Impact of SARS-CoV-2 vaccination of children ages 5–11 years on COVID-19 disease burden and resilience to new variants in the United States, November 2021–March 2022: A multi-model study

Rebecca K. Borchering, Luke C. Mullany, Emily Howerton, Matteo Chinazzi, Claire P. Smith, Michelle Qin, Nicholas G. Reich, Lucie Contamin, John Levander, Jessica Kerr, J. Espino, Harry Hochheiser, Kaitlin Lovett, Matt Kinsey, Kate Tallaksen, Shelby Wilson, Lauren Shin, Joseph C. Lemaitre, Juan Dent Hulse, Joshua KaminskyElizabeth C. Lee, Alison L. Hill, Jessica T. Davis, Kunpeng Mu, Xinyue Xiong, Ana Pastore y Piontti, Alessandro Vespignani, Ajitesh Srivastava, Przemyslaw Porebski, Srini Venkatramanan, Aniruddha Adiga, Bryan Lewis, Brian Klahn, Joseph Outten, Benjamin Hurt, Jiangzhuo Chen, Henning Mortveit, Amanda Wilson, Madhav Marathe, Stefan Hoops, Parantapa Bhattacharya, Dustin Machi, Shi Chen, Rajib Paul, Daniel Janies, Jean Claude Thill, Marta Galanti, Teresa Yamana, Sen Pei, Jeffrey Shaman, Guido España, Sean Cavany, Sean Moore, Alex Perkins, Jessica M. Healy, Rachel B. Slayton, Michael A. Johansson, Matthew Biggerstaff, Katriona Shea, Shaun A. Truelove, Michael C. Runge, Cécile Viboud, Justin Lessler

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17 Scopus citations


Background: The COVID-19 Scenario Modeling Hub convened nine modeling teams to project the impact of expanding SARS-CoV-2 vaccination to children aged 5–11 years on COVID-19 burden and resilience against variant strains. Methods: Teams contributed state- and national-level weekly projections of cases, hospitalizations, and deaths in the United States from September 12, 2021 to March 12, 2022. Four scenarios covered all combinations of 1) vaccination (or not) of children aged 5–11 years (starting November 1, 2021), and 2) emergence (or not) of a variant more transmissible than the Delta variant (emerging November 15, 2021). Individual team projections were linearly pooled. The effect of childhood vaccination on overall and age-specific outcomes was estimated using meta-analyses. Findings: Assuming that a new variant would not emerge, all-age COVID-19 outcomes were projected to decrease nationally through mid-March 2022. In this setting, vaccination of children 5–11 years old was associated with reductions in projections for all-age cumulative cases (7.2%, mean incidence ratio [IR] 0.928, 95% confidence interval [CI] 0.880–0.977), hospitalizations (8.7%, mean IR 0.913, 95% CI 0.834–0.992), and deaths (9.2%, mean IR 0.908, 95% CI 0.797–1.020) compared with scenarios without childhood vaccination. Vaccine benefits increased for scenarios including a hypothesized more transmissible variant, assuming similar vaccine effectiveness. Projected relative reductions in cumulative outcomes were larger for children than for the entire population. State-level variation was observed. Interpretation: Given the scenario assumptions (defined before the emergence of Omicron), expanding vaccination to children 5–11 years old would provide measurable direct benefits, as well as indirect benefits to the all-age U.S. population, including resilience to more transmissible variants. Funding: Various (see acknowledgments).

Original languageEnglish (US)
Article number100398
JournalThe Lancet Regional Health - Americas
StatePublished - Jan 2023

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health
  • Health Policy
  • Internal Medicine


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