Journal Article

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

Skura, Adam L., Pannaraj, Pia S., Smith, Chelsea, Lockwood, Justin M., Rowan, Courtney M., Villarreal-Chico, Denise, Berbert, Laura, Chatani, Brandon M., Goertzen, Lexie A., Typpo, Katri V., Cvijanovich, Natalie Z., Peralta, Harvey, Hussaini, Laila, Kucukak, Suden, Kamidani, Satoshi, Stumpf, Mary, Cullimore, Melissa L., Kelley, Connor P., Chen, Sabrina R., Patterson, Kayla, Halasa, Natasha B., Maddux, Aline B., Weller, Edie, Patel, Manish M., Flori, Heidi R., Mack, Elizabeth H., Behl, Supriya, Douglas, Rebecca L., Newhams, Margaret M., Kietzman, Abigail, Hobbs, Charlotte V., Carson, Imogene A., Crane, Katheryn, Boom, Julie A., Coates, Bria M., Zinter, Matt S., Golchha, Meena, Heidemann, Sabrina M., Wolfe, Amber, Hill, Shannon M., Gaspers, Mary Glas, Sanders, Cameron, Oates, Jennifer N., Murdock, Meghan, Campbell, Angela P., Dhanrajani, Anita, Orzel, Amber O., Maamari, Mia, Baida, Nadine, Price, Ashley M., Twinem, Nicole A., Bline, Katherine E., Cameron, Melissa A., Wakefield, Lauren E., Zambrano, Laura D., Sahni, Leila C., Schuster, Jennifer E., Yates, Masson, Lionetti, Geraldina, Stewart, Laura S., Mur

2022

Overview

Multisystem inflammatory syndrome in children (MIS-C) is a severe postinfectious hyperinflammatory condition, which generally occurs 2-6 weeks after a typically mild or asymptomatic infection with SARS-CoV-2, the virus that causes COVID-19 (1-3). In the United States, the BNT162b2 (Pfizer-BioNTech) COVID-19 vaccine is currently authorized for use in children and adolescents aged 5-15 years under an Emergency Use Authorization and is fully licensed by the Food and Drug Administration for persons aged ≥16 years (4). Prelicensure randomized trials in persons aged ≥5 years documented high vaccine efficacy and immunogenicity (5), and real-world studies in persons aged 12-18 years demonstrated high vaccine effectiveness (VE) against severe COVID-19 (6). Recent evidence suggests that COVID-19 vaccination is associated with lower MIS-C incidence among adolescents (7); however, VE of the 2-dose Pfizer-BioNTech regimen against MIS-C has not been evaluated. The effectiveness of 2 doses of Pfizer-BioNTech vaccine received ≥28 days before hospital admission in preventing MIS-C was assessed using a test-negative case-control design among hospitalized patients aged 12-18 years at 24 pediatric hospitals in 20 states** during July 1-December 9, 2021, the period when most MIS-C patients could be temporally linked to SARS-CoV-2 B.1.617.2 (Delta) variant predominance. Patients with MIS-C (case-patients) and two groups of hospitalized controls matched to case-patients were evaluated: test-negative controls had at least one COVID-19-like symptom and negative SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) or antigen-based assay results, and syndrome-negative controls were hospitalized patients without COVID-19-like illness. Among 102 MIS-C case-patients and 181 hospitalized controls, estimated effectiveness of 2 doses of Pfizer-BioNTech vaccine against MIS-C was 91% (95% CI = 78%-97%). All 38 MIS-C patients requiring life support were unvaccinated. Receipt of 2 doses of the Pfizer-BioNTech vaccine is associated with a high level of protection against MIS-C in persons aged 12-18 years, highlighting the importance of vaccination among all eligible children.

• Publisher: U.S. Government Printing Office,U.S. Center for Disease Control,Centers for Disease Control and Prevention
• Subject: Adolescent / Age groups / Antigens / BNT162 Vaccine - therapeutic use / Case-Control Studies / Child / Children / Coronaviruses / COVID-19 / COVID-19 - complications / COVID-19 - drug therapy / COVID-19 vaccines / Dosage / Effectiveness / Electronic health records / Extracorporeal membrane oxygenation / Female / Full Report / Hospitalization / Hospitalization - statistics & numerical data / Humans / Immunization / Infection / Infections / Inflammation / Life sustaining treatment / Male / Medical records / Messenger RNA / mRNA / Multisystem inflammatory syndrome in children / Patient Acuity / Patients / Pediatrics / Public health / SARS-CoV-2 - immunology / Severe acute respiratory syndrome coronavirus 2 / Systemic Inflammatory Response Syndrome - drug therapy / United States - epidemiology / Vaccination / Vaccine Efficacy / Vaccines / Ventilators