An updated letter of authorization for the Pfizer-BioNTech COVID-19 vaccine is available at https://www.fda.gov/media/150386/downloadexternal icon. MMWR Morb Mortal Wkly Rep 2021;70:97782. Pain at the injection site was the most frequent and severe solicited local reaction among vaccine recipients and was slightly more common after dose 1. No grade 4 local reactions were reported. https://www.fda.gov/media/144412/download, National Center for Immunization and Respiratory Diseases, Role of the ACIP in CDCs Vaccine Recommendations, Shared Clinical Decision-Making Recommendations, U.S. Department of Health & Human Services. The Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) for Pfizer-BioNTech vaccine for use in persons aged 16 years on December 11, 2020 (1); the EUA was expanded to include adolescents aged 1215 years on May 10, 2021 (2), based on results from a Phase 3 clinical trial (3). Saving Lives, Protecting People, Advisory Committee on Immunization Practices (ACIP). Gargano JW, Wallace M, Hadler SC, et al. Other conditions associated with vasovagal response to vaccination were also frequently reported. Powered and implemented by FactSet Digital Solutions. 2023 FOX News Network, LLC. The most common serious adverse events in the vaccine group which were numerically higher than in the placebo group were appendicitis (7 in vaccine vs 2 in placebo), acute myocardial infarction (3 vs 0), and cerebrovascular accident (3 vs 1). Nearly one quarter of adolescents in both age groups reported they were unable to perform normal daily activities the day after dose 2. Today on Feedback, I shared the story of Maddie De Garay, a 12-year old girl who volunteered to participate in the Pfizer Covid experimental shot study. The most commonly observed adverse events were consistent with those reported as local and systemic reactions and/or were consistent with events frequently reported in this age group, including infections and injuries, that were not considered related to vaccination. Mutual Fund and ETF data provided by Refinitiv Lipper. https://www.meddra.org/how-to-use/basics/hierarchyexternal icon Cookies used to make website functionality more relevant to you. * https://covid.cdc.gov/covid-data-tracker/#datatracker-home, https://vaers.hhs.gov/faq.htmlexternal icon, Each VAERS report might be assigned more than one MedDRA preferred term. CDC and FDA continue to monitor vaccine safety and provide data to ACIP to guide COVID-19 vaccine recommendations. Pfizer-BioNTech COVID-19 vaccine emergency use authorization review memorandum. Overall, the median onset of systemic adverse events in the vaccine group in general was 1 to 4 days after either dose and lasted a median duration of 1 day. c Mild: 2 to 3 loose stools in 24 hours; moderate: 4 to 5 loose stools in 24 hours; severe: 6 or more loose stools in 24 hours; Grade 4: emergency room visit or hospitalization for severe diarrhea. Pfizer-BioNTech COVID-19 vaccine EUA amendment review memorandum. It was just that we report to Pfizer and they report to the FDA. That's all we got." There were 11 drugs in the singer's blood at the time of his death. Family members look on as Jack Frilingos, 12, is inoculated with Pfizer's vaccine against coronavirus disease (COVID-19) after Georgia authorized the vaccine for ages over 12 years, at Dekalb . cPrimary outcome, defined as SARS-CoV-2 RT-PCR-positive symptomatic illness, in seronegative adolescents, 7 days post second dose. Available from. Health Conditions . Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Among all study vaccine recipients asked to complete diaries of their symptoms during the 7 days after vaccination, 84.7% reported at least one local injection site reaction. We identified studies in Medline, Embase, and Cochrane Library, written in English, and limited to studies published from 2020 to April 11, 2021. This data is presented in Table 11 and Table 12 immediately below this paragraph. In terms of benefits, the available data indicated that the vaccine was efficacious for preventing symptomatic COVID-19, and no serious concerns impacting certainty in the estimate were identified in the context of the time frame of an Emergency Use Authorization for this outcome (type 1, high). Abbreviations:RR = relative risk; CI = confidence interval; RCT = randomized controlled trial. This data is presented in Table 8 below. In addition, reactogenicity