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.
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Zambrano Laura D, Newhams Margaret M, Olson Samantha M, Halasa Natasha B, Price Ashley M, Orzel Amber O, Young Cameron C, Boom Julie A, Sahni Leila C, Maddux Aline B, Bline Katherine E, Kamidani Satoshi, Tarquinio Keiko M, Chiotos Kathleen, Schuster Jennifer E, Cullimore Melissa L, Heidemann Sabrina M, Hobbs Charlotte V, Nofziger Ryan A, Pannaraj Pia S, Cameron Melissa A, Walker Tracie C, Schwartz Stephanie P, Michelson Kelly N, Coates Bria M, Flori Heidi R, Mack Elizabeth H, Smallcomb Laura, Gertz Shira J, Bhumbra Samina S, Bradford Tamara T, Levy Emily R, Kong Michele, Irby Katherine, Cvijanovich Natalie Z, Zinter Matt S, Bowens Cindy, Crandall Hillary, Hume Janet R, Patel Manish M, Campbell Angela P, Randolph Adrienne G, Overcoming COVID-19 Investigators
Аннотация
METHODS: In a multicenter, case-control, public health investigation of children ages 5-18 years hospitalized from 1 July 2021 to 7 April 2022, we compared the odds of being fully vaccinated (2 doses of BNT162b2 vaccine ≥28 days before hospital admission) between MIS-C case-patients and hospital-based controls who tested negative for SARS-CoV-2. These associations were examined by age group, timing of vaccination, and periods of Delta and Omicron variant predominance using multivariable logistic regression.
RESULTS: We compared 304 MIS-C case-patients (280 [92%] unvaccinated) with 502 controls (346 [69%] unvaccinated). MIS-C was associated with decreased likelihood of vaccination (adjusted OR [aOR]: .16; 95% CI: .10-.26), including among children ages 5-11 years (aOR: .22; 95% CI: .10-.52), ages 12-18 years (aOR: .10; 95% CI: .05-.19), and during the Delta (aOR: .06; 95% CI: .02-.15) and Omicron (aOR: .22; 95% CI: .11-.42) variant-predominant periods. This association persisted beyond 120 days after the second dose (aOR: .08; 95% CI: .03-.22) in 12-18-year-olds. Among all MIS-C case-patients, 187 (62%) required intensive care unit admission and 280 (92%) vaccine-eligible case-patients were unvaccinated.
CONCLUSIONS: Vaccination with 2 doses of BNT162b2 is associated with reduced likelihood of MIS-C in children ages 5-18 years. Most vaccine-eligible hospitalized patients with MIS-C were unvaccinated.