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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
Clinical infectious diseases, 02/2023, Volume: 76, Issue: 3Journal Article
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. 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. 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. 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.
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