Vaccinating adolescents against SARS-CoV-2 in England: a risk–benefit analysis

Deepti Gurdasani; Samir Bhatt; Anthony Costello; Spiros Denaxas; Seth Flaxman; Trisha Greenhalgh; Stephen Griffin; Zoë Hyde; Aris Katzourakis; Martin McKee; Susan Michie; Oliver Ratmann; Stephen Reicher; Gabriel Scally; Christopher Tomlinson; Christian Yates; Hisham Ziauddeen; Christina Pagel

doi:10.1177/01410768211052589

Vaccinating adolescents against SARS-CoV-2 in England: a risk–benefit analysis

Deepti Gurdasani, Samir Bhatt, Anthony Costello, Spiros Denaxas, Seth Flaxman, Trisha Greenhalgh, Stephen Griffin, Zoë Hyde, Aris Katzourakis, Martin McKee, Susan Michie, Oliver Ratmann, Stephen Reicher, Gabriel Scally, Christopher Tomlinson, Christian Yates, Hisham Ziauddeen, Christina Pagel

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Abstract

Objective

To offer a quantitative risk–benefit analysis of two doses of SARS-CoV-2 vaccination among adolescents in England.

Setting

England.

Design

Following the risk–benefit analysis methodology carried out by the US Centers for Disease Control, we calculated historical rates of hospital admission, Intensive Care Unit admission and death for ascertained SARS-CoV-2 cases in children aged 12–17 in England. We then used these rates alongside a range of estimates for incidence of long COVID, vaccine efficacy and vaccine-induced myocarditis, to estimate hospital and Intensive Care Unit admissions, deaths and cases of long COVID over a period of 16 weeks under assumptions of high and low case incidence.

Participants

All 12–17 year olds with a record of confirmed SARS-CoV-2 infection in England between 1 July 2020 and 31 March 2021 using national linked electronic health records, accessed through the British Heart Foundation Data Science Centre.

Main outcome measures

Hospitalisations, Intensive Care Unit admissions, deaths and cases of long COVID averted by vaccinating all 12–17 year olds in England over a 16-week period under different estimates of future case incidence.

Results

At high future case incidence of 1000/100,000 population/week over 16 weeks, vaccination could avert 4430 hospital admissions and 36 deaths over 16 weeks. At the low incidence of 50/100,000/week, vaccination could avert 70 hospital admissions and two deaths over 16 weeks. The benefit of vaccination in terms of hospitalisations in adolescents outweighs risks unless case rates are sustainably very low (below 30/100,000 teenagers/week). Benefit of vaccination exists at any case rate for the outcomes of death and long COVID, since neither have been associated with vaccination to date.

Conclusions

Given the current (as at 15 September 2021) high case rates (680/100,000 population/week in 10–19 year olds) in England, our findings support vaccination of adolescents against SARS-CoV2.

Original language	English
Number of pages	12
Journal	Journal of the Royal Society of Medicine
Volume	Online First
Early online date	1 Nov 2021
DOIs	https://doi.org/10.1177/01410768211052589
Publication status	E-pub ahead of print - 1 Nov 2021

Keywords

SARS-CoV-2
Clinical
Evidence-based practice
Non-clinical
Paediatrics
Public health
Vaccination programmes

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1177/01410768211052589Licence: CC BY

Gurdasani_2021_JRSM_Vaccinating_CC
Copyright © The Royal Society of Medicine 2021. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
Final published version, 888 KBLicence: CC BY

Cite this

Gurdasani, D., Bhatt, S., Costello, A., Denaxas, S., Flaxman, S., Greenhalgh, T., Griffin, S., Hyde, Z., Katzourakis, A., McKee, M., Michie, S., Ratmann, O., Reicher, S., Scally, G., Tomlinson, C., Yates, C., Ziauddeen, H., & Pagel, C. (2021). Vaccinating adolescents against SARS-CoV-2 in England: a risk–benefit analysis. Journal of the Royal Society of Medicine, Online First. Advance online publication. https://doi.org/10.1177/01410768211052589

