COVID-19 mRNA vaccination may be associated with a lower risk of developing two or more post–COVID-19 condition symptoms following SARS-CoV-2 infections, according to a recent study. 

Investigators conducted a multicenter case-control study to evaluate the association between COVID-19 mRNA vaccination and the likelihood of post–COVID-19 condition (PCC) in children aged 5 to 17 years. In the study, published in JAMA Network Open, the investigators analyzed data from 622 children enrolled between July 2021 and May 2023 across multiple U.S. locations. The participants were categorized as case participants if they reported at least one new or ongoing symptom lasting at least 1 month following real time polymerase chain reaction–confirmed SARS-CoV-2 infections, whereas control participants did not report PCC symptoms.

The primary exposure of interest was COVID-19 mRNA vaccination status at the time of infection, defined as the completion of at least a two-dose series 14 or more days prior to testing positive. Vaccination status was verified through medical records or vaccination cards. The primary outcome was the presence of PCC symptoms, assessed via surveys completed at least 60 days postinfection. Multivariable logistic regression models that adjusted for age, sex, acute infection severity, and baseline health status were used to estimate adjusted odds ratios (OR).

Among the 622 participants, 5% (n = 28) of them developed PCC, while 95% (n = 594) of them did not. The median age was 10.0 years (interquartile range [IQR] = 7.0–11.9) for case participants and 10.3 years (IQR = 7.8–12.7) for controls (P = .37). Vaccinated participants comprised 57% (n = 16/28) of case participants and 77% (n = 458/594) of control participants (P = .05). After adjusting for potential confounders, COVID-19 vaccination was associated with a 57% reduction in the risk of experiencing at least one PCC symptom (adjusted OR = 0.43, 95% confidence interval [CI] = 0.19–0.98) and a 73% reduction in the risk of experiencing two or more symptoms (adjusted OR = 0.27, 95% CI = 0.10–0.69). Vaccination was also associated with a 72% reduction in respiratory PCC symptoms (adjusted OR = 0.28, 95% CI = 0.10–0.75) and a 75% reduction in PCC symptoms that impaired daily function (adjusted OR = 0.25, 95% CI = 0.08–0.74).

The investigators, led by Anna R. Yousaf, MD, of the Coronavirus and Other Respiratory Viruses Division at the National Center for Immunization and Respiratory Diseases at the U.S. Centers for Disease Control and Prevention, noted that participation bias among vaccinated participants could influence symptom reporting.

This study had several limitations, including potential misclassification of infection status as a result of incomplete serology testing and possible misreporting of PCC symptoms from underlying conditions or other diseases. Generalizability was limited by the small sample size, a predominantly non-Hispanic White cohort of children from health care and frontline worker families, and the study’s focus on the BNT162b2 vaccine.

These findings indicated that COVID-19 mRNA vaccination was associated with a lower risk of PCC in children. The study added to existing evidence on potential benefits of vaccination beyond acute disease prevention and highlighted the need for further research on long-term postviral sequelae.

Full disclosures can be found in the published study.