies Resume, Drobeniuc J., kitty T, et al. Estimated SARS-CoV-2 seroprevalence amongst individuals youthful than 18 years — Mississippi, Might–September 2020. MMWR Morb Mortal Wkly Rep 2021;70:312315.

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