scholarly journals Effectiveness of BNT162b2 (Pfizer-BioNTech) mRNA Vaccination Against Multisystem Inflammatory Syndrome in Children Among Persons Aged 12–18 Years — United States, July–December 2021

2022 ◽  
Vol 71 (2) ◽  
Author(s):  
Laura D. Zambrano ◽  
Margaret M. Newhams ◽  
Samantha M. Olson ◽  
Natasha B. Halasa ◽  
Ashley M. Price ◽  
...  
Keyword(s):  
United States ◽  
Inflammatory Syndrome

scholarly journals COVID-19 and Treatment and Immunization of Children—The Time to Redefine Pediatric Age Groups is Here

2021 ◽  
Vol 12 (2) ◽  
pp. e0010
Author(s):  
Klaus Rose ◽  
◽  
Jane M. Grant-Kels ◽  
Earl B. Ettienne ◽  
Oishi Tanjinatus ◽  
...  
Keyword(s):  
United States ◽  
Age Groups ◽  
Drug Approval ◽  
The United States ◽  
The Body ◽  
Kawasaki Syndrome ◽  
Pediatric Age ◽  
Prevention And Treatment ◽  
Control And Prevention ◽  
Inflammatory Syndrome

Children are infected with coronavirus disease 2019 (COVID-19) as often as adults, but with fewer symptoms. During the first wave of the COVID-19 pandemic, multisystem inflammatory syndrome (MIS) in children (MIS-C), with symptoms similar to Kawasaki syndrome, was described in young minors testing positive for COVID-19. The United States (US) Centers for Disease Control and Prevention (CDC) defined MIS-C as occurring in <21-year-olds, triggering hundreds of PubMed-listed papers. However, postpubertal adolescents are no longer children biologically; the term MIS-C is misleading. Furthermore, MIS also occurs in adults, termed MIS-A by the CDC. Acute and delayed inflammations can be triggered by COVID-19. The 18th birthday is an administrative not a biological age limit, whereas the body matures slowly during puberty. This blur in defining children leads to confusion regarding MIS-C/MIS-A. United States and European Union (EU) drug approval is handled separately for children, defined as <18-year-olds, ascribing non-existent physical characteristics up to the 18th birthday. This blur between the administrative and the physiological meanings for the term child is causing flawed demands for pediatric studies in all drugs and vaccines, including those against COVID-19. Effective treatment of all conditions, including COVID-19, should be based on actual physiological need. Now, the flawed definition for children in the development of drugs and vaccines and their approval is negatively impacting prevention and treatment of COVID-19 in minors. This review reveals the necessity for redefining pediatric age groups to rapidly establish recommendations for optimal prevention and treatment in minors.

scholarly journals Demographic and clinical factors associated with death among persons <21 years old with multisystem inflammatory syndrome in children (MIS-C) — United States, February 2020–March 2021

2021 ◽  
Author(s):  
Anna Bowen ◽  
Allison D Miller ◽  
Laura D Zambrano ◽  
Michael J Wu ◽  
Matthew E Oster ◽  
...  
Keyword(s):  
United States ◽  
Ethnic Minority ◽  
Clinical Factors ◽  
Factors Associated ◽  
Inflammatory Syndrome ◽  
Racial Ethnic

Abstract MIS-C occurs among persons aged &lt;21 years following SARS-CoV-2 infection. Among 2,818 MIS-C cases, 35 (1.2%) deaths were reported, primarily affecting racial/ethnic minority persons. Being 16–20 years old or having comorbidities was associated with death. Targeting COVID-19 prevention among these groups and their caregivers might prevent MIS-C–related deaths.

scholarly journals Multisystem Inflammatory Syndrome in Infants <12 months of Age, United States, May 2020–January 2021

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Shana Godfred-Cato ◽  
Clarisse A. Tsang ◽  
Jennifer Giovanni ◽  
Joseph Abrams ◽  
Matthew E. Oster ◽  
...  
Keyword(s):  
United States ◽  
Inflammatory Syndrome

scholarly journals Echocardiographic Findings in Pediatric Multisystem Inflammatory Syndrome Associated With COVID-19 in the United States

