Citations 2
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
Zambrano, Laura D. , Newhams, Margaret M. , Olson, Samantha M. , Halasa, Natasha , Price, Ashley M. , Orzel, Amber, Boom, Julie A. , Bline, Katherine , Kamidani, Satoshi , Tarquinio, Keiko M. , Schuster, Jennifer E. , Cullimore, Melissa L. , Heidemann, Sabrina M. , Nofziger, Ryan A. , Cameron, Melissa A. , Walker, Tracie C. , 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, Zinter, Matt S. , Bowens, Cindy, Crandall, Hillary , Hume, Janet R. , Patel, Manish M, Campbell, Angela P. , Randolph, Adrienne G. , Investigators, for the Overcoming COVID-19, Murdock, Meghan, Gaspers, Mary Glas , Kelley, Connor P. , Irby, Katherine, Sanders, Ronald C., Yates, Masson, Smith, Chelsea , Crane, Katheryn, Lionetti, Geraldina, Murcia-Montoya, Juliana, Villarreal-Chico, Denise, Skura, Adam L., Hakimi, Daniel , Peralta, Harvey, Sea, Yea Ji, Mrotek, Kennis-Grace, Lockwood, Justin M. , Port, Emily, Carson, Imogene A., Chatani, Brandon , Kamidani, Satoshi, Hussaini, Laila, Baida, Nadine, Michelson, Kelly N, Rhodes, Simone T., Khan, Hassan A, Rowan, Courtney M. , Stumpf, Mary, Johnston, Marla , Newhams, Margaret M, Kücükak, Suden, Orzel, Amber O, Chen, Sabrina R., Boutselis, Benjamin J., McCadden, Timothy P. , Stewart, Kasey R, Weller, Edie, Berbert, Laura , He, Jie , Bruno, Ellen R., Goertzen, Lexie A., Drapeau, Noelle M., Martin, Lora , Malloch, Lacy , Harrison, Virginia A., Sanders, Cameron , Patterson, Kayla , Chikere, Chidinma A, Kietzman, Abigail , Sullivan, Melissa, Rinehart, Valerie H., Hoody, Lauren A., Bennett, Paris C., Twinem, Nicole A., Tomcany, Merry, Staat, Mary Allen , Rohlfs, Chelsea C., Wolfe, Amber, Chiotos, Kathleen, Douglas, Rebecca L. , Phengchomphet, Kathlyn, Bickford, Megan M., Wakefield, Lauren E., Hayek, Haya , Romero, Yesenia, Boom, Julie A, Oates, Jennifer N., Maamari, Mia , Bowens, Cindy, Olson, Mady, Zambrano, Laura D, Patel, Manish M, Kamidani, Satoshi , Levy, Emily R , Randolph, Adrienne G , Kong, Michele , Hume, Janet R , Zambrano, Laura D , Staat, Mary A , Gertz, Shira J , Bline, Katherine E , Young, Cameron C. , Sahni, Leila C , Maddux, Aline B. , Chiotos, Kathleen , Hobbs, Charlotte V. , Pannaraj, Pia S. , Schwartz, Stephanie P. , Michelson, Kelly N, Irby, Katherine, Cvijanovich, Natalie Z , Bowens, Cindy, Patel, Manish M, Investigators, for the Overcoming COVID-19, Typpo, Katri , Irby, Katherine, Kamidani, Satoshi, Michelson, Kelly N, Newhams, Margaret M, Orzel, Amber O, Moran, Patrick, Behl, Supriya , Chiotos, Kathleen, Boom, Julie A, Bowens, Cindy, Olson, M, Zambrano, Laura D, Patel, Manish M
Clinical Infectious Diseases | August 4, 2022 | Volume: 76 | Issue: 3 | Pages: e90-e100
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.
