BNT162b2 mRNA Vaccination Against Coronavirus Disease 2019 is Associated With a Decreased Likelihood of Multisystem Inflammatory Syndrome in Children Aged 5–18 Years—United States, July 2021 – April 2022

Olson, Samantha M; Kong, Michele; Murdock, Meghan; Gaspers, Mary Glas; Typpo, Katri; Kelley, Connor P; Irby, Katherine; Sanders, Ronald C.; Yates, Masson; Smith, Chelsea; Cameron, Melissa A; Crane, Katheryn; Cvijanovich, Natalie Z.; Lionetti, Geraldina; Murcia-Montoya, Juliana; Zinter, Matt S; Villarreal-Chico, Denise; Pannaraj, Pia S.; Skura, Adam L.; Hakimi, Daniel; Peralta, Harvey; Sea, Yea Ji; Mrotek, Kennis-Grace; Maddux, Aline B; Lockwood, Justin; Port, Emily; Carson, Imogene; Chatani, Brandon; Kamidani, Satoshi; Tarquinio, Keiko M.; Hussaini, Laila; Baida, Nadine; Michelson, Kelly; Coates, Bria M.; Rhodes, Simone T.; Khan, Hassan; Bhumbra, Samina; Rowan, Courtney M.; Stumpf, Mary; Bradford, Tamara T; Johnston, Marla S.; Randolph, Adrienne G.; Newhams, Margaret M; Kucukak, Suden; Orzel, Amber O; Young, Cameron C; Chen, Sabrina R; Boutselis, Benjamin J; McCadden, Timothy P; Stewart, Kasey R; Weller, Edie; Berbert, Laura; He, Jie; Heidemann, Sabrina M.; Flori, Heidi R.; Moran, Patrick; Hume, Janet R.; Bruno, Ellen R.; Goertzen, Lexie A.; Levy, Emily R.; Behl, Supriya; Drapeau, Noelle M.; Hobbs, Charlotte V.; Martin, Lora; Malloch, Lacy; Harrison, Virginia A.; Sanders, Cameron; Patterson, Kayla; Chikere, Chidinma A; Schuster, Jennifer E; Kietzman, Abigail; Sullivan, Melissa; Cullimore, Melissa L; Rinehart, Valerie H.; Hoody, Lauren A.; Gertz, Shira J.; Schwartz, Stephanie P; Walker, Tracie C; Bennett, Paris C.; Nofziger, Ryan A; Twinem, Nicole A.; Tomcany, Merry L.; Staat, Mary Allen; Rohlfs, Chelsea C.; Bline, Katherine; Wolfe, Amber; Chiotos, Kathleen; Douglas, Rebecca L.; Phengchomphet, Kathlyn; Mack, Elizabeth H.; Bickford, Megan M.; Wakefield, Lauren E; Smallcomb, Laura; Halasa, Natasha; Hayek, Haya; Romero, Yesenia; Boom, Julie A.; Sahni, Leila C; Oates, Jennifer N.; Maamari, Mia; Bowens, Cindy Darnell; Crandall, Hillary; Olson, M; Price, Ashley M; Zambrano, Laura D.; Campbell, Angela P; Patel, Manish

doi:10.1093/cid/ciac637

Cited by 34 publications

(29 citation statements)

References 23 publications

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“…COVID-19 vaccination became available for adolescents and children during 2021, but most vaccine-eligible patients were unvaccinated. COVID-19 vaccination is effective at preventing hospitalization for acute COVID-19 and MIS-C and may decrease associated neurologic complications.…”

Section: Discussionmentioning

confidence: 99%

Changes in Distribution of Severe Neurologic Involvement in US Pediatric Inpatients With COVID-19 or Multisystem Inflammatory Syndrome in Children in 2021 vs 2020

et al. 2023

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ImportanceIn 2020 during the COVID-19 pandemic, neurologic involvement was common in children and adolescents hospitalized in the United States for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–related complications.ObjectiveTo provide an update on the spectrum of SARS-CoV-2–related neurologic involvement among children and adolescents in 2021.Design, Setting, and ParticipantsCase series investigation of patients reported to public health surveillance hospitalized with SARS-CoV-2–related illness between December 15, 2020, and December 31, 2021, in 55 US hospitals in 31 states with follow-up at hospital discharge. A total of 2253 patients were enrolled during the investigation period. Patients suspected of having multisystem inflammatory syndrome in children (MIS-C) who did not meet criteria (n = 85) were excluded. Patients (&lt;21 years) with positive SARS-CoV-2 test results (reverse transcriptase–polymerase chain reaction and/or antibody) meeting criteria for MIS-C or acute COVID-19 were included in the analysis.ExposureSARS-CoV-2 infection.Main Outcomes and MeasuresPatients with neurologic involvement had acute neurologic signs, symptoms, or diseases on presentation or during hospitalization. Life-threatening neurologic involvement was adjudicated by experts based on clinical and/or neuroradiological features. Type and severity of neurologic involvement, laboratory and imaging data, vaccination status, and hospital discharge outcomes (death or survival with new neurologic deficits).ResultsOf 2168 patients included (58% male; median age, 10.3 years), 1435 (66%) met criteria for MIS-C, and 476 (22%) had documented neurologic involvement. Patients with neurologic involvement vs without were older (median age, 12 vs 10 years) and more frequently had underlying neurologic disorders (107 of 476 [22%] vs 240 of 1692 [14%]). Among those with neurologic involvement, 42 (9%) developed acute SARS-CoV-2–related life-threatening conditions, including central nervous system infection/demyelination (n = 23; 15 with possible/confirmed encephalitis, 6 meningitis, 1 transverse myelitis, 1 nonhemorrhagic leukoencephalopathy), stroke (n = 11), severe encephalopathy (n = 5), acute fulminant cerebral edema (n = 2), and Guillain-Barré syndrome (n = 1). Ten of 42 (24%) survived with new neurologic deficits at discharge and 8 (19%) died. Among patients with life-threatening neurologic conditions, 15 of 16 vaccine-eligible patients (94%) were unvaccinated.Conclusions and RelevanceSARS-CoV-2–related neurologic involvement persisted in US children and adolescents hospitalized for COVID-19 or MIS-C in 2021 and was again mostly transient. Central nervous system infection/demyelination accounted for a higher proportion of life-threatening conditions, and most vaccine-eligible patients were unvaccinated. COVID-19 vaccination may prevent some SARS-CoV-2–related neurologic complications and merits further study.