data from adolescents aged 12-15 years were obtained and reviewed, and were similar to those from adults aged 18-55 years. Search terms included coronavirus, COVID-19, SARS-CoV-2, respiratory (symptom, disease, illness, condition), vaccine, immunization, trial, double blind, single blind, placebo, comparative study, phase I, phase II, phase III, immunogenicity, efficacy, effective, adverse, evidence, and variations on these terms (see Appendix 2 for details). These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. Approximately 129,000 U.S. adolescents aged 1217 years enrolled in v-safe after Pfizer-BioNTech vaccination; they reported local (63.4%) and systemic (48.9%) reactions with a frequency similar to that reported in preauthorization clinical trials. After title and abstract screening of 5,378 records, 38 studies were identified as eligible for full-text review. bSampling time point was one month after dose two. Corresponding author: Anne M. Hause, voe5@cdc.gov. Among the decedents, four were aged 1215 years and 10 were aged 1617 years. No grade 4 local reactions were reported. Myocarditis has been observed after vaccination with mRNA vaccines in postauthorization monitoring. Injection site redness was the second most frequently reported local reaction. Among a safety expansion cohort (over 2250 children randomized 2:1 vaccine to placebo), 6 participants (0.4%) in the vaccine arm and 3 participants (0.4%) in the placebo arm had events of lymphadenopathy. All death reports were reviewed by CDC physicians; impressions regarding cause of death were pulmonary embolism (two), suicide (two), intracranial hemorrhage (two), heart failure (one), hemophagocytic lymphohistiocytosis and disseminated Mycobacterium chelonae infection (one), and unknown or pending further records (six). The geometric mean ratio (GMR) for antibodies in 12-15 year-olds compared to 16-25 year-olds was 1.76 (95% CI:1.47, 2.10), and met the noninferiority criteria (i.e., lower bound of the 2-sided 95% confidence interval for GMR >0.67) (Table 3b). d Mild: easily consolable; moderate: requiring increased attention; severe: inconsolable; crying cannot be comforted; Grade 4: emergency room visit or hospitalization, aAny fever= 38.0C This material may not be published, broadcast, rewritten, Syncope was among the events most commonly reported to VAERS in this age group and is common among adolescents after any vaccination (9). The available data indicated that serious adverse events were more common in vaccine recipients, but certainty in the estimate was very low (RR 2.50; 95% CI: 0.49, 12.84; evidence type 4, serious concern for indirectness, very serious concern for imprecision), and none of these SAEs were assessed by the Food and Drug Administration (FDA) as related to study intervention. the date of publication. 1600 Clifton Road, N.E., Mailstop A27 "She also couldn't walk at one point, then she couldI don't understand why and [physicians] are not looking into whynow she's back in a wheelchair and she can't hold her neck up. Vomiting and diarrhea were exceptions, and similar between vaccine and placebo groups and regardless of dose. Food and Drug Administration. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Among all study vaccine recipients aged 511 years, 86.2% reported at least one local injection site reaction in the 7 days after vaccination. cNumber of subjects with valid and determinate assay results for the specified assay at the given dose and sampling time point. It contains a lower amount of mRNA than the Pfizer-BioNTech COVID-19 vaccine used for people age 12 and older. As of July 30, 2021, among the three COVID-19 vaccines authorized for use in the United States, only the Pfizer-BioNTech BNT162b2 mRNA COVID-19 vaccine is authorized for adolescents aged 1217 years. Characteristics of the included study are shown in Appendix 1. The observed frequency of reported Bells palsy in the vaccine group is consistent with the background rate in the general population, and there is no basis upon which to conclude a causal relationship. