Benefit-Risk Ratio of the Abdala Anti-COVID-19 Vaccine Administered to Children and Adolescents

Authors

Keywords:

Abdala vaccine; risk; benefit; Bayes.

Abstract

Introduction: The benefit-risk assessment of vaccines in pediatric populations is urgent and necessary in normal times; during a pandemic, it responds to the need to demonstrate that vaccines are effective, safe, or that their benefit-risk ratio is favorable.

Objective: To demonstrate the benefit-risk ratio of the Abdala anti-COVID-19 vaccine administered to children and adolescents.

Methods: A phase 2, single-center, uncontrolled clinical trial was conducted with the Abdala anti-COVID-19 vaccine between September and November 2021 in Havana. A total of 703 subjects aged 3 to 18 years, healthy or with controlled chronic diseases, were included. For the benefit-risk analysis, the following events were considered: for benefit, the number of subjects with seroconversion of SARS-CoV-2 anti-RBD IgG antibodies (seroconversion was defined as a ≥4-fold increase from the initial antibody titer); and for risk, the number of individuals with at least one adverse event. The Bayes factor was used as the decision criterion. If the benefit-to-risk ratio was greater than one, there was evidence in favor of benefit.

Results: Favorable results were obtained showing benefit over risk. Ninety-eight percent had positive seroconversion, and only 264 individuals had at least one adverse event (37.6%), which occurred most frequently after the first dose, were mild in intensity, and were local in nature.

Conclusions: The Abdala vaccine has a benefit-risk ratio favoring benefit in children and adolescents.

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References

1. Vázquez-Romero JE, Romeu-Álvarez B. Vacunas anti-COVID-19: una mirada desde la perspectiva reguladora. Vaccimonitor. 2022 [acceso 10/12/2023];31(2):90-9. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1025-028X2022000200090&lng=es

2. Van der Steen M, Leroy PL, Driessen GJA, Bannier MAGE. COVID-19 in children and adolescents: MIS(-C)-taken diagnoses. Eur J Pediatr. 2022;181(9):3549-54. DOI: https://doi.org/10.1007/s00431-022-04562-0

3. Quezada A. Los orígenes de la vacuna. Rev Med Clin CONDES. 2020;31(3-4):367-73. DOI: https://doi.org/10.1016/jrmclc.2020.07.002

4. Sociedad Latinoamericana de Infectología Pediátrica. Guía sobre vacunación para COVID en niños. 2023 [acceso 03/07/2023]. Disponible en: https://slipe.org/web/wp-content/uploads/2023/04/Publicacion-vacunas-covid-ninios.pdf

5. Puga R. Vacunas cubanas contra la COVID-19 para niños. Rev MEDICC. 2022;24(1):14-8. DOI: https://doi.org/10.37757/MR2022.V24.N1.12

6. Hernández F, Ricardo MC, Martín Y, Rodríguez E, Urrutia K, Urrutia K, et al. A phase 3, randomised, double-blind, placebo-controlled clinical trial evaluation of the efficacy and safety of a SARS-CoV-2 recombinant spike RBD protein vaccine in adults (ABDALA-3 study). Lancet Reg Health Am. 2023 [acceso 02/07/2023];21:100497. Disponible en: https://www.thelancet.com/journals/lanam/article/PIIS2667-193X(23)00071-6/fulltext#secsectitle0110

7. Fonseca M, Casanova M, Chávez D, Toledo M, Díaz L, Geroy E. Características clínicas de pacientes en edad pediátrica con COVID-19 en diferentes momentos epidemiológicos. Cienfuegos (2020-2022). Rev Cubana Pediatr. 2023 [acceso 13/11/2023];95:e4073. Disponible en: https://revpediatria.sld.cu/index.php/ped/article/view/4073

8. López LR. COVID-19 cuadro clínico y epidemiológico. Simposio Nacional de Enfermedades Infecciosas en Niños y Adolescentes; 2023 20-24 febr; Infomed, Portal de la Red de la Salud de Cuba. Instituto de Medicina Tropical Pedro Kourí. 2023 [acceso 13/11/2023]. Disponible en: https://promociondeeventos.sld.cu/pediatriaipk/

9. Bravo Ramírez M, Morales Peralta E, Zúñiga Rosales Y, Roblejo Balbuena H, González Torres MA, Álvarez Gavilán Y, et al. Primer brote de COVID-19 en pacientes pediátricos cubanos Rev Cubana Pediatr. 2021 [acceso 17/09/2021];93(supl. especial):e1514. Disponible en: https://revpediatria.sld.cu/index.php/ped/article/view/1514

10. Software R, versión 3.6.2. 2018 [acceso 17/09/2021]. Disponible en: https://cran.rproject.org/bin/windows/base/old/3.6.2

11. Rendón ME, Riojas A, Contreras D, Martínez JD. Análisis bayesiano. Conceptos básicos y prácticos para su interpretación y uso. Rev Alerg Mex. 2018 [acceso 16/09/2023];65(3):285-98. Disponible en: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S2448-91902018000300205&lng=es

12. Registro Público Cubano de Ensayos Clínicos. Seguridad e inmunogenicidad de la vacuna Abdala en edades pediátricas. (COVID-19). Estudio MEÑIQUE. La Habana, Cuba. 2021 [acceso 20/08/2023]. Disponible en: https://rpcec.sld.cu/ensayos/RPCEC00000390-Sp

