Incidence and clinical phenotype of multisystem inflammatory syndrome in children after infection with the SARS-CoV-2 delta variant by vaccination status: a Danish nationwide prospective cohort study

Nygaard, Ulrikka; Holm, Mette; Hartling, Ulla Birgitte; Glenthøj, Jonathan; Schmidt, Lene Skytthe Kaarsberg; Nordly, Sannie Brit; Matthesen, Astrid Thaarup; Linstow, Marie‐Louise von; Espenhain, Laura

doi:10.1016/s2352-4642(22)00100-6

Cited by 70 publications

(78 citation statements)

References 18 publications

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“…37 In contrast, 113 cases of MIS-C were observed among one million SARS-CoV-2 infections in the same age group. 37 Evidence is starting to emerge that vaccination can reduce the risk of MIS-C. 38 Prevention of MIS-C is important because affected infants and adolescents may face long-term health sequalae that are not yet known. Neurological manifestations have been seen in about 20% of MIS-C patients.…”

Section: S E Vere D Is E a S E From Covid Doe S Not O Ccur Frequently...mentioning

confidence: 99%

Routine SARS‐CoV‐2 vaccination for all children*

Paris

Permar

2022

Immunological Reviews

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The SARS-CoV-2 pandemic has resulted in unprecedented health and economic losses. Children generally present with less severe disease from this virus compared with adults, yet neonates and children with COVID-19 can require hospitalization, and older children can develop severe complications, such as the multisystem inflammatory syndrome, resulting in >1500 deaths in children from COVID-19 since the onset of the pandemic. The introduction of effective SARS-CoV-2 vaccines in school-age children and adult populations combined with the emergence of new, more highly transmissible SARS-CoV-2 variants has resulted in a proportional increase of infections in young children. Here, we discuss (1) the current knowledge on pediatric SARS-CoV-2 infection and pathogenesis in comparison with adults, (2) the data on vaccine immunogenicity and efficacy in children, and (3) the benefits of early life SARS-CoV-2 vaccination. K E Y W O R D S children, infant immunity, MIS-C, SARS-CoV-2, vaccines *This article is part of a series of reviews covering SARS-CoV-2 Immunity appearing in Volume 309 of Immunological Reviews.

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Section: S E Vere D Is E a S E From Covid Doe S Not O Ccur Frequently...mentioning

confidence: 99%

Routine SARS‐CoV‐2 vaccination for all children*

Paris

Permar

2022

Immunological Reviews

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“…Left-ventricular dysfunction and shock are typical of MIS-C, and potential long-term sequelae, including coronary artery aneurysms, carry high risk of morbidity (9). Although therapies are available for MIS-C, the condition is vaccine preventable (9)(10)(11). A two-dose series of Pfizer-BioNTech was 91% (95% CI, 78%-97%) effective against MIS-C in a study of US adolescents and 94% (95% CI, 55%-99%) effective in a study of children and adolescents in Denmark (10,11).…”

Section: Mis-c Following Sars-cov-2 Infectionmentioning

confidence: 99%

“…Although therapies are available for MIS-C, the condition is vaccine preventable (9)(10)(11). A two-dose series of Pfizer-BioNTech was 91% (95% CI, 78%-97%) effective against MIS-C in a study of US adolescents and 94% (95% CI, 55%-99%) effective in a study of children and adolescents in Denmark (10,11). In the former study, none of the fully vaccinated adolescents with MIS-C required respiratory or cardiovascular support, as opposed to 39% of their unvaccinated counterparts (11).…”

Section: Mis-c Following Sars-cov-2 Infectionmentioning

confidence: 99%

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COVID-19 vaccines protect children of all ages

Amarin¹,

Hayek²,

Halasa³

2022

Journal of Clinical Investigation

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As of June 30, 2022, there have been 87,298,343 cases of coronavirus disease 2019 reported in the United States, of which approximately 17.4% occurred in children 0-17 years old (1). So far in 2022, individuals 0-19 years old have accounted for 23.6% of cases, a considerable increase, from 14.4%, throughout 2020 (Figure 1). The increasing case burden in children corresponds with differential vaccine access and uptake compared with adults, of whom the vast majority received an mRNA COVID-19 vaccine ref. 1). The first Emergency Use Authorization (EUA) for Pfizer-Bi-oNTech was issued on December 11, 2020, by the FDA, and it was the only available option for individuals 16 years and older (Figure 1 and ref. 2). It was not until May 10, 2021, almost 5 months later, that the FDA expanded the EUA for Pfizer-BioNTech to include adolescents 12-15 years old (Figure 1 and ref. 3). Some 6 months after that, on November 3, 2021, the US FDA amended the EUA to include children 5-11 years old (Figure 1 and refs. 1, 4). More than 1.5 years after the first EUA, on June 17, 2022, the Pfizer-BioNTech and Moderna COVID-19 vaccines were authorized for use in children 6 months and older (Figure 1 and ref. 5). Notably, Moderna had only been authorized for use in adults 18 years and older prior to the most recent EUA amendment (5).Despite the CDC recommendation that everyone 6 months and older get vaccinated against COVID-19, vaccine uptake has been suboptimal in children compared with adults; 63.4% of children 5-11 years old were unvaccinated as of June 30, 2022, as opposed to 30.0% of adolescents 12-17 years old and 10.1% of adults at aged 18 years and older (1). According to a systematic

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“…4 A small proportion of children have had serious sequelae of SARS-CoV-2 infection itself, with the most dramatic being multisystem inflammatory syndrome in children (MIS-C). 5 Furthermore, a less welldefined entity, termed long COVID or post-COVID-19 condition, has been suggested, referring to children with long-lasting symptoms after SARS-CoV-2 infection that are not explained by another disease. 6 In contrast to MIS-C, the symptoms attributed to long COVID are non-specific and occur frequently in otherwise healthy children; headache, mood swings, abdominal pain, and fatigue are all common, and, although they can be symptoms of a disease, they often are not.…”

mentioning

confidence: 99%

Difficult questions about long COVID in children

Rytter

2022

The Lancet Child & Adolescent Health

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Incidence and clinical phenotype of multisystem inflammatory syndrome in children after infection with the SARS-CoV-2 delta variant by vaccination status: a Danish nationwide prospective cohort study

Cited by 70 publications

References 18 publications

Routine SARS‐CoV‐2 vaccination for all children*

Routine SARS‐CoV‐2 vaccination for all children*

COVID-19 vaccines protect children of all ages

Difficult questions about long COVID in children

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