New Haven, CT—During much of the push for vaccinations against COVID-19, the least emphasis has been on children. That has especially been the case with the latest formulation—the bivalent booster.

A new study led by researchers from the Yale School of Public Health and the University of Maryland School of Medicine questions, however, whether accelerating the uptake of the COVID booster might significantly decrease pediatric hospitalizations and decrease school absenteeism. The results were published in the Journal of the American Medical Association Network Open.

To assess whether accelerating COVID-19 bivalent booster vaccination uptake across the general population would be associated with reduced pediatric hospitalizations and school absenteeism, the researchers employing a decision analytical model using incidence data from October 1, 2020, to September 30, 2022. The outcomes were simulated from October 1, 2022, to March 31, 2023.

While the transmission model included the entire age-stratified U.S. population, the outcome model included children aged younger than 18 years. The study team created simulated scenarios of accelerated bivalent COVID-19 booster campaigns to achieve uptake that was either one-half of or similar to the age-specific uptake observed for 2020 to 2021 seasonal influenza vaccination in the eligible population across all age groups.

The main outcomes were defined as estimated hospitalizations, ICU admissions, and isolation days of symptomatic infection averted among children aged 0 to 17 years and estimated days of school absenteeism averted among children aged 5 to 17 years under the accelerated bivalent booster campaign simulated scenarios.

The results indicated that among children aged 5 to 17 years, a COVID-19 bivalent booster campaign achieving age-specific coverage similar to influenza vaccination could have averted an estimated 5.4 million (95% credible interval [CrI]; 4,936,933-5,957,507) days of school absenteeism due to COVID-19 illness. “In addition, the booster campaign could have prevented an estimated 10,019 (95% CrI; 8,756-11,278) hospitalizations among the pediatric population aged 0 to 17 years, of which 2,645 (95% CrI; 2,152-3,147) were estimated to require intensive care,” the researchers explained.

Even a less ambitious booster campaign, with only 50% of the age-specific uptake of influenza vaccination among eligible individuals, could have averted an estimated 2.9 million (95% CrI; 2,524,351-3,332,783) days of school absenteeism among children aged 5 to 17 years and an estimated 5,791 (95% CrI; 4,391-6,932) hospitalizations among children aged 0 to 17 years, of which 1,397 (95% CrI; 846-1,948) were estimated to require intensive care, they added.

“These findings suggest that although COVID-19 prevention strategies often focus on older populations, the benefits of booster campaigns for children may be substantial,” the authors concluded.

Background information in the articles pointed out that, as of early March, the pandemic had been responsible for more than 185,000 hospitalizations and 1,700 deaths in the pediatric population.

One of the reasons decreasing school absenteeism is so important, according to the researchers, is that school closures earlier in the COVID-19 pandemic affected more than 90% of students worldwide. “In subsequent academic years,” they wrote, “students have faced challenges including illness-related absenteeism, pandemic-related instability in their personal lives, outbreak-related school closures, and transition to virtual or hybrid learning formats. A consequence of these experiences has been lower test scores among children receiving education during the COVID-19 pandemic compared with their pre-pandemic counterparts. Preventing severe illness among children and maintaining high levels of school attendance should be important goals for policymakers.”

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