Examination of Adverse Reactions After COVID-19 Vaccination Among Patients With a History of Multisystem Inflammatory Syndrome in Children.

Autor:	Elias MD; Division of Cardiology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania., Truong DT; Division of Pediatric Cardiology, University of Utah, Primary Children's Hospital, Salt Lake City., Oster ME; Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia., Trachtenberg FL; HealthCore Inc, Newton, Massachusetts., Mu X; HealthCore Inc, Newton, Massachusetts., Jone PN; Department of Pediatrics, Pediatric Cardiology, Children's Hospital Colorado, University of Colorado, Anschutz Medical Campus, Aurora., Mitchell EC; Cohen Children's Medical Center, Northwell Health, New Hyde Park, New York., Dummer KB; Division of Pediatric Cardiology, Department of Pediatrics, University of California, San Diego, School of Medicine and Rady Children's Hospital, San Diego, California., Sexson Tejtel SK; Baylor College of Medicine, Texas Children's Hospital, Houston., Osakwe O; University of Mississippi Medical Center, Jackson., Thacker D; Nemours Children's Hospital, Wilmington, Delaware., Su JA; Division of Cardiology, Children's Hospital Los Angeles, Los Angeles, California., Bradford TT; Children's Hospital of New Orleans, New Orleans, Louisiana., Burns KM; National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland., Campbell MJ; Division of Pediatric Cardiology, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina., Connors TJ; Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian Morgan Stanley Children's Hospital, New York, New York., D'Addese L; The Heart Institute, Joe DiMaggio Children's Hospital, Hollywood, Florida., Forsha D; Ward Family Heart Center, Children's Mercy Kansas City, Kansas City, Missouri., Frosch OH; Division of Pediatric Cardiology, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor., Giglia TM; Division of Cardiology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania., Goodell LR; Heart Center, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois., Handler SS; Department of Pediatrics, Division of Pediatric Cardiology, Medical College of Wisconsin, Milwaukee., Hasbani K; Dell Children's Medical Center, The University of Texas at Austin., Hebson C; Department of Pediatrics, Division of Pediatric Cardiology, University of Alabama at Birmingham, Birmingham., Krishnan A; Division of Cardiology, Children's National Hospital, Washington, DC., Lang SM; The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio., McCrindle BW; Department of Pediatrics, University of Toronto, Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Canada., McHugh KE; Department of Pediatrics, Medical University of South Carolina, Charleston., Morgan LM; Valley Children's Healthcare and Hospital, Madera, California., Payne RM; Riley Hospital for Children, Indiana University School of Medicine, Indianapolis., Sabati A; Center for Heart Care, Phoenix Children's Hospital, Phoenix, Arizona., Sagiv E; Division of Pediatric Cardiology, Seattle Children's Hospital and the University of Washington School of Medicine, Seattle, Washington., Sanil Y; Division of Pediatric Cardiology, Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit, Michigan., Serrano F; Baylor College of Medicine, Texas Children's Hospital, Houston., Newburger JW; Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts.; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts., Dionne A; Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts.; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
Jazyk:	angličtina
Zdroj:	JAMA network open [JAMA Netw Open] 2023 Jan 03; Vol. 6 (1), pp. e2248987. Date of Electronic Publication: 2023 Jan 03.
DOI:	10.1001/jamanetworkopen.2022.48987
Abstrakt:	Importance: Data are limited regarding adverse reactions after COVID-19 vaccination in patients with a history of multisystem inflammatory syndrome in children (MIS-C). The lack of vaccine safety data in this unique population may cause hesitancy and concern for many families and health care professionals. Objective: To describe adverse reactions following COVID-19 vaccination in patients with a history of MIS-C. Design, Setting, and Participants: In this multicenter cross-sectional study including 22 North American centers participating in a National Heart, Lung, and Blood Institute, National Institutes of Health-sponsored study, Long-Term Outcomes After the Multisystem Inflammatory Syndrome in Children (MUSIC), patients with a prior diagnosis of MIS-C who were eligible for COVID-19 vaccination (age ≥5 years; ≥90 days after MIS-C diagnosis) were surveyed between December 13, 2021, and February 18, 2022, regarding COVID-19 vaccination status and adverse reactions. Exposures: COVID-19 vaccination after MIS-C diagnosis. Main Outcomes and Measures: The main outcome was adverse reactions following COVID-19 vaccination. Comparisons were made using the Wilcoxon rank sum test for continuous variables and the χ2 or Fisher exact test for categorical variables. Results: Of 385 vaccine-eligible patients who were surveyed, 185 (48.1%) received at least 1 vaccine dose; 136 of the vaccinated patients (73.5%) were male, and the median age was 12.2 years (IQR, 9.5-14.7 years). Among vaccinated patients, 1 (0.5%) identified as American Indian/Alaska Native, non