Kaiser Permanente study supports COVID-19 vaccination of children, pregnant mothers
An analysis of unvaccinated children who had COVID-19 between 2020 and 2022 found they were more likely to be hospitalized if they were 6 months old or younger, and more likely to be treated in an intensive care unit at ages 12 to 17. The study was published in the journal Influenza and Other Respiratory Viruses.
The overall risk of hospitalization from COVID-19 remained relatively low, the authors said, but if children were hospitalized, they could face serious outcomes. Most of those admitted to the ICU had no comorbid conditions that might have made their symptoms worse.
“When you look at children who are being hospitalized, we see particular concerns for teens who may end up in the ICU or need oxygen, and infants who are too young to be vaccinated,“ said lead author Ousseny Zerbo, PhD, a research scientist with the Kaiser Permanente Division of Research. “Inoculation against COVID-19 is still an important childhood vaccination.”
The study examined records for more than 1.1 million children who were members of Kaiser Permanente Northern California between 2020 and 2022. The researchers found 423 children hospitalized for COVID-19 during that time and analyzed trends within the group. The children were all unvaccinated against COVID-19.
They found babies 6 months and younger had the highest incidence of hospitalization. There is no COVID-19 vaccine available for this age group, though research shows a mother’s vaccination against COVID-19 during pregnancy can protect the baby.
“Previous research has shown that a mother’s vaccination can transfer to her baby while she is pregnant,” Zerbo said. “The risk of hospitalization for an infant can be reduced so much by getting that done during pregnancy.” However, vaccination rates in pregnancy remain low — the Centers for Disease Control and Prevention said the average was 13% in spring 2024.
The risk of ICU admission was highest among the teenaged patients. Overall, 20.3% of the hospitalized children were admitted to the ICU, but admission was 36.1% among ages 12 to 17.
Most (91.8%) of the pediatric ICU patients with COVID-19 had no comorbidities — unrelated diseases or conditions that might make them sicker or more vulnerable to COVID.
While COVID-19 variants have been viewed as less likely to lead to hospitalization in the population overall as time has gone on, this study actually found later variants to result in higher rates of hospitalization among children. Among infants 6 months old and younger, the incidence of hospitalization for COVID-19 was 7 per 100,000 person-months during the pre-Delta variant period, 13.3 per 100,000 during the Delta period, and 22.4 per 100,000 during the Omicron period.
Despite evidence of pediatric hospitalization with COVID-19, vaccination rates in children have remained low. Just 6% of children ages 6 months to 4 years were up to date with COVID-19 vaccine in spring 2024, the CDC reports.
The study also found inequity by race or ethnicity in health outcomes among hospitalized unvaccinated children; Black and Hispanic children had higher risk of hospitalization than white children.
The study was funded by the National Institutes of Health and Centers for Disease Control and Prevention.
Additional co-authors were Nicola P. Klein, MD, PhD, Julius Timbol, MS, John R. Hansen, MPH, Kristin Goddard, MPH, Evan Layefsky, BA, Pat Ross, BA, and Bruce Fireman, MA, of the Division of Research Vaccine Study Center; and Dao Nguyen, MD, and Tara L. Greenhow, MD, of The Permanente Medical Group.
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About the Kaiser Permanente Division of Research
The Kaiser Permanente Division of Research conducts, publishes and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and society at large. It seeks to understand the determinants of illness and well-being, and to improve the quality and cost-effectiveness of health care. Currently, DOR’s 600-plus staff is working on more than 450 epidemiological and health services research projects. For more information, visit divisionofresearch.kaiserpermanente.org or follow us @KPDOR.
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