Skip to main content
Top

09-05-2024 | COVID-19 | RESEARCH

Multisystemic inflammatory syndrome in children and the BNT162b2 vaccine: a nationwide cohort study

Authors: Naama Schwartz, Ronit Ratzon, Itay Hazan, Deena Rachel Zimmerman, Shepherd Roee Singer, Janice Wasser, Tunie Dweck, Sharon Alroy-Preis

Published in: European Journal of Pediatrics

Login to get access

Abstract

Multisystemic inflammatory syndrome in children (MIS-C) is a rare, severe, post-infectious hyperinflammatory condition that occurs after COVID-19 infection. In this study, we aimed to demonstrate the risk reduction of MIS-C and severe MIS-C after Pfizer–BioNTech BNT162b2 mRNA COVID-19 vaccination. This nationwide cohort study included 526,685 PCR-confirmed COVID-19 cases (age < 19 years), of whom 14,118 were fully vaccinated prior to COVID-19 infection. MIS-C cases were collected from all hospitals in Israel from April 2020 through November 2021. The MIS-C rates were calculated among two COVID-19 populations: positive PCR confirmed cases and estimated COVID-19 cases (PCR confirmed and presumed). Vaccination status was determined from Ministry of Health (MoH) records. The MIS-C risk difference (RD) and 95% confidence intervals (95%CI) between vaccinated and unvaccinated patients are presented. Overall, 233 MIS-C cases under the age of 19 years were diagnosed and hospitalized in Israel during the study period. Among the estimated COVID-19 cases, MIS-C RD realistically ranged between 2.1 [95%CI 0.7–3.4] and 1.0 [95%CI 0.4–1.7] per 10,000 COVID-19 cases. For severe MIS-C, RD realistically ranged between 1.6 [95%CI 1.3–1.9] and 0.8 [95%CI 0.7–1.0], per 10,000 COVID-19 cases. Sensitivity analysis was performed on a wide range of presumed COVID-19 rates, demonstrating significant RD for each of these rates.
Conclusion: This research demonstrates that vaccinating children and adolescents against COVID-19 has reduced the risk of MIS-C during the study period.
What is Known:
• Most of the published literature regarding vaccine effectiveness is based on case-control studies, which are limited due to small sample sizes and the inability to fully estimate the risk of MIS-C among vaccinated and unvaccinated children and adolescents.
• The known underestimation of COVID-19 diagnosis among children and adolescents is challenging, as they often have few to no symptoms.
What is New:
• Significant risk difference was found in favor of the vaccinated group, even after including extreme assumptions regarding the underdiagnosed COVID-19 rate.
• During this nationwide study period, it was found that vaccinating children and adolescents reduced the risk of MIS-C and its complications.
Appendix
Available only for authorised users
Literature
25.
go back to reference Zambrano LD, Newhams MM, Olson SM et al (2023) 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. Clin Infect Dis 76:e90–e100. https://doi.org/10.1093/cid/ciac637CrossRefPubMed Zambrano LD, Newhams MM, Olson SM et al (2023) 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. Clin Infect Dis 76:e90–e100. https://​doi.​org/​10.​1093/​cid/​ciac637CrossRefPubMed
Metadata
Title
Multisystemic inflammatory syndrome in children and the BNT162b2 vaccine: a nationwide cohort study
Authors
Naama Schwartz
Ronit Ratzon
Itay Hazan
Deena Rachel Zimmerman
Shepherd Roee Singer
Janice Wasser
Tunie Dweck
Sharon Alroy-Preis
Publication date
09-05-2024
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Pediatrics
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI
https://doi.org/10.1007/s00431-024-05586-4