Evaluation of the BNT162b2 Covid-19 Vaccine in Children 5 to 11 Years of Age
Emmanuel B Walter, Kawsar R Talaat, Charu Sabharwal, Alejandra Gurtman, Stephen Lockhart, Grant C Paulsen, Elizabeth D Barnett, Flor M Muñoz, Yvonne Maldonado, Barbara A Pahud, Joseph B Domachowske, Eric A F Simões, Uzma N Sarwar, Nicholas Kitchin, Luke Cunliffe, Pablo Rojo, Ernest Kuchar, Mika Rämet, Iona Munjal, John L Perez, Robert W Frenck Jr, Eleni Lagkadinou, Kena A Swanson, Hua Ma, Xia Xu, Kenneth Koury, Susan Mather, Todd J Belanger, David Cooper, Özlem Türeci, Philip R Dormitzer, Uğur Şahin, Kathrin U Jansen, William C Gruber, C4591007 Clinical Trial Group, Armando Acevedo, Rogelio Amisola, Evan Anderson, Josep Lluís Arimany Montañà, Samir Arora, Manuel Baca Cots, Jeffrey Baker, Elizabeth Barnett, Jacques Benun, Suresh Boppana, David Butuk, Mary Caserta, Janet Casey, Shane Christensen, Hanna Czajka, James Christopher Day, Oscar De Valle, Michael Dever, Joseph Domachowske, Frank Eder, Janet Englund, Jaime Fergie, Daniel Finn, Clàudia Fortuny Guasch, Julia Garcia-Diaz, Jose Garcia-Sicilia Lopez, Homero Garza, Aaron Hartman, Robert Heller, Timothy Jennings, Anu Kantele, Hanna Karhusaari, Nicola Klein, Terry Klein, Satu Kokko, Elzbieta Kopinska, Piotr Korbal, Susanna Koski, Ernest Kuchar, Karolina Kulig, Outi Laajalahti, Daniel Leonard, Simon Li, Ewa Majda-Stanislawska, Yvonne Maldonado, Gary Marshall, Federico Martinón Torres, Mariano Miranda Valdivieso, Flor M Munoz, Sharon Nachman, Silvinia Natalini Martínez, Onyema Ogbuagu, Richard Ohnmacht, Pauliina Paavola, Barbara Pajek, Nehali Patel, Grant Paulsen, Lauri Peltonen, James Peterson, M Mildred Rey, Robert Riesenberg, Pablo Rojo, Ignacio Salamanca de la Cueva, Shelly Senders, Ilkka Seppa, Stephan Sharp, Lawrence Sher, Eric A F Simões, Kari Simonsen, Marjaana Sipila, Lance Slade, Stacy Slechta, Joanna Stryczyńska-Kazubska, Kawsar Talaat, Benita Ukkonen, Angels Ulied Armiñana, John Vanchiere, Emmanuel Walter, Bernhard Wiedermann, Paul Wisman, Anne Zomcik, Emmanuel B Walter, Kawsar R Talaat, Charu Sabharwal, Alejandra Gurtman, Stephen Lockhart, Grant C Paulsen, Elizabeth D Barnett, Flor M Muñoz, Yvonne Maldonado, Barbara A Pahud, Joseph B Domachowske, Eric A F Simões, Uzma N Sarwar, Nicholas Kitchin, Luke Cunliffe, Pablo Rojo, Ernest Kuchar, Mika Rämet, Iona Munjal, John L Perez, Robert W Frenck Jr, Eleni Lagkadinou, Kena A Swanson, Hua Ma, Xia Xu, Kenneth Koury, Susan Mather, Todd J Belanger, David Cooper, Özlem Türeci, Philip R Dormitzer, Uğur Şahin, Kathrin U Jansen, William C Gruber, C4591007 Clinical Trial Group, Armando Acevedo, Rogelio Amisola, Evan Anderson, Josep Lluís Arimany Montañà, Samir Arora, Manuel Baca Cots, Jeffrey Baker, Elizabeth Barnett, Jacques Benun, Suresh Boppana, David Butuk, Mary Caserta, Janet Casey, Shane Christensen, Hanna Czajka, James Christopher Day, Oscar De Valle, Michael Dever, Joseph Domachowske, Frank Eder, Janet Englund, Jaime Fergie, Daniel Finn, Clàudia Fortuny Guasch, Julia Garcia-Diaz, Jose Garcia-Sicilia Lopez, Homero Garza, Aaron Hartman, Robert Heller, Timothy Jennings, Anu Kantele, Hanna Karhusaari, Nicola Klein, Terry Klein, Satu Kokko, Elzbieta Kopinska, Piotr Korbal, Susanna Koski, Ernest Kuchar, Karolina