COVID-19 vaccination reduces childhood asthma symptoms

In a recently published study, JAMA Network OpenResearchers are investigating associations between population-level COVID-19 mitigation strategies, such as vaccination rates and mask mandates, and the prevalence of symptomatic asthma in children.

study: COVID-19 vaccination and parent-reported prevalence of childhood asthmaImage credit: SeventyFour / Shutterstock.com

COVID-19 and its impact on children with asthma

Asthma was initially thought to be a significant risk factor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and subsequent hospitalization with COVID-19, and medical experts were concerned that children with asthma might be particularly vulnerable during the pandemic.

Various measures that promoted or enforced social distancing during the early stages of the pandemic were found to be effective in reducing asthma-related emergency department visits and hospitalizations in children. Similarly, vaccination efforts in 2020 and 2021 significantly reduced the risk of SARS-CoV-2 infection in both children and adults.

COVID-19 vaccination may confer additional protective benefits, such as reducing asthma symptoms. However, these potential effects have not been studied. Furthermore, the relationship between COVID-19 illness exposure, mitigation strategies, and symptomatic asthma in children remains unclear.

About the Research

The researchers used a cross-sectional study design and publicly available data to examine state-level trends and associations to better understand how public health measures during the COVID-19 pandemic have affected children's asthma symptoms.

The analysis included data on the prevalence of asthma symptoms in children as reported by parents through the National Survey of Children's Health in 2018 to 2019 and 2020 to 2021. These data were collected at the state level.

Additional data included age-adjusted COVID-19 mortality rates from the Centers for Disease Control and Prevention (CDC) for 2020 and 2021, the percentage of the population aged 5 years and older who have received primary COVID-19 vaccination, and state-level mask mandates in enclosed spaces through August 2021.

Changes in state-level prevalence of parent-reported childhood asthma symptoms were recorded between 2018–2019 and 2020–2021. Time trends for these symptoms were then assessed using statistical tests, and associations of trends with other state-level covariates were determined using pairwise linear regression and pairwise correlation analyses.

research result

The average rate of childhood asthma symptoms decreased significantly, from 7.8% in 2018-2019 to 6.9% in 2020-2021, an overall decrease of 0.85 percentage points. Notably, this decrease occurred amid significant public health efforts to control COVID-19, including widespread vaccination and mask mandates.

During the same time period, the average state-level COVID-19 death rate increased from 80.3 to 99.3 per 100,000 in 2020 and 2021, respectively. By December 2021, state-level COVID-19 vaccination coverage averaged 72.3%.

Linear regression analysis showed that for every 10 percentage point increase in COVID-19 vaccination coverage, parent-reported rates of childhood asthma symptoms decreased by 0.4 percentage points, but no significant associations were found between asthma symptoms and COVID-19 mortality or state-level mask mandates.

State-level COVID-19 vaccination rates were negatively correlated with COVID-19 mortality in 2021, but not in 2020. In comparison, mask mandates were positively correlated with higher vaccination rates.

These findings suggest that increasing vaccination rates may have broader health benefits beyond preventing COVID-19, potentially reducing the incidence of asthma symptoms in children.

Conclusion

Higher COVID-19 vaccination rates were associated with fewer parent-reported childhood asthma symptoms, but no significant correlation was found between state-level COVID-19 mortality rates and mask mandates.

The findings highlight the importance of vaccination in reducing health risks during the pandemic: widespread uptake of COVID-19 vaccines also appears to have broader health benefits, such as reducing the prevalence of childhood asthma symptoms.

Notable strengths of the current study are its use of comprehensive state-level data and focus on population-level trends. However, major limitations include a lack of specific data on vaccination rates in children with asthma and an inability to directly compare vaccinated and unvaccinated children.

Future studies should further explore this relationship and evaluate whether ongoing vaccination efforts against COVID-19 can continue to alleviate asthma symptoms in children. Continued public health strategies are also needed to address chronic diseases during the pandemic and highlight the role of vaccination in protecting vulnerable populations.