Exploring the dual benefits of COVID-19 vaccination in mitigating asthma symptoms in children

Matthew M Davis, MD, MAPP

Recent research published in JAMA Network Open suggests that states with higher COVID-19 vaccination rates among individuals aged 5 and up may experience benefits beyond controlling the virus itself. The study explores a potential correlation between vaccination rates and improved outcomes for pediatric asthma patients.

For every 10% increase in COVID-19 vaccination coverage, there was a corresponding decrease of .36 percentage points in parent-reported childhood asthma symptoms. States with the highest vaccination rates saw the most significant improvements, with asthma symptom decreases of 1.7 percentage points. This effect was nearly 3 times greater than in states with the lowest vaccination rates, where symptom reductions were only .6 percentage points.¹

Matthew M Davis, MD, MAPP, executive vice-president, enterprise physician-in-chief, and chief scientific officer of Nemours Children's Health, along with his coauthor Lakshmi Halasyamani, MD, chief clinical officer of Endeavor Health, highlight two potential mechanisms linking higher vaccination rates to improved asthma outcomes,

“First, higher population-level vaccination coverage might indicate that children with asthma are more likely to be vaccinated against COVID-19, themselves, compared with children with asthma in other states with lower COVID-19 vaccination coverage. Second, higher population-level vaccination coverage might mean that adults and other children essentially provide a protective community around children with asthma, by making it less likely that viruses will spread from person to person in the community. This protection would be especially important for children with asthma who were not vaccinated against COVID-19. “

The study suggests that community-level immunity from higher vaccination rates may have contributed to reducing children's risk of contracting COVID-19 and potentially easing asthma symptoms. Furthermore, it indicates that COVID-19 vaccinations might mitigate other respiratory illnesses associated with coronaviruses, suggesting broader protective benefits.

“Herd immunity against COVID-19 may help reduce the chances of person-to-person transmission of the SARS-CoV-2 virus, which may help prevent children with asthma from contracting COVID-19 illness and having a higher likelihood of developing a flare of asthma symptoms," Davis and Halasyamani explain further. "In addition, COVID-19 vaccination may protect against other coronavirus infections through cross-reactive antibodies, so the benefits for children through vaccination of themselves and/or others may not be limited to protection against SARS-CoV-2.”

The limitation of this study is that it relied on parent-reported data rather than clinical measures like hospitalizations or emergency department visits to assess asthma outcomes. Additionally, it did not specifically measure vaccination rates among children with asthma, which could provide more targeted insights.

“Childhood vaccination against influenza, pneumococcus, and COVID-19 is already recommended universally in the United States for children, based on their ages, because of the morbidity and mortality associated with respiratory illnesses caused by these organisms at the population level among children and adults. The findings in our study may help encourage vaccination against COVID-19, especially for children with asthma or their close contacts,” according to Davis and Halasyamani.

During the CDC's Advisory Committee on Immunization Practices (ACIP) meeting held on June 27, 2024, voting members recommended the authorized 2024-2025 COVID-19 vaccines for those 6 months of age and older and reaffirmed the influenza vaccination guidelines.²

Davis finalizes his thoughts by sharing, "With the pandemic in our rearview mirror, I know with my patients, there is less importance of vaccinating against COVID-19. What this study reminds us, is that we may still get benefit from the COVID-19 vaccine. We keep developing the latest version of the vaccine to protect against the latest circulating strains of the virus, along with other common cold viruses, and that is the benefit developers have been seeking for years, only now because of the pandemic we developed a vaccine that accomplishes that goal."

This article was initially published by our sister publication Contagion Live.

References

1. Davis MM, Halasyamani LK. COVID-19 Vaccination and Parent-Reported Symptomatic Child Asthma Prevalence. JAMA Netw Open. 2024;7(7):e2419979. Published July 3, 2024. Accessed July 11, 2024. doi:10.1001/jamanetworkopen.2024.19979
2. Abene S. CDC Updated COVID-19 and Influenza Vaccination Guidelines for 2024-2025 Season. Contagion. Published June 27, 2024. Accessed July 11, 2024. https://www.contagionlive.com/view/cdc-recommends-2024-2025-covid-19-vaccines-for-fda-authorized-use-in-persons-6-months-and-older