Journal article
Target Trial Emulation of Vaccine Effectiveness in 5- to 17-years-olds with Prior SARS-CoV-2 Infection
Nature communications
04/17/2026
DOI: 10.1038/s41467-026-71820-2
PMID: 41997986
Abstract
The effectiveness of COVID-19 vaccination in children and adolescents with prior SARS-CoV-2 infection remains unclear, particularly for Omicron subvariants. We evaluate vaccine effectiveness against reinfection with Omicron BA.1/BA.2, BA.4/BA.5, XBB, and later subvariants among 5- to 17-year-olds using data from the RECOVER initiative, a national electronic health record database covering 37 U.S. children's hospitals and health institutions. We emulate target trials by age group and variant period, comparing previously infected participants between January 2022 and August 2023. During the BA.1/BA.2 period, vaccination reduces the risk of reinfection, with effectiveness rates of 62% in children and 65% in adolescents. During the BA.4/BA.5 period, protection effectiveness in children was 57%, whereas no statistically significant protection is observed in adolescents. During the XBB and later period, no significant protection is observed in either group. In summary, COVID-19 vaccination provides protection against reinfection during the early and mid-Omicron periods in previously infected pediatric populations, but effectiveness declines for later variants.
Details
- Title: Subtitle
- Target Trial Emulation of Vaccine Effectiveness in 5- to 17-years-olds with Prior SARS-CoV-2 Infection
- Creators
- Yuqing Lei - University of PennsylvaniaJiajie Chen - University of PennsylvaniaQiong Wu - University of PittsburghTing Zhou - University of PennsylvaniaBingyu Zhang - University of PennsylvaniaMichael J Becich - University of PittsburghYuriy Bisyuk - University Medical Center New OrleansSaul Blecker - New York UniversityElizabeth A Chrischilles - University of IowaDimitri A Christakis - Seattle Children's HospitalLindsay G Cowell - The University of Texas Southwestern Medical CenterMollie R Cummins - University of UtahSoledad A Fernandez - The Ohio State UniversityDaniel Fort - Ochsner Health SystemSandy L Gonzalez - Miami Children's HospitalSharon J Herring - Temple UniversityBenjamin D Horne - Intermountain Medical CenterCarol Horowitz - Icahn School of Medicine at Mount SinaiMei Liu - University of FloridaSusan Kim - UCSF Benioff Children's HospitalParsa Mirhaji - Albert Einstein College of MedicineAbu Saleh Mohammad Mosa - University of Alabama at BirminghamJennifer A Muszynski - Nationwide Children's HospitalCatharine I Paules - Penn State Milton S. Hershey Medical CenterAlice I Sato - University of Nebraska Medical CenterHayden T Schwenk - Stanford MedicineSoumitra Sengupta - Columbia UniversitySrinivasan Suresh - University of PittsburghBradley W Taylor - Medical College of WisconsinDavid A Williams - University of MichiganYongqun He - University of MichiganJeffrey S Morris - University of PennsylvaniaRavi Jhaveri - Lurie Children's HospitalChristopher B Forrest - Children's Hospital of PhiladelphiaYong Chen - University of PennsylvaniaRECOVER Consortium
- Resource Type
- Journal article
- Publication Details
- Nature communications
- DOI
- 10.1038/s41467-026-71820-2
- PMID
- 41997986
- NLM abbreviation
- Nat Commun
- ISSN
- 2041-1723
- eISSN
- 2041-1723
- Grant note
- RI-CHOP-01-PS10 / Patient-Centered Outcomes Research Institute (PCORI) OT2HL161847-01 / Foundation for the National Institutes of Health (Foundation for the National Institutes of Health, Inc.)
- Language
- English
- Electronic publication date
- 04/17/2026
- Academic Unit
- Pharmacy; Epidemiology
- Record Identifier
- 9985153517002771
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