Findings from a study in the journal Nature Communications suggests that cross-reactive immunity against the Omicron variant is low among pediatric patients with prior COVID-19 infection or multisystem inflammatory syndrome in children (MIS-C).

The researchers examined virus-neutralizing capacity against the SARS-CoV-2 Alpha, Beta, Gamma, Delta, and Omicron variants in 177 pediatric patients hospitalized with severe acute COVID-19 or acute MIS-C and in convalescent samples of outpatients with mild COVID-19 during 2020 and early 2021.

The researchers discovered that fewer than 10% of all patients showed neutralizing antibody titers against Omicron. Lower neutralizing antibodies to SARS-CoV-2 variants were observed in pediatric patients aged younger than 5 years versus those aged older than 5 years.

Researchers noted that when compared with hospitalized, acute COVID-19 patients, convalescent pediatric COVID-19 and MIS-C cohorts had greater neutralization titers. Some loss of cross-neutralization was observed against all variants, with the most pronounced loss against the Omicron variant.

Pediatric patients receiving two doses of an mRNA COVID-19 vaccine had higher titers against the Alpha, Beta, Gamma, Delta, and Omicron variants than those with previous SARS-CoV-2 infection.

The authors concluded, "Our study highlights the importance of vaccinating children and younger adolescents even with preexisting antibody immunity by an earlier SARS-CoV-2 strain to prevent severe disease in children from Omicron and future infections. These findings have direct implications for developing age-targeted strategies for testing, disease mitigation, vaccination, and protecting this vulnerable population."

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