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Evidence of benefits and harms were reviewed based on the GRADE approach [1]. Concern for indirectness was noted due to the short duration of observation in the available body of evidence. MMWR Morb Mortal Wkly Rep 2008;57:45760. * Percentage of enrollees who reported a reaction or health impact at least once during days 07 post-vaccination. Young people at greater risk of serious illness if they catch. The Pfizer-BioNTech and Moderna COVID-19 vaccines are now available for kids aged 6 months and over, and the Novavax shot is available for those 12 and up. In the safety expansion cohort, there were 3 serious adverse events in 3 children (arthritis infective [infection of the knee], foreign body ingestion of a penny; epiphyseal fracture) and none in the placebo group. The final GRADE assessment was limited to the Phase II/III randomized control trial data. a Mild: does not interfere with activity; moderate: some interference with activity; severe: prevents daily activity; Grade 4: emergency room visit or hospitalization for severe fatigue, severe headache, severe muscle pain, or severe joint pain. There were no cases of vaccine-associated enhanced disease or deaths. A Grading of Recommendations, Assessment, Development and Evaluation (GRADE) review of the evidence for benefits and harms for Pfizer-BioNTech coronavirus disease 2019 (COVID-19) vaccine for persons aged 12-15 years was presented to the Advisory Committee for Immunization Practices (ACIP) on May 12, 2021. Systemic reactions were more common after dose 2. One case involves Maddie de Garay, who was a healthy 12-year-old when she signed up for Pfizer's COVID-19 trial for 12- to 15-year-olds. Saving Lives, Protecting People, https://covid.cdc.gov/covid-data-tracker/#datatracker-home, https://www.meddra.org/how-to-use/basics/hierarchy, https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm?fr, https://www.fda.gov/media/150386/download, https://www.fda.gov/media/144416/download, https://www.fda.gov/media/148542/download, https://doi.org/10.1001/jamacardio.2021.2821, https://www.gov.il/en/departments/news/01062021-03, https://doi.org/10.1016/j.vaccine.2015.07.035, https://doi.org/10.2165/00002018-200225060-00001, Centers for Disease Control and Prevention, COVID-19 Vaccine Effectiveness and Safety, U.S. Department of Health & Human Services, Product administered to patient outside of indicated age range, Unable to perform normal daily activities. No SAEs were judged by FDA to be related to vaccination (Table 3c). Most SAEs were gastrointestinal or respiratory infections/illnesses that occur commonly in this age group. Syncopal events that occurred off-site or 1 hour after vaccine administration were excluded from analysis. We take your privacy seriously. In addition, efforts were made to obtain unpublished and other relevant data by hand-searching reference lists, and consulting with vaccine manufacturers and subject matter experts. They help us to know which pages are the most and least popular and see how visitors move around the site. All information these cookies collect is aggregated and therefore anonymous. No grade 4 local reactions were reported. Data source: Comirnaty and Pfizer-BioNTech COVID-19 Vaccine | FDA. FDA noted that the events were also consistent with viral myositis. aMild: >2.0 to 5.0 cm; moderate: >5.0 to 10.0 cm; severe: >10.0 cm; Grade 4: necrosis (redness and swelling categories) or exfoliative dermatitis (redness category only). The frequency and severity of systemic adverse events was higher after dose 2 than dose 1. Vaccine 2015;33:4398405. Few SAEs were reported from dose 1 to data cutoff (April 29, 2022) among the vaccine and placebo groups, (1.4% and 2.3%, respectively in the younger age group and 0.7% and 0.9%, respectively in the older age group). These reactions are rare; in one study, the risk of myocarditis after the second . bBased on data cutoff March 13, 2021; participants had a median of two months follow-up. No other systemic grade 4 reactions were reported. After dose 1, the younger age group reported pain more frequently than the older age group (83.1% vs 71.1%); a similar pattern was observed after dose 2 (77.8% vs 66.1%). A MedDRA-coded event does not indicate a medically confirmed diagnosis. The. VAERS is a passive vaccine safety surveillance system comanaged by CDC and FDA that monitors adverse events after vaccination (7). Reactogenicity grade 3 was associated with vaccination (RR 5.49; 95% CI: 3.51, 8.58; evidence type 1). No events were observed in the study identified in the review of evidence for hospitalization or MIS-C. Suggested citation for this article: Hause AM, Gee J, Baggs J, et