| アブストラクト | BACKGROUND: Multisystem inflammatory syndrome in children (MIS-C) is a hyperinflammatory condition associated with antecedent SARS-CoV-2 infection. In the USA, reporting of MIS-C after vaccination is required under COVID-19 vaccine emergency use authorisations. We aimed to investigate reports of individuals aged 12-20 years with MIS-C after COVID-19 vaccination reported to passive surveillance systems or through clinician outreach to the US Centers for Disease Control and Prevention (CDC). METHODS: In this surveillance activity, we investigated potential cases of MIS-C after COVID-19 vaccination reported to CDC's MIS-C national surveillance system, the Vaccine Adverse Event Reporting System (co-administered by CDC and the US Food and Drug Administration), and CDC's Clinical Immunization Safety Assessment Project. A multidisciplinary team adjudicated cases by use of the CDC MIS-C definition. Any positive SARS-CoV-2 serology test satisfied case criteria; although anti-nucleocapsid antibodies indicate previous SARS-CoV-2 infection, anti-spike protein antibodies indicate either past or recent infection or COVID-19 vaccination. We describe the demographic and clinical features of cases, stratified by laboratory evidence of SARS-CoV-2 infection. To calculate the reporting rate of MIS-C, we divided the count of all individuals meeting the MIS-C case definition, and of those without evidence of SARS-CoV-2 infection, by the number of individuals aged 12-20 years in the USA who received one or more COVID-19 vaccine doses up to Aug 31, 2021, obtained from CDC national vaccine surveillance data. FINDINGS: Using surveillance results from Dec 14, 2020, to Aug 31, 2021, we identified 21 individuals with MIS-C after COVID-19 vaccination. Of these 21 individuals, median age was 16 years (range 12-20); 13 (62%) were male and eight (38%) were female. All 21 were hospitalised: 12 (57%) were admitted to an intensive care unit and all were discharged home. 15 (71%) of 21 individuals had laboratory evidence of past or recent SARS-CoV-2 infection, and six (29%) did not. As of Aug 31, 2021, 21 335 331 individuals aged 12-20 years had received one or more doses of a COVID-19 vaccine, making the overall reporting rate for MIS-C after vaccination 1.0 case per million individuals receiving one or more doses in this age group. The reporting rate in only those without evidence of SARS-CoV-2 infection was 0.3 cases per million vaccinated individuals. INTERPRETATION: Here, we describe a small number of individuals with MIS-C who had received one or more doses of a COVID-19 vaccine before illness onset; the contribution of vaccination to these illnesses is unknown. Our findings suggest that MIS-C after COVID-19 vaccination is rare. Continued reporting of potential cases and surveillance for MIS-C illnesses after COVID-19 vaccination is warranted. FUNDING: US Centers for Disease Control and Prevention. |
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| ジャーナル名 | The Lancet. Child & adolescent health |
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| Pubmed追加日 | 2022/2/27 |
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| 投稿者 | Yousaf, Anna R; Cortese, Margaret M; Taylor, Allan W; Broder, Karen R; Oster, Matthew E; Wong, Joshua M; Guh, Alice Y; McCormick, David W; Kamidani, Satoshi; Schlaudecker, Elizabeth P; Edwards, Kathryn M; Creech, C Buddy; Staat, Mary A; Belay, Ermias D; Marquez, Paige; Su, John R; Salzman, Mark B; Thompson, Deborah; Campbell, Angela P |
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| 組織名 | CDC COVID-19 Response Team, US Centers for Disease Control and Prevention,;Atlanta, GA, USA. Electronic address: pgy6@cdc.gov.;Atlanta, GA, USA.;Division of Cardiology, Children's Healthcare of Atlanta, Department of;Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.;Atlanta, GA, USA; Epidemic Intelligence Service, US Centers for Disease Control;and Prevention, Atlanta, GA, USA.;Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta,;Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.;Division of Infectious Diseases, Department of Pediatrics, University of;Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center,;Cincinnati, OH, USA.;Division of Infectious Diseases, Department of Pediatrics, Vanderbilt University;Medical Center, Nashville, TN, USA.;Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt;University Medical Center, Nashville, TN, USA.;Kaiser Permanente West Los Angeles Medical Center, Los Angeles, CA, USA.;US Food and Drug Administration, Center for Biologics Evaluation and Research,;Silver Spring, MD, USA. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/35216660/ |
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