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title = "Vaccinating adolescents against SARS-CoV-2 in England: a risk–benefit analysis",

abstract = "ObjectiveTo offer a quantitative risk–benefit analysis of two doses of SARS-CoV-2 vaccination among adolescents in England.SettingEngland.DesignFollowing the risk–benefit analysis methodology carried out by the US Centers for Disease Control, we calculated historical rates of hospital admission, Intensive Care Unit admission and death for ascertained SARS-CoV-2 cases in children aged 12–17 in England. We then used these rates alongside a range of estimates for incidence of long COVID, vaccine efficacy and vaccine-induced myocarditis, to estimate hospital and Intensive Care Unit admissions, deaths and cases of long COVID over a period of 16 weeks under assumptions of high and low case incidence.ParticipantsAll 12–17 year olds with a record of confirmed SARS-CoV-2 infection in England between 1 July 2020 and 31 March 2021 using national linked electronic health records, accessed through the British Heart Foundation Data Science Centre.Main outcome measuresHospitalisations, Intensive Care Unit admissions, deaths and cases of long COVID averted by vaccinating all 12–17 year olds in England over a 16-week period under different estimates of future case incidence.ResultsAt high future case incidence of 1000/100,000 population/week over 16 weeks, vaccination could avert 4430 hospital admissions and 36 deaths over 16 weeks. At the low incidence of 50/100,000/week, vaccination could avert 70 hospital admissions and two deaths over 16 weeks. The benefit of vaccination in terms of hospitalisations in adolescents outweighs risks unless case rates are sustainably very low (below 30/100,000 teenagers/week). Benefit of vaccination exists at any case rate for the outcomes of death and long COVID, since neither have been associated with vaccination to date.ConclusionsGiven the current (as at 15 September 2021) high case rates (680/100,000 population/week in 10–19 year olds) in England, our findings support vaccination of adolescents against SARS-CoV2.",

keywords = "SARS-CoV-2, Clinical, Evidence-based practice, Non-clinical, Paediatrics, Public health, Vaccination programmes",

author = "Deepti Gurdasani and Samir Bhatt and Anthony Costello and Spiros Denaxas and Seth Flaxman and Trisha Greenhalgh and Stephen Griffin and Zo{\"e} Hyde and Aris Katzourakis and Martin McKee and Susan Michie and Oliver Ratmann and Stephen Reicher and Gabriel Scally and Christopher Tomlinson and Christian Yates and Hisham Ziauddeen and Christina Pagel",

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month = nov,

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doi = "10.1177/01410768211052589",

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Gurdasani, D, Bhatt, S, Costello, A, Denaxas, S, Flaxman, S, Greenhalgh, T, Griffin, S, Hyde, Z, Katzourakis, A, McKee, M, Michie, S, Ratmann, O, Reicher, S, Scally, G, Tomlinson, C, Yates, C, Ziauddeen, H & Pagel, C 2021, 'Vaccinating adolescents against SARS-CoV-2 in England: a risk–benefit analysis', Journal of the Royal Society of Medicine, vol. Online First. https://doi.org/10.1177/01410768211052589

