Preventive effect of vaccination on long COVID in adolescents with SARS-CoV-2 infection

Tanayott Thaweethai; Rachel S Gross; Deepti B Pant; Kyung E Rhee; Terry L Jernigan; Lawrence C Kleinman; Jessica N Snowden; Amy L Salisbury; Patricia A Kinser; Joshua D Milner; Kelan Tantisira; David Warburton; Sindhu Mohandas; John C Wood; Megan L Fitzgerald; Megan Carmilani; Aparna Krishnamoorthy; Harrison T Reeder; Andrea S Foulkes; Melissa S Stockwell; RECOVER-Pediatrics Consortium

doi:10.1016/j.vaccine.2025.127907

Preventive effect of vaccination on long COVID in adolescents with SARS-CoV-2 infection

Vaccine. 2025 Dec 5:68:127907. doi: 10.1016/j.vaccine.2025.127907. Epub 2025 Nov 1.

Authors

Tanayott Thaweethai¹, Rachel S Gross², Deepti B Pant³, Kyung E Rhee⁴, Terry L Jernigan⁵, Lawrence C Kleinman⁶, Jessica N Snowden⁷, Amy L Salisbury⁸, Patricia A Kinser⁹, Joshua D Milner¹⁰, Kelan Tantisira¹¹, David Warburton¹², Sindhu Mohandas¹³, John C Wood¹⁴, Megan L Fitzgerald¹⁵, Megan Carmilani¹⁶, Aparna Krishnamoorthy¹⁷, Harrison T Reeder¹⁸, Andrea S Foulkes¹⁹, Melissa S Stockwell²⁰; RECOVER-Pediatrics Consortium

Affiliations

¹ Massachusetts General Hospital Biostatistics, 399 Revolution Drive, Suite 1068, Somerville, MA 02145, USA; Department of Medicine, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA. Electronic address: tthaweethai@mgh.harvard.edu.
² Division of General Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine, 227 East 30(th) Street, 6th Floor, New York, NY 10016, USA. Electronic address: Rachel.Gross@nyulangone.org.
³ Massachusetts General Hospital Biostatistics, 399 Revolution Drive, Suite 1068, Somerville, MA 02145, USA. Electronic address: dpant1@mgh.harvard.edu.
⁴ Division of Child and Community Health, Department of Pediatrics, UC San Diego School of Medicine, 9500 Gilman Dr, MC 0874, La Jolla, CA 92093, USA. Electronic address: k1rhee@health.ucsd.edu.
⁵ Departments of Cognitive Science, Psychiatry, and Radiology, and Center for Human Development, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA. Electronic address: tjernigan@ucsd.edu.
⁶ Division of Population Health, Quality, and Implementation Sciences (PopQuIS), Department of Pediatrics, Child Health Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, 89 French Street, Room 1201, New Brunswick, NJ 08901, USA; Bristol Myers Squibb Children's Hospital, 200 Somerset Street, New Brunswick, NJ 08901, USA. Electronic address: lk157@rwjms.rutgers.edu.
⁷ Division of Infectious Diseases, Department of Pediatrics, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR 72205, USA. Electronic address: jsnowde2@uthsc.edu.
⁸ School of Nursing, Virginia Commonwealth University, 1100 E Leigh St, Richmond, VA 23298, USA. Electronic address: salisburya@vcu.edu.
⁹ School of Nursing, Virginia Commonwealth University, 1100 E Leigh St, Richmond, VA 23298, USA. Electronic address: kinserpa@vcu.edu.
¹⁰ Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, 622 West 168th Street Presbyterian Hospital Building, PH-17, New York, NY 10032, USA; NewYork-Presbyterian Hospital, 622 West 168th Street, New York, NY 10032, USA. Electronic address: jdm2249@cumc.columbia.edu.
¹¹ Division of Respiratory Medicine, Department of Pediatrics, UC San Diego School of Medicine, Rady Children's Hospital, 3030 Children's Way 2nd Floor, San Diego, CA 92123, USA. Electronic address: ktantisira@health.ucsd.edu.
¹² Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, 4650 Sunset Blvd, Los Angeles, CA 90027, USA. Electronic address: DWarburton@chla.usc.edu.
¹³ Division of Infectious Diseases, Department of Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, 4650 Sunset Blvd, Los Angeles, CA 90027, USA. Electronic address: smohandas@chla.usc.edu.
¹⁴ Division of Cardiology, Department of Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, 4650 Sunset Blvd, Los Angeles, CA 90027, USA. Electronic address: JWood@chla.usc.edu.
¹⁵ RECOVER Patient, Caregiver, or Community Advocate Representative, 550 1st Ave, New York, NY 10016, USA; Patient Led Research Collaborative, 23564 Calabasas Road, Suite 201, Calabasas, CA 91302, USA.
¹⁶ RECOVER Patient, Caregiver, or Community Advocate Representative, 550 1st Ave, New York, NY 10016, USA; Long Covid Families, Charlotte, NC, United States.
¹⁷ Massachusetts General Hospital Biostatistics, 399 Revolution Drive, Suite 1068, Somerville, MA 02145, USA. Electronic address: AKRISHNAMOORTHY2@mgh.harvard.edu.
¹⁸ Massachusetts General Hospital Biostatistics, 399 Revolution Drive, Suite 1068, Somerville, MA 02145, USA; Department of Medicine, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA. Electronic address: HREEDER@mgh.harvard.edu.
¹⁹ Massachusetts General Hospital Biostatistics, 399 Revolution Drive, Suite 1068, Somerville, MA 02145, USA; Department of Medicine, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue Building 2, 4th Floor, Boston, MA 02115, USA. Electronic address: AFOULKES@mgh.harvard.edu.
²⁰ NewYork-Presbyterian Hospital, 622 West 168th Street, New York, NY 10032, USA; Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, 622 West 168th Street Presbyterian Hospital Building, PH-17, New York, NY 10032, USA; Department of Population and Family Health, Mailman School of Public Health, New York-Presbyterian Hospital, 722 West 168th Street, New York, NY 10032, USA. Electronic address: mss2112@cumc.columbia.edu.

Abstract

Purpose: In adolescents (12-17 years), it is unknown whether COVID-19 vaccination reduces progression from COVID-19 to Long COVID (LC) beyond preventing SARS-CoV-2 infection. We assessed the effect of vaccination among SARS-CoV-2 infected adolescents.

Methods and results: Participants were recruited from over 60 US healthcare and community settings. The exposure was any COVID-19 vaccination 6 months prior to infection. The outcome was LC defined using the LC research index. Vaccinated (n = 724) and unvaccinated (n = 507) adolescents were matched on sex, infection date, and enrollment date. The risk of LC was 36 % lower (95 % CI, 17 %, 50 %) in vaccinated compared to unvaccinated participants.

Conclusions: Vaccination reduces the risk of LC. Given the profound impact LC can have on the health and well-being of adolescents and the limited availability of treatments during this developmental stage, this supports vaccination as a strategy for preventing LC by demonstrating an important secondary prevention effect.

Keywords: Adolescent health; COVID-19; Long COVID; Secondary prevention; Vaccination.

MeSH terms

Adolescent
COVID-19 Vaccines* / administration & dosage
COVID-19 Vaccines* / immunology
COVID-19* / epidemiology
COVID-19* / immunology
COVID-19* / prevention & control
Child
Disease Progression
Female
Humans
Male
SARS-CoV-2 / immunology
United States / epidemiology
Vaccination*

Substances

COVID-19 Vaccines

Abstract

MeSH terms

Substances

Grants and funding