Efficacy, Effectiveness, and Safety of COVID-19 Vaccine Compared to Placebo in Preventing COVID-19 Infection among 12-17 Years Old: A Systematic Review

Authors

  • Germana Emerita V. Gregorio, MD, PhD Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, College of Medicine and Philippine General Hospital, University of the Philippines Manila https://orcid.org/0009-0009-0117-3142
  • Angelo Martin B. Catacutan, MD, MBA Clinical Trials and Research Division, Philippine Children’s Medical Center, Quezon City
  • Ma. Lucila M. Perez, MD, MSc 2Clinical Trials and Research Division, Philippine Children’s Medical Center, Quezon City; College of Medicine, St. Luke’s Medical Center, Quezon City
  • Leonila F. Dans, MD, MSc Division of Pediatric Rheumatology, Department of Pediatrics, College of Medicine and Philippine General Hospital, University of the Philippines Manila

DOI:

https://doi.org/10.47895/amp.v58i7.7930

Keywords:

RNA vaccine, vector-based vaccine, inactivated vaccine

Abstract

Objectives. The World Health Organization recently revised their recommendations and considered healthy children and adolescents as low priority group for COVID-19 vaccine. This review comprehensively assessed existing clinical evidence on COVID-19 vaccine in 12-17 years old.

Methods. Included in this review were any type of study that investigated the efficacy, immunogenicity, safety, and effectiveness of COVID-19 vaccine on protection against SARS-COV-2 infection in 12-17 years old. Various electronic databases were searched up to March 15, 2023. Studies were screened, data extracted, risk of bias appraised, and certainty of evidence was judged using GRADE. Review Manager 5.4 was used to estimate pooled effects. Difference between the two groups was described as mean difference for continuous variables and as relative risk or odds ratio for categorical variables.

Results. There were six randomized controlled trials and 16 effectiveness studies (8 cohorts and 8 case control). Low certainty evidence showed that BNT162b2 (Pfizer) was effective, immunogenic, and safe in healthy adolescents. There were 15 effectiveness studies on BNT162b2 (Pfizer) in healthy adolescent and one on immunocompromised patients. It was protective against infection with any of the variants, with higher protection against Delta than Omicron. BNT162b2 is protective against hospitalization and emergency and urgent care (high certainty); and critical care and MIS-C (low). Very low certainty evidence noted that BNT 162b2 was also immunogenic in 12-21 years old with rheumatic diseases while on immunomodulatory treatment but with possible increased exacerbation of illness. Low certainty evidence demonstrated that mRNA-1273 (Moderna) was effective, immunogenic, and safe. Low to very low certainty evidence were noted on the safety and immunogenicity of two vector base vaccines (ChAdOx1-19 and Ad5 vector COVID vaccine) and two inactivated vaccines (CoronaVac and BBIBP CorV).

Conclusion. There is presently low certainty evidence on the use of RNA vaccines in 12-17 years old. The
recommendation on its use is weak. There is presently insufficient evidence for the use of inactivated and
vector-based COVID-19 vaccines. Different countries should consider whether to vaccinate healthy adolescent
without comprising the other recommended immunization and health priorities that are crucial for this age
group. Other factors including cost-effectiveness of vaccination and disease burden should be accounted.

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Published

2024-04-30

How to Cite

1.
Efficacy, Effectiveness, and Safety of COVID-19 Vaccine Compared to Placebo in Preventing COVID-19 Infection among 12-17 Years Old: A Systematic Review. Acta Med Philipp [Internet]. 2024 Apr. 30 [cited 2025 Apr. 4];58(7). Available from: https://actamedicaphilippina.upm.edu.ph/index.php/acta/article/view/7930

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