COVID-19 vaccination for children with pulmonary hypertension: efficacy, safety and reasons for opting against vaccination

Objective: To determine the reasons why pulmonary hypertension (PH) children refused vaccination against COVID-19, evaluate the safety and efficacy of COVID-19 vaccine in PH children.Study design: This retrospective cohort study included congenital heart disease-associated pulmonary arterial hypertension (CHD-PAH) and bronchopulmonary dysplasia associated PH (BPD-PH) children who were divided into vaccinated group and non-vaccinated group. Univariate logistic regression analysis and multivariate logistic regression analysis were conducted to explore the reasons why PH children refused COVID-19 vaccine. Then, the prevalence, the number of symptoms, and the severity of COVID-19 disease were compared between the vaccinated and unvaccinated groups.Result: We included 73 children and 61 children (83.6%) were unvaccinated. The main reasons for not being vaccinated were fear of worsening of existing diseases (31%). Age < 36 months (RR: 0.012; P < 0.001) and the presence of comorbidities (RR = 0.06; P = 0.023) were risk factors influencing willingness to vaccinate. The most common adverse events (AEs) were injection site pain (29.6%). COVID-19 vaccines are safe for PH children. The prevalence of COVID-19 disease decreased in PH children after vaccination (RR = 0.51; P = 0.009). 1 month after negative nucleic acid test or negative antigen test, PH children in the vaccinated group had fewer symptoms (P = 0.049).Conclusions: The vaccination rate of COVID-19 vaccine is low in CHD-PAH and BPD-PH children while COVID-19 vaccines are safe. Vaccination can reduce the prevalence of COVID-19 disease and the number of symptoms 1 month after negative nucleic acid or antigen tests.

Automated summary

This study investigated the reasons why children with pulmonary hypertension (PH) refuse to be vaccinated against COVID-19, and evaluated the safety and efficacy of COVID-19 vaccines in these children. The study found that the main reason for not being vaccinated was the fear of worsening of existing diseases. Age less than 36 months and the presence of comorbidities were identified as risk factors influencing willingness to vaccinate. After vaccination, the prevalence of COVID-19 disease decreased in PH children, and PH children in the vaccinated group had fewer symptoms one month after negative nucleic acid or antigen tests.