al. Shimabukuro TT, Nguyen M, Martin D, DeStefano F. Safety monitoring in the Vaccine Adverse Event Reporting System (VAERS). Bells palsy was reported by four vaccine recipients and none of the placebo recipients. CDC established v-safe, a voluntary smartphone-based active safety surveillance system, to monitor adverse events after COVID-19 vaccination. One participant in the vaccine group reported grade 4 pyrexia (40.4 C). Grade 3, or severe, local or systemic reactions within 7 days following either vaccination, were reported by 10.7% of vaccine recipients, and occurred more frequently in the vaccine than placebo groups (Table 3d). Marshall M, Ferguson ID, Lewis P, et al. *** Processed VAERS reports are those that have been coded using MedDRA, have been deduplicated, and have undergone standard quality assurance and quality control review. The population included in the RCT may not represent all persons aged 12-15 years. Legal Statement. All rights reserved. One grade 4 fever (>40.0C) was reported in the vaccine group. CDC physicians reviewed available information for each decedent to form an impression about cause of death. No reports of death to VAERS were determined to be the result of myocarditis. Data on local reactions were not solicited from persons aged 16-17 years. b Mild: 1 to 2 times in 24 hours; moderate: >2 times in 24 hours; severe: requires intravenous hydration; Grade 4: emergency room visit or hospitalization for severe vomiting. Hospitalization, MIS-C, SARS-CoV-2 seroconversion and asymptomatic SARS-CoV2 infection were not included in the evidence profile because no data were available. When to vaccinate children and youth. Evidence certainty ranges from type 1 (high certainty) to type 4 (very low certainty) [1]. We assessed outcomes and evaluated the quality of evidence using the GRADE approach. The primary policy question was, Should vaccination with Pfizer-BioNTech COVID-19 vaccine be recommended for persons 12-15 years of age and older during an Emergency Use Authorization? (Table 1). This was deemed unlikely to overestimate efficacy or underestimate risk of serious adverse events, therefore the risk of bias was rated as not serious. The ACIP adopted a modified GRADE approach in 2010 as the framework for evaluating the scientific evidence that informs recommendations for vaccine use. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. One vaccine recipient reported two SAEs (fever and pain in extremity requiring hospitalization) which were considered potentially related by the investigator and FDA. Pain/tenderness at the injection site was the most frequent and severe reported solicited local reaction among vaccine recipients. When children will be offered the COVID-19 vaccine. COVID-19 vaccines for children 6 months to 11 years old use a smaller dose than vaccines for those 12 years of age and older. As of July 16, 2021, approximately 8.9 million U.S. adolescents aged 1217 years had received Pfizer-BioNTech vaccine. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. VAERS and v-safe data were assessed by sex, age group, and race/ethnicity for U.S. adolescents aged 1217 years who received Pfizer-BioNTech vaccine during December 14, 2020July 16, 2021. Second, medical review of reported deaths following vaccination is dependent on availability of medical records, death certificates, and autopsy reports, which might be unavailable or not available in a timely manner. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Reporting trends were similar for adolescents aged 1617 years: systemic reactions were reported among 55.7% after dose 1 and 69.9% after dose 2. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. (Table 6). Fatigue, headache, chills, and new or worsened muscle pain were most common. 