Parent-reported asthma symptom prevalence and COVID vaccination association


Matthew M. Davis, MD, MAAP, breaks down a newly-published study highlighting a potential association between COVID-19 vaccination and prevalence of symptomatic childhood asthma.

A new study published in JAMA Network Open explored population-level, parent-reported childhood asthma symptom prevalence and COVID-19 vaccination, demonstrating that higher COVID-19 vaccination rates could offer protection against symptomatic asthma.

In this Contemporary Pediatrics interview, study author Matthew M. Davis, MD, MAAP, executive vice president, enterprise physician-in-chief and chief scientific officer, Nemours Children's Health, Wilmington, Delaware, breaks down the study, offering insight to design, patient groups, and outcomes.

"Asthma is one of the most common, chronic health conditions of childhood," said Davis. "We were very impressed that in the first year of the COVID-19 pandemic, the rates of childhood asthma decreased suddenly during the lockdown, where many children who had asthma were not in school, were not having exposures to different types of viruses that can cause things as simple as the common cold, that often cause asthma flares. We wanted to understand something that nobody had looked at before, which is, did the rates of asthma stay lower in 2021?"

Davis and co-author Lakshmi K. Halasyamani, MD, of Endeavor Health in Evanston, Illinois and the University of Chicago Pritzker School of Medicine in Chicago, Illinois, developed a cross-sectional study using publicly-available data. State-level data were used regarding the following:

  • Parent-reported current asthma symptom prevalence in their children (National Survey of Children’s Health, 2018-2019 and 2020-2021)
  • Age-adjusted COVID-19 mortality rates (US Centers for Disease Control and Prevention [CDC]; 2020 and 2021)
  • Proportion of population aged 5 years and older who completed the COVID-19 primary vaccination series in 2020 to 2021
  • Face mask requirements in enclosed spaces through August 2021

Davis and Halasyamani evaluated trend associations with concurrent state-level variables, with all analyses performed with StataSE version 16. Statistical significance was defined as two-tailed a=0.05.

"What we found [was] states that were able to achieve higher vaccination rates among adults and children, saw persistently lower rates of asthma symptoms among children in those same states," said Davis.

According to study results, the mean state-level prevalence of parent-reported asthma symptoms decreased from 7.77% (SD +/-1.54) in 2018-2019, to 6.93% (+/-1.39) in 2020-2021 (P < 0.001), with an absolute mean change score of -0.85 percentage points.

In addition, with each increase of 10 percentage points in COVID-19 vaccination coverage, childhood asthma symptom prevalence via parent report decreased by 0.36 percentage points (P < 0.05).

"I'm a general pediatrician myself, so I have many kids that I've treated for asthma over the years," Davis told Contemporary Pediatrics. "I believe that these latest findings indicate the continuing value of COVID-19 vaccination, even as we are seeing the epidemic and the transmission patterns change over time. We're seeing some suggestion of the benefit of COVID-19 vaccination for kids with asthma over that long time period."

Watch the 8-minute video with Matthew Davis, MD, at the top of this article for further discussion of the study and this association.


Davis MM, Halasyamani, LK. COVID-19 vaccination and parent-reported symptomatic child asthma prevalence. JAMA Network Open. July 3, 2024. Accessed July 3, 2024. doi:10.1001/jamanetworkopen.2024.19979.

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