Respiratory Diseases Roundup

Long COVID Burden in Health Care Workers, Pediatric Vaccination Protection, and More Infectious Disease Updates

Miranda Manier, BA

Vaccination Reduces Long COVID Risk in Youth1

A large-scale observational study across 20 United States health systems evaluated the effectiveness of the BNT162b2 vaccine in reducing long COVID risk among children and adolescents during Delta and Omicron SARS-CoV-2 variant periods. The data included over 112,000 adolescents during the Delta wave and nearly 274,000 children and adolescents during Omicron. Results indicated substantial reductions in long COVID incidence post-vaccination: 95.4% effectiveness among adolescents during Delta, 60.2% among children and 75.1% among adolescents during Omicron. These reductions were attributed primarily to the vaccine’s prevention of acute infection, rather than any independent effect on long COVID development post-infection.

A mediation analysis confirmed that the vaccine's protective effect was indirect—mainly by reducing infection rates. The direct effect of vaccination on long COVID was not statistically significant across any subgroup. These findings suggest that while vaccination does not independently alter post-infection sequelae, its substantial role in infection prevention translates into meaningful protection against long COVID.

RSV and New Vaccine Recommendations Expand Coverage2

The Advisory Committee on Immunization Practices (ACIP) has recommended expanding respiratory syncytial virus (RSV) vaccine eligibility to adults aged 50 to 59 who are at high risk of severe illness. This recommendation applies to FDA-licensed RSV vaccines, including those from GSK and Pfizer, and would require insurance coverage upon CDC approval. Moderna’s application to extend its RSV vaccine to this group is pending. Although CDC approval may be delayed due to a vacant directorship, acting leadership or the HHS Secretary may authorize the recommendation.

Alongside RSV vaccine changes, ACIP endorsed use of Bavarian Nordic’s new chikungunya vaccine, Vimkunya, for travelers and lab personnel aged 12 years and older. The committee also revised earlier guidance on Valneva’s chikungunya vaccine due to six serious adverse events in older adults, now recommending added precautions for use in people aged 65 years and older. ACIP also supported GSK’s MenABCWY meningococcal vaccine for individuals aged 16–23 with prior meningitis B indication and those aged 10 years and older with high-risk conditions.

Model Predicts Surge in Disease With Vaccination Decline3

A simulation study in JAMA modeled the impact of declining childhood vaccination on the reemergence of vaccine-preventable diseases in the United States. Using historical and demographic data across 51 jurisdictions, the model projected outcomes over 25 years under varying immunization rates. If current vaccination rates continue, measles may become endemic again within approximately 21 years. A 10% drop in MMR coverage would result in 11.1 million measles cases, while a 50% decline in routine childhood vaccination could yield 51.2 million measles cases, 9.9 million rubella cases, 4.3 million polio cases, and nearly 160,000 deaths.

The model also estimated significant disease burden, including 10.3 million hospitalizations, 51,200 post-measles neurological cases, and thousands of instances of congenital rubella syndrome and paralytic polio. Measles and rubella were predicted to reach endemic levels fastest, within 5 and 18 years, respectively.

Long COVID Prevalence High Among Healthcare Workers4

A systematic review and meta-analysis of 28 studies involving 6481 health care workers (HCWs) globally assessed the prevalence and symptomatology of long COVID. The pooled prevalence was 40% among HCWs previously infected with SARS-CoV-2, with follow-up averaging 22 weeks. Fatigue (35%), neurological symptoms (25%), loss of smell/taste (25%), myalgia (22%), and shortness of breath (19%) were the most common symptoms. The review noted substantial heterogeneity (I² = 97.2%) across studies due to variable definitions and methodologies.

The study was limited by data quality concerns and inconsistent definitions of long COVID. Nevertheless, the analysis highlights a significant burden of post-acute sequelae among frontline health professionals. The authors call for enhanced cohort study designs and standardized long COVID definitions to better understand its impact and guide effective mitigation strategies.

References

  1. Zheng X, Jiang M, Wang Y, et al. Effectiveness of BNT162b2 against long COVID in children and adolescents: a comparative effectiveness study and causal mediation analysis. EClinicalMedicine. 2024;69:102349. doi:10.1016/j.eclinm.2024.102962
  2. Branswell H. CDC vaccine advisers recommend expanded RSV vaccine use and two new vaccines. STAT. April 16, 2025. Accessed April 29, 2025. https://www.statnews.com/2025/04/16/cdc-acip-advisory-panel-recommends-expanded-rsv-and-two-new-vaccines/
  3. Kiang MV, Bubar KM, Maldonado Y, et al. Modeling reemergence of vaccine-eliminated infectious diseases under declining vaccination in the US. JAMA. Published online April 24, 2025. doi:10.1001/jama.2025.6495
  4. Al-Oraibi A, Woolf K, Naidu J, et al. Global prevalence of long COVID and its most common symptoms among healthcare workers: a systematic review and meta-analysis. BMJ Public Health. 2025;3:e000269. doi:10.1136/bmjph-2023-000269