2020 ◽  
Vol 76 (17) ◽  
pp. 1947-1961 ◽  
Author(s):  
Daisuke Matsubara ◽  
Hunter L. Kauffman ◽  
Yan Wang ◽  
Renzo Calderon-Anyosa ◽  
Sumekala Nadaraj ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Inflammatory Syndrome ◽  
Echocardiographic Findings

scholarly journals Racial and Ethnic Disparities in Multisystem Inflammatory Syndrome in Children in the United States, March 2020 to February 2021

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Bryan Stierman ◽  
Joseph Y. Abrams ◽  
Shana E. Godfred-Cato ◽  
Matthew E. Oster ◽  
Lu Meng ◽  
...  
Keyword(s):  
United States ◽  
Ethnic Disparities ◽  
The United States ◽  
Racial And Ethnic Disparities ◽  
Inflammatory Syndrome

scholarly journals MIS-C in February 2020 and Implications of Genomic Sequencing for SARS-CoV-2

2020 ◽  
Author(s):  
Emily Parsons ◽  
Matthew Timlin ◽  
Clarise Starr ◽  
Anthony Fries ◽  
Ronald Wells ◽  
...  
Keyword(s):  
United States ◽  
Disease Process ◽  
The United States ◽  
Spike Protein ◽  
Genomic Sequencing ◽  
Inflammatory Syndrome

Abstract Multisystem Inflammatory Syndrome in Children (MIS-C) is a newly recognized disease process that can complicate SARS-CoV-2 infection. We present what we believe to be the earliest case of MIS-C, occurring in February 2020. Our patient’s SARS-CoV-2 infection was caused by an emerging lineage with the D614G variant in the Spike protein. This lineage would subsequently become the predominant cause of SARS-CoV-2 outbreaks in Europe and the United States where MIS-C was first described.

scholarly journals Reported Cases of Multisystem Inflammatory Syndrome in Children (MIS-C) Aged 12–20 Years in the United States Who Received COVID-19 Vaccine, December 2020 through August 2021

2022 ◽  
Author(s):  
Anna R. Yousaf ◽  
Margaret M. Cortese ◽  
Allan W. Taylor ◽  
Karen R. Broder ◽  
Matthew E. Oster ◽  
...  
Keyword(s):  
United States ◽  
Safety Assessment ◽  
Adverse Event Reporting System ◽  
Case Series ◽  
Vaccine Dose ◽  
The United States ◽  
Case Definition ◽  
Laboratory Evidence ◽  
Serology Test ◽  
Inflammatory Syndrome

