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COVID-19 vaccination was associated with a decrease in the prevalence of parent-reported asthma symptoms among kids, according to a cross-sectional study.

A linear regression analysis showed that with each increase of 10 percentage points in COVID vaccination coverage, parent-reported child asthma symptom prevalence decreased by 0.36 percentage points (P=0.04), reported Matthew M. Davis, MD, MAPP, of Nemours Children's Health in Wilmington, Delaware, and Lakshmi K. Halasyamani, MD, of the University of Chicago Pritzker School of Medicine.

Mean state-level prevalence of parent-reported childhood asthma symptoms decreased from 7.77% in 2018-2019 to 6.93% in 2020-2021 (P<0.001), they noted in a research letter in .

"COVID-19 vaccination yields prophylactic benefits against SARS-CoV-2 infection for individual children and may also protect against other human coronaviruses through cross-reactive antibody responses," they wrote. "Community-level immunity in states with higher vaccination rates may have helped reduce children's asthma risk."

Sindhura Bandi, MD, of Rush University in Chicago, told MedPage Today that the results of this study were not surprising.

"Vaccination reduces infection rates as well as severity of illness. Respiratory viruses, like COVID-19, are known triggers of asthma," she said via email. "Just as with other respiratory viruses, such as influenza, these data further support our recommendations to vaccinate, particularly those with comorbid conditions such as asthma."

State-level COVID vaccination rates were inversely correlated with the state-level COVID mortality rate in 2021 (r = -0.75; P<0.001) but not in 2020 (r = -0.20; P=0.16), and were positively correlated with face mask mandates (r=0.49; P<0.001).

While asthma was considered to be a risk factor for COVID infection and hospitalization early in the pandemic, it was unclear whether symptomatic asthma among children was associated with population-level COVID exposure or mitigation strategies, Davis and Halasyamani said.

Carey Lumeng, MD, PhD, of the C.S. Mott Children's Hospital at the University of Michigan in Ann Arbor, told MedPage Today that these findings support his current practices for vaccinating kids against COVID.

"Would it change what I do right now? Probably not, because I still recommend COVID vaccination for all my pediatric patients, along with the CDC guidelines for everybody over 6, and I especially encourage it for my patients with asthma, because I definitely think that if we can do anything to mitigate exacerbations ... that can be beneficial," he said.

Lumeng explained that the various strains and mutations of SARS-CoV-2, along with public health factors like changes in masking, have likely affected the disease burden from respiratory illnesses since the onset of the pandemic.

"I would say that, at least here in Michigan, we're seeing that the viral respiratory season doesn't really seem to end," he noted. "And it used to be confined to really the wintertime, but we're seeing lots of children admitted for viruses we wouldn't usually see in the summer rearing their heads now in the hospital."

For this study, Davis and Halasyamani used state-level data on parent-reported current asthma symptom prevalence in their children from the National Survey of Children's Health for 2018-2019 and 2020-2021; CDC data on age-adjusted COVID mortality rates in 2020 and 2021 and on the proportion of children ages 5 years and older who completed their primary vaccination series in 2020-2021; and data on face mask requirements for enclosed spaces through August 2021 from 20 states and the District of Columbia.

The mean state-level COVID primary series vaccination rate through December 2021 was 72.3%. The mean age-adjusted state-level COVID mortality rate was 80.3 per 100,000 population in 2020, increasing to 99.3 per 100,000 population in 2021.

State-level estimates of COVID vaccination rates in children who have a history of asthma were not available, which was a key limitation to the study, since the researchers could not assess for differences in symptomatic asthma among vaccinated versus unvaccinated children.

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