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Section: Discussionmentioning

confidence: 99%

Changes in Distribution of Severe Neurologic Involvement in US Pediatric Inpatients With COVID-19 or Multisystem Inflammatory Syndrome in Children in 2021 vs 2020

et al. 2023

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“…Furthermore, children have been identified as an important source of household and community transmission [ 13 , 14 ]. Critically, vaccination is a protective factor [ 15 , 16 , 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

Vaccinating Children against SARS-CoV-2: A Literature Review and Survey of International Experts to Assess Safety, Efficacy and Perceptions of Vaccine Use in Children

et al. 2022

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Introduction: The balance of risks and benefits of COVID-19 vaccination in children is more complex than in adults with limited paediatric data resulting in no global consensus on whether all healthy children should be vaccinated. We sought to assess the safety, efficacy, and effectiveness of childhood vaccination against SARS-CoV-2, as well as better understanding perceptions of vaccination in parents and vaccine experts. Methods: We performed a literature review for COVID-19 vaccine safety, efficacy, effectiveness, and perceptions. We searched international safety databases for safety data and developed an electronic survey to elicit country-specific COVID-19 immunisation data, including vaccine regulations, policies, rates, and public attitudes solicited from vaccine experts. Results: Nine studies were included in the final safety analysis. Local reactions were frequently reported across all studies and vaccine types. Adverse events reported to surveillance systems tended to be non-serious, and commonly included injection site reactions and dizziness. Twenty-three studies reported immunogenicity, efficacy, and effectiveness data. There were nine randomised control trials of six different vaccine types, which showed seroconversion of neutralising antibodies in vaccinated children ranging from 88% to 100%. The vaccine efficacy for Pfizer and Moderna vaccines ranged from 88% to 100%. There were 118 survey responses representing 55 different countries. Reported vaccination rates ranged from <1% to 98%. Most respondents described “mixed opinions” regarding paediatric vaccination policies in their country. By region, a more positive public attitude towards vaccination correlated with higher vaccination rates. Discussion: In this mixed-methods review, we have found evidence that vaccination against COVID-19 in children is safe, efficacious, and effective. Overall, the combined evidence from both the literature review and survey highlights the need for further data on both the safety and effectiveness of COVID-19 vaccinations in children.

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“…63 To date, the only known strategy to prevent MIS-C is to avoid infection in the first place, which can be achieved through immunization. 64,65…”

Section: Multisystem Inflammatory Syndrome In Childrenmentioning

confidence: 99%

Clinical Epidemiology of Pediatric Coronavirus Disease 2019 and its Postacute Sequelae

Habet

Oliveira

2023

Semin Respir Crit Care Med

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The coronavirus disease 2019 (COVID-19) pandemic has affected individuals of all ages across. Although children generally experience a benign illness from COVID-19, the emergence of novel variants of the virus has resulted in significant changes in the morbidity and mortality rates for this age group. Currently, COVID-19 is the eighth leading cause of pediatric deaths in the United States. In addition to acute respiratory illness, some children can develop a severe postinfectious condition known as a multisystem inflammatory syndrome in children, which can progress to rapid-onset cardiogenic shock. Recovery from COVID-19 can also be slow for some children, resulting in persistent or reoccurring symptoms for months, commonly referred to as long COVID. These postinfectious sequelae are often distressing for children and their parents, can negatively impact the quality of life, and impose a considerable burden on the health care system. In this article, we review the clinical epidemiology of pediatric COVID-19 and outline the management considerations for its acute and postacute manifestations.

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BNT162b2 mRNA Vaccination Against Coronavirus Disease 2019 is Associated With a Decreased Likelihood of Multisystem Inflammatory Syndrome in Children Aged 5–18 Years—United States, July 2021 – April 2022

Cited by 34 publications

References 23 publications

Changes in Distribution of Severe Neurologic Involvement in US Pediatric Inpatients With COVID-19 or Multisystem Inflammatory Syndrome in Children in 2021 vs 2020

Changes in Distribution of Severe Neurologic Involvement in US Pediatric Inpatients With COVID-19 or Multisystem Inflammatory Syndrome in Children in 2021 vs 2020

Vaccinating Children against SARS-CoV-2: A Literature Review and Survey of International Experts to Assess Safety, Efficacy and Perceptions of Vaccine Use in Children

Clinical Epidemiology of Pediatric Coronavirus Disease 2019 and its Postacute Sequelae

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