AbstractBackgroundMultisystem inflammatory syndrome in children (MIS-C) is a hyperinflammatory condition associated with antecedent SARS-CoV-2 infection. In the United States, reporting of MIS-C after vaccination is required under COVID-19 vaccine emergency use authorizations. This case series describes persons aged 12–20 years with MIS-C following COVID-19 vaccination reported to passive surveillance systems or through clinician outreach to CDC.MethodsWe investigated potential cases of MIS-C after COVID-19 vaccination reported to CDC’s health department-based national MIS-C surveillance, the Vaccine Adverse Event Reporting System (VAERS, co-administered by CDC and the U.S. FDA), and CDC’s Clinical Immunization Safety Assessment Project (CISA) from December 14, 2020, to August 31, 2021. We describe cases meeting the CDC MIS-C case definition. Any positive SARS-CoV-2 serology test satisfied the case criteria although anti-nucleocapsid antibody indicates SARS-CoV-2 infection, while anti-spike protein antibody indicates either infection or COVID-19 vaccination.FindingsWe identified 21 persons with MIS-C after COVID-19 vaccination. Of these 21 persons, median age was 16 years (range, 12–20 years); 13 (62%) were male. All were hospitalized; 12 (57%) had intensive care unit admission, and all were discharged home. Fifteen (71%) of the 21 had laboratory evidence of past or recent SARS-CoV-2 infection, and six (29%) did not. Through August 2021, 21,335,331 persons aged 12–20 years had received ≥1 dose of COVID-19 vaccine, making the overall reporting rate for MIS-C following vaccination 1·0 case per million persons receiving ≥1 vaccine dose in this age group. The reporting rate for those without evidence of SARS-CoV-2 infection was 0·3 cases per million vaccinated persons.InterpretationIn our case series, we describe a small number of persons with MIS-C who had received ≥1 COVID-19 vaccine dose before illness onset. Continued reporting of potential cases and surveillance for MIS-C illnesses after COVID-19 vaccination is warranted.FundingThis work was supported by the Centers for Disease Control and Prevention Clinical Immunization Safety Assessment (CISA] Project contracts 200-2012-50430-0005 to Vanderbilt University Medical Center and 200-2012-53661 to Cincinnati Children’s Hospital Medical Center.Research in context panelEvidence before this studyMultisystem inflammatory syndrome in children (MIS-C), also known as paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS), is an uncommon, but serious, complication described after SARS-CoV-2 infection that is characterized by a generalized hyperinflammatory response. A review of the literature using PubMed identified reports of six persons aged 12–20 years who developed MIS-C following COVID-19 vaccination. Search terms used to identify these reports were: “multisystem inflammatory syndrome in children”, “MIS-C”, “MISC”, “multisystem inflammatory syndrome in adults”, “MIS-A”, “MISA”, “paediatric inflammatory multisystem syndrome”, and “PIMS-TS” each with any COVID-19 vaccine type. There were no exclusion criteria (i.e., all ages and languages).Added value of this studyWe conducted integrated surveillance for MIS-C after COVID-19 vaccination using two passive surveillance systems, CDC’s MIS-C national surveillance and the Vaccine Adverse Event Reporting System (VAERS), and clinician or health department outreach to CDC, including through Clinical Immunization Safety Assessment (CISA) Project consultations. We investigated reports of potential MIS-C occurring from December 14, 2020, to August 31, 2021, in persons aged 12–20 years any time after receipt of COVID-19 vaccine to identify those that met the CDC MIS-C case definition. Any positive serology test was accepted as meeting the CDC MIS-C case definition, although anti- nucleocapsid antibody is indicative of SARS-CoV-2 infection, while anti-spike protein antibody may be induced either by SARS-CoV-2 infection or by COVID-19 vaccination. We investigated 47 reports and identified 21 persons with MIS-C after receipt of COVID-19 vaccine. Of the 21 persons with MIS-C, median age was 16 years (range 12–20 years), and 13 (62%) were male. Fifteen (71%) had laboratory evidence of past or recent SARS-CoV-2 infection (positive SARS-CoV-2 nucleic acid amplification test [NAAT], viral antigen, or serology test before or during MIS-C illness evaluation), and 5 (33%) of those 15 had illness onset after their second vaccine dose. Six (29%) of 21 persons had no laboratory evidence of past or recent SARS-CoV-2 infection, and five of those six (83%) had onset of MIS-C after the second vaccine dose.Implications of all the available evidenceDuring the first nine months of the COVID-19 vaccination program in the United States, >21 million persons aged 12 to 20 years received ≥1 dose of COVID-19 vaccine as of August 31, 2021. This case series describes MIS-C in 21 persons following vaccine receipt during this time period; the majority of persons reported also had evidence of SARS-CoV-2 infection. The surveillance has limitations, but our findings suggest that MIS-C as identified in this report following COVID-19 vaccination is rare. In evaluating persons with a clinical presentation consistent with MIS-C after COVID-19 vaccination it is important to consider alternative diagnoses, and anti-nucleocapsid antibody testing may be helpful. Continued surveillance for MIS-C illness after COVID-19 vaccination is warranted, especially as pediatric COVID-19 vaccination expands. Providers are encouraged to report potential MIS-C cases after COVID-19 vaccination to VAERS.

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