Kulig, Outi Laajalahti, Daniel Leonard, Simon Li, Ewa Majda-Stanislawska, Yvonne Maldonado, Gary Marshall, Federico Martinón Torres, Mariano Miranda Valdivieso, Flor M Munoz, Sharon Nachman, Silvinia Natalini Martínez, Onyema Ogbuagu, Richard Ohnmacht, Pauliina Paavola, Barbara Pajek, Nehali Patel, Grant Paulsen, Lauri Peltonen, James Peterson, M Mildred Rey, Robert Riesenberg, Pablo Rojo, Ignacio Salamanca de la Cueva, Shelly Senders, Ilkka Seppa, Stephan Sharp, Lawrence Sher, Eric A F Simões, Kari Simonsen, Marjaana Sipila, Lance Slade, Stacy Slechta, Joanna Stryczyńska-Kazubska, Kawsar Talaat, Benita Ukkonen, Angels Ulied Armiñana, John Vanchiere, Emmanuel Walter, Bernhard Wiedermann, Paul Wisman, Anne Zomcik
Abstract
Background: Safe, effective vaccines against coronavirus disease 2019 (Covid-19) are urgently needed in children younger than 12 years of age.
Methods: A phase 1, dose-finding study and an ongoing phase 2-3 randomized trial are being conducted to investigate the safety, immunogenicity, and efficacy of two doses of the BNT162b2 vaccine administered 21 days apart in children 6 months to 11 years of age. We present results for 5-to-11-year-old children. In the phase 2-3 trial, participants were randomly assigned in a 2:1 ratio to receive two doses of either the BNT162b2 vaccine at the dose level identified during the open-label phase 1 study or placebo. Immune responses 1 month after the second dose of BNT162b2 were immunologically bridged to those in 16-to-25-year-olds from the pivotal trial of two 30-μg doses of BNT162b2. Vaccine efficacy against Covid-19 at 7 days or more after the second dose was assessed.
Results: During the phase 1 study, a total of 48 children 5 to 11 years of age received 10 μg, 20 μg, or 30 μg of the BNT162b2 vaccine (16 children at each dose level). On the basis of reactogenicity and immunogenicity, a dose level of 10 μg was selected for further study. In the phase 2-3 trial, a total of 2268 children were randomly assigned to receive the BNT162b2 vaccine (1517 children) or placebo (751 children). At data cutoff, the median follow-up was 2.3 months. In the 5-to-11-year-olds, as in other age groups, the BNT162b2 vaccine had a favorable safety profile. No vaccine-related serious adverse events were noted. One month after the second dose, the geometric mean ratio of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) neutralizing titers in 5-to-11-year-olds to those in 16-to-25-year-olds was 1.04 (95% confidence interval [CI], 0.93 to 1.18), a ratio meeting the prespecified immunogenicity success criterion (lower bound of two-sided 95% CI, >0.67; geometric mean ratio point estimate, ≥0.8). Covid-19 with onset 7 days or more after the second dose was reported in three recipients of the BNT162b2 vaccine and in 16 placebo recipients (vaccine efficacy, 90.7%; 95% CI, 67.7 to 98.3).
Conclusions: A Covid-19 vaccination regimen consisting of two 10-μg doses of BNT162b2 administered 21 days apart was found to be safe, immunogenic, and efficacious in children 5 to 11 years of age. (Funded by BioNTech and Pfizer; ClinicalTrials.gov number, NCT04816643.).
Copyright © 2021 Massachusetts Medical Society.
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Source: PubMed