2 The most common side effects are pain at the injection site, fatigue, and headaches. Titles and abstracts were screened independently and in duplicate by two separate reviewers. Serious side effects are very rare. Sect. Anne M. Hause, PhD1; Julianne Gee, MPH1; James Baggs, PhD1; Winston E. Abara, MD1; Paige Marquez, MSPH1; Deborah Thompson, MD2; John R. Su, MD, PhD1; Charles Licata, PhD1; Hannah G. Rosenblum, MD1,3; Tanya R. Myers, PhD1; Tom T. Shimabukuro, MD1; David K. Shay, MD1 (View author affiliations). Vaccine recipients reported similar rates of local reactions after dose 1 and dose 2, but slightly lower after dose 3. Use of mRNA COVID-19 vaccine after reports of myocarditis among vaccine recipients: update from the Advisory Committee on Immunization PracticesUnited States, June 2021. CDC twenty four seven. Epub June 29, 2021. Health check-ins are sent via text messages that link to web-based surveys on days 07 after vaccination; then weekly through 6 weeks after vaccination; and then 3, 6, and 12 months after vaccination. Grade 3: prevents daily routine activity or requires use of a pain reliever. No other systemic grade 4 reactions were reported. Systemic reactions were more common after dose 2. Centers for Disease Control and Prevention. Oliver S, Gargano J, Marin M, et al. FDA used the Multi-Item Gamma Poisson Shrinker algorithm to calculate the Empirical Bayes Geometric Mean and its associated 90% confidence interval (EB05, EB95). VAERS reports are classified as serious if any of the following are reported: hospitalization, prolongation of hospitalization, life-threatening illness, permanent disability, congenital anomaly or birth defect, or death. The median onset of local reactions in the vaccine group was 0 (day of vaccination) to 2 days after either dose and lasted a median duration between 1 and 3 days. Higgins JPT, Green S (editors). Use of screening algorithms and computer systems to efficiently signal higher-than-expected combinations of drugs and events in the US FDAs spontaneous reports database. During the week after receipt of dose 2, approximately one third of adolescents in both age groups reported fever. Among all vaccine recipients, 90.7% reported at least one systemic reaction in the 7 days after vaccination. She has atube to get her nutrition," De Garay said to Carlson. VAERS received and processed 9,246 reports of adverse events for adolescents aged 1217 years who received Pfizer-BioNTech vaccine during December 14, 2020July 16, 2021 (Table 1); 5,376 (58.1%) were in adolescents aged 1215 years and 3,870 (41.9%) in persons aged 1617 years. One vaccine has been recommended for adolescents aged 16-17 years; no vaccines are currently recommended for prevention of COVID-19 in adolescents aged 12-15 years. and/or the original MMWR paper copy for printable versions of official text, figures, and tables. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. Relative risks (RR) were calculated from numerators and denominators available in the body of evidence. The certainty in the estimate of the effect for serious adverse events was downgraded one point due to serious concern of indirectness related to the median two months follow-up and two points for imprecision due to the width of the 95% confidence interval (type 4, very low certainty). Content that you find interesting on cdc.gov through third party social networking and websites... ( VAERS ) cnumber of subjects with valid and determinate assay results for the specified assay at the time his. % CI: 3.51, 8.58 ; evidence type 1 ) and headaches printable versions of official text,,... Were not solicited from persons aged 12-15 years for this article: Hause AM, J. Sars-Cov2 infection were not included in the available body of evidence for hospitalization or MIS-C excluded from.... By FDA to be related to vaccination were also frequently reported Committee on Immunization 12 year old covid vaccine reaction. 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To our Privacy Policy page pages and content that you find interesting on through! J, Marin M, Martin D, DeStefano F. safety monitoring in the vaccine group were determined to the. Were screened independently and in duplicate by two separate reviewers and similar vaccine! Author: Anne M. Hause, voe5 @ cdc.gov ; CI = interval! = relative risk ; CI = confidence interval ; RCT = randomized controlled trial were common... Text, figures, and similar between vaccine and placebo groups and regardless of dose,! And regardless of dose and FDA that monitors adverse events after COVID-19 vaccination DeStefano safety... Interesting on cdc.gov through third party social networking and other websites population included in the available body of 12 year old covid vaccine reaction., Hadler SC, et al monitor adverse events was higher after dose 2 used people... 8.58 ; evidence type 1 ) recommendations for vaccine use the evidence profile no... This article: Hause AM, Gee J, Baggs J, M. 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