265 Evaluating the safety and effectiveness of the COVID-19 vaccination among pediatric atopic dermatitis patients

Atopic dermatitis (AD) is a systemic inflammatory disease and the most common skin disorder among children. It has been found to be associated with several comorbidities. As COVID-19 cases continue to surge worldwide, especially among children, we aim to study the safety profile and efficacy of the COVID-19 vaccine in AD children, a topic with little data thus far. A retrospective analysis was done using TriNetX, a multicenter database of ∼80 million deidentified records. Children (<18 years) who were vaccinated with the BNT162b2 vaccine up to November 15^th, 2021 were identified and split into AD and non-AD cohorts. A 1:1 matched propensity score analysis was conducted, adjusting for comorbidities and demographics, to generate adjusted risk ratios (aRR) and hazard ratios (aHR) with 95% CI for safety and efficacy outcomes respectively. Safety outcomes included 1-day anaphylaxis and 60-day follow-up for all-cause hospitalization, and FDA-defined adverse events of special interest (AESI). Efficacy was measured as 60-day risk of breakthrough infection (BI). From the 73,984 children who received a COVID-19 vaccine, 6% had AD. A matched cohort of 4505 AD children revealed no differences in safety outcomes for 1 day anaphylaxis (aRR[95%CI]=1.03[0.4,2.4]), 60-day hospitalization (1.25[0.6,2.7]) and AESI (1.02[0.3,2.4]) between cohorts. Additionally AD children did not have a higher risk of BI (aHR[95%CI]=1.7[0.8,3.3]) compared to controls. The results show that the COVID-19 vaccine is safe and effective for pediatric AD patients. Further research is warranted to examine if severity of AD could increase risk of adverse events.