13. Pérez Y, Arce A, Macias C. Respuesta de anticuerpos en la enfermedad por coronavirus 2019. Rev Cubana Hematol Inmunol Hemoter. 2020 [acceso 14/09/2023];36:e1267. Disponible en: https://revhematologia.sld.cu/index.php/hih/article/view/1267

14. Sánchez P, García D, Sánchez M, Mendoza G, Portela M. Utilidad diagnóstica de pruebas rápidas para detectar anticuerpos IgG/IgM anti-COVID-19. Medisur. 2022 [acceso 08/03/2023];20(2). Disponible en: http://medisur.sld.cu/index.php/medisur/article/view/5230

15. Fougère Y, Schwob JM, Miauton A, Hoegger F, Opota O, Jaton K, et al. Performance of RT-PCR on Saliva Specimens Compared with Nasopharyngeal Swabs for the Detection of SARS-CoV-2 in Children: A Prospective Comparative Clinical Trial. Pediatr Infect Dis J. 2021;40(8):e3004. DOI: https://doi.org/10.1097/INF.0000000000003198

16. Cinza Z, Resik S, Figueroa NL, Oquendo R, Campa I, Tejeda A, et al. Immunogenicity and safety assessment of a SARS-CoV-2 recombinant spike RBD protein vaccine (Abdala) in pediatrics ages 3-18 years old: a double-blinded, multicenter, randomised, study. EClinicalMedicine. 2023;63:102160. DOI: https://doi.org/10.1016/j.eclinm.2023.102160

17. Puga-Gómez R, Ricardo-Delgado Y, Rojas-Iriarte C, Céspedes-Henriquez L, Piedra-Bello M, Vega-Mendoza D, et al. SOBERANA Research Group (2023). Open-label phase I/II clinical trial of SARS-CoV-2 receptor binding domain-tetanus toxoid conjugate vaccine (FINLAY-FR-2) in combination with receptor binding domain-protein vaccine (FINLAY-FR-1A) in children. Int J Infect Dis. 2023;126:164-73. DOI: https://doi.org/10.1016/j.ijid.2022.11.016

18. Du Y, Chen L, Shi Y. Safety, Immunogenicity and Efficacy of COVID-19 Vaccines in Adolescents, Children, and Infants: A Systematic Review and Meta-Analysis. Front Public Health. 2022;10:829176. DOI: https://doi.org/10.3389/fpubh.2022.829176

19. Creech CB, Anderson EJ, Berthaud V, Yildirim I, Atz AM, Melendez I, et al. Evaluation of mRNA-1273 Covid-19 Vaccine in Children 6 to 11 Years of Age. NEJM. 2022;386(21):2011-23. DOI: https://doi.org/10.1056/NEJMoa2203315

20. Frenck RW, Klein NP, Kitchin N, Gurtman A, Absalon J, Lockhart S, et al. Seguridad, inmunogenicidad y eficacia de la vacuna BNT162b2 Covid-19 en adolescentes. NEJM. 2021;385(3):239‐50. DOI: https://doi.org/10.1056/NEJMoa2107456

21. Aarons DE. Explorando el equilibrio riesgo/beneficio en la investigación biomédica: algunas consideraciones. Rev Bioética. 2017 [acceso 15/11/2023];25(2):320-7. Disponible en: https://www.redalyc.org/articulo.oa?id=361552153013

22. Kochhar S, Izurieta HS, Chandler RE, Hacker A, Chen RT, Levitan B. Benefit-risk assessment of vaccines. Vaccine. 2024 6;42(4):969-71. DOI: https://doi.org/10.1016/j.vaccine.2023.07.041

23. Sinclair JE, Mayfield HJ, Short KR, Brown SJ, Puranik R, Mengersen K, et al. A Bayesian network analysis quantifying risks versus benefits of the Pfizer COVID-19 vaccine in Australia. NPJ Vaccines. 2022;7(1):93. DOI: https://doi.org/10.1038/s41541-022-00517-6

24. Manual de vigilancia de eventos supuestamente atribuibles a la vacunación inmunización en la Región de las Américas. Washington, D. C.: Organización Panamericana de la Salud; 2021. DOI: https://doi.org/10.37774/9789275323861

25. Más-Bermejo PI, Dickinson FO, Almenares K, Sánchez L, Guinovart R, Vidal M, et al. Cuban Abdala vaccine: Effectiveness in preventing severe disease and death from COVID-19 in Havana, Cuba; A cohort study. Lancet Reg Health Am. 2022;16:100366. DOI: https://10.1016/j.lana.2022.100366

26. Palacios SGC, Rivera MLG, Reyes GNL, Alonso TC, Vázquez G, Solórzano S, et al. Inmunidad de rebaño: a propósito de la COVID-19. Enf Infec Microbiol. 2022 [acceso 03/01/2023];42(2):61-70. Disponible en: https://www.medigraphic.com/pdfs/micro/ei-2022/ei222d.pdf

27. Cairney P. The UK government's COVID-19 policy: assessing evidence-informed policy analysis in real time. Br Politics. 2021;16(1):90-116. DOI: https://doi.org/10.1057/s41293-020-00150-8

Published

2026-04-27

How to Cite

1.
Alvaré Alvaré LE, Felipe Mallea D, Salvato Dueñas A, Porta Díaz M, Abijana Rodríguez MI, Portuondo Leyva R, et al. Benefit-Risk Ratio of the Abdala Anti-COVID-19 Vaccine Administered to Children and Adolescents. Rev Cubana Pediatría [Internet]. 2026 Apr. 27 [cited 2026 May 9];98. Available from: https://revpediatria.sld.cu/index.php/ped/article/view/8247