Life-Threatening Complications of Influenza vs Coronavirus Disease 2019 (COVID-19) in US Children
Halasa, Natasha , Young, Cameron C. , Newhams, Margaret M. , Nakamura, Mari , Levy, Emily R. , Soma, Vijaya L, Talj, Rana, Fitzgerald, Julie C. , Mack, Elizabeth H. , Schuster, Jennifer E. , Coates, Bria M. , Hall, Mark W. , Schwarz, Adam J. , Kong, Michele, Spinella, Philip C. , Loftis, Laura L. , McLaughlin, Gwenn E., Rowan, Courtney M. , Nofziger, Ryan A. , Babbitt, Christopher , Bowens, Cindy , Flori, Heidi R. , Gertz, Shira J. , Zinter, Matt S. , Hume, Janet R. , Singh, Aalok R. , Crandall, Hillary A, Cullimore, Melissa L. , Patel, Manish M. , Randolph, Adrienne G. , Influenza, for the Pediatric Intensive Care, Investigators, Overcoming COVID-19, Kong, Michele, Gaspers, Mary Glas , Sanders, Ronald C., Irby, Katherine , Peter, Mourani, Harvey, Helen , Osborne, Christina , Sara, Shankman, Mourani, Peter M. , Port, Emily, Van, Kevin A, Carroll, Christopher L. , Tarquinio, Keiko M. , Coates, Bria M, Wellnitz, Kari , Bhoojhawon, Guru , Sullivan, Janice E, Bradford, Tamara T. , Riggs, Becky J. , Randolph, Adrienne G, Chen, Sabrina R., Carroll, Ryan W. , Yager, Phoebe H. , Heidemann, Sabrina M. , Hume, Janet R, Martin, Lora , Malloch, Lacy , Inagaki, Kengo , Schuster, Jennifer E, Kietzman, Abigail , Clouser, Katharine N. , Kleinman, Lawrence C. , Horwitz, Steven M. , Keenaghan, Michael , Doymaz, Sule , Walker, Tracie C. , Hall, Mark W, Lansell, Amanda , Staat, Mary Allen , Carcillo, Joseph A. , Smallcomb, Laura , Halasa, Natasha B, Stewart, Laura S , Romero, Yesenia, Hayek, Haya , Bowens, Cindy, Maamari, Mia , Crandall, Hillary , Smith, Lincoln , Kong, Michele , Young, Cameron C , Randolph, Adrienne G , Levy, Emily R , Spinella, Philip C , Kong, Michele , Hume, Janet R , Staat, Mary A , Gertz, Shira J , Spieker, Andrew J. , Olson, Samantha M. , Amarin, Justin Z. , Moffitt, Kristin , Weiss, Scott L. , Maddux, Aline B. , Schwartz, Stephanie P. , Kong, Michele, Hobbs, Charlotte V. , Bembea, Melania M. , Giuliano, John S. , Cvijanovich, Natalie Z , Thomas, Neal J. , Influenza, for the Pediatric Intensive Care, Investigators, Overcoming COVID-19, Kong, Michele, Typpo, Katri , Michelson, Kelly Nicole , Coates, Bria M, Sullivan, Janice E, Montgomery, Vicki , Havlin, Kevin , Randolph, Adrienne G, Fernandes, Neil D. , Hume, Janet R, Dhanrajani, Anita D. , Schuster, Jennifer E, Hill, Shannon, McCulloh, Russell J. , Li, Simon , Ratner, Adam J. , Dapul, Heda , Harwayne‐Gidansky, Ilana , Hymes, Saul , Hall, Mark W, Shein, Steven L. , Fink, Ericka L. , Halasa, Natasha B, Muñoz, Álvaro Coronado , Bowens, Cindy, McGuire, John K.
Clinical Infectious Diseases | June 19, 2022 | Volume: 76 | Issue: 3 | Pages: e280-e290
Abstract Background Clinical differences between critical illness from influenza infection vs coronavirus disease 2019 (COVID-19) have not been well characterized in pediatric patients. Methods We compared demographics, clinical characteristics, and outcomes of US children (aged 8 months to 17 years) admitted to the intensive care or high-acuity unit with influenza or COVID-19. Using mixed-effects models, we assessed the odds of death or requiring life support for influenza vs COVID-19 after adjustment for age, sex, race and Hispanic origin, and underlying conditions including obesity. Results Children with influenza (n = 179) were younger than those with COVID-19 (n = 381; median, 5.2 years vs 13.8 years), less likely to be non-Hispanic Black (14.5% vs 27.6%) or Hispanic (24.0% vs 36.2%), and less likely to have ≥1 underlying condition (66.4% vs 78.5%) or be obese (21.4% vs 42.2%), and a shorter hospital stay (median, 5 days vs 7 days). They were similarly likely to require invasive mechanical ventilation (both 30.2%), vasopressor support (19.6% and 19.9%), or extracorporeal membrane oxygenation (2.2% and 2.9%). Four children with influenza (2.2%) and 11 children with COVID-19 (2.9%) died. The odds of death or requiring life support in children with influenza vs COVID-19 were similar (adjusted odds ratio, 1.30; 95% confidence interval, .78–2.15; P = .32). Conclusions Despite differences in demographics and clinical characteristics of children with influenza or COVID-19, the frequency of life-threatening complications was similar. Our findings highlight the importance of implementing prevention measures to reduce transmission and disease severity of influenza and COVID-19.