TY - JOUR

T1 - Vaccinating adolescents against SARS-CoV-2 in England

T2 - a risk–benefit analysis

AU - Gurdasani, Deepti

AU - Bhatt, Samir

AU - Costello, Anthony

AU - Denaxas, Spiros

AU - Flaxman, Seth

AU - Greenhalgh, Trisha

AU - Griffin, Stephen

AU - Hyde, Zoë

AU - Katzourakis, Aris

AU - McKee, Martin

AU - Michie, Susan

AU - Ratmann, Oliver

AU - Reicher, Stephen

AU - Scally, Gabriel

AU - Tomlinson, Christopher

AU - Yates, Christian

AU - Ziauddeen, Hisham

AU - Pagel, Christina

PY - 2021/11/1

Y1 - 2021/11/1

N2 - ObjectiveTo offer a quantitative risk–benefit analysis of two doses of SARS-CoV-2 vaccination among adolescents in England.SettingEngland.DesignFollowing the risk–benefit analysis methodology carried out by the US Centers for Disease Control, we calculated historical rates of hospital admission, Intensive Care Unit admission and death for ascertained SARS-CoV-2 cases in children aged 12–17 in England. We then used these rates alongside a range of estimates for incidence of long COVID, vaccine efficacy and vaccine-induced myocarditis, to estimate hospital and Intensive Care Unit admissions, deaths and cases of long COVID over a period of 16 weeks under assumptions of high and low case incidence.ParticipantsAll 12–17 year olds with a record of confirmed SARS-CoV-2 infection in England between 1 July 2020 and 31 March 2021 using national linked electronic health records, accessed through the British Heart Foundation Data Science Centre.Main outcome measuresHospitalisations, Intensive Care Unit admissions, deaths and cases of long COVID averted by vaccinating all 12–17 year olds in England over a 16-week period under different estimates of future case incidence.ResultsAt high future case incidence of 1000/100,000 population/week over 16 weeks, vaccination could avert 4430 hospital admissions and 36 deaths over 16 weeks. At the low incidence of 50/100,000/week, vaccination could avert 70 hospital admissions and two deaths over 16 weeks. The benefit of vaccination in terms of hospitalisations in adolescents outweighs risks unless case rates are sustainably very low (below 30/100,000 teenagers/week). Benefit of vaccination exists at any case rate for the outcomes of death and long COVID, since neither have been associated with vaccination to date.ConclusionsGiven the current (as at 15 September 2021) high case rates (680/100,000 population/week in 10–19 year olds) in England, our findings support vaccination of adolescents against SARS-CoV2.

AB - ObjectiveTo offer a quantitative risk–benefit analysis of two doses of SARS-CoV-2 vaccination among adolescents in England.SettingEngland.DesignFollowing the risk–benefit analysis methodology carried out by the US Centers for Disease Control, we calculated historical rates of hospital admission, Intensive Care Unit admission and death for ascertained SARS-CoV-2 cases in children aged 12–17 in England. We then used these rates alongside a range of estimates for incidence of long COVID, vaccine efficacy and vaccine-induced myocarditis, to estimate hospital and Intensive Care Unit admissions, deaths and cases of long COVID over a period of 16 weeks under assumptions of high and low case incidence.ParticipantsAll 12–17 year olds with a record of confirmed SARS-CoV-2 infection in England between 1 July 2020 and 31 March 2021 using national linked electronic health records, accessed through the British Heart Foundation Data Science Centre.Main outcome measuresHospitalisations, Intensive Care Unit admissions, deaths and cases of long COVID averted by vaccinating all 12–17 year olds in England over a 16-week period under different estimates of future case incidence.ResultsAt high future case incidence of 1000/100,000 population/week over 16 weeks, vaccination could avert 4430 hospital admissions and 36 deaths over 16 weeks. At the low incidence of 50/100,000/week, vaccination could avert 70 hospital admissions and two deaths over 16 weeks. The benefit of vaccination in terms of hospitalisations in adolescents outweighs risks unless case rates are sustainably very low (below 30/100,000 teenagers/week). Benefit of vaccination exists at any case rate for the outcomes of death and long COVID, since neither have been associated with vaccination to date.ConclusionsGiven the current (as at 15 September 2021) high case rates (680/100,000 population/week in 10–19 year olds) in England, our findings support vaccination of adolescents against SARS-CoV2.

KW - SARS-CoV-2

KW - Clinical

KW - Evidence-based practice

KW - Non-clinical

KW - Paediatrics

KW - Public health

KW - Vaccination programmes

U2 - 10.1177/01410768211052589

DO - 10.1177/01410768211052589

M3 - Article

SN - 0141-0768

VL - Online First

JO - Journal of the Royal Society of Medicine

JF - Journal of the Royal Society of Medicine

ER -

Vaccinating adolescents against SARS-CoV-2 in England: a risk–benefit analysis

Abstract

Keywords

UN SDGs

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