Abstract
Background: Multisystem inflammatory syndrome in children (MIS-C), linked to antecedent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is associated with considerable morbidity. Prevention of SARS-CoV-2 infection or coronavirus disease 2019 (COVID-19) by vaccination might also decrease MIS-C likelihood. 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.
Original language | English (US) |
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Pages (from-to) | E90-E100 |
Journal | Clinical Infectious Diseases |
Volume | 76 |
Issue number | 3 |
DOIs | |
State | Published - Feb 1 2023 |
Externally published | Yes |
Keywords
- COVID-19
- MIS-C
- Pfizer (BioNTech)
- children
- vaccine effectiveness
ASJC Scopus subject areas
- Microbiology (medical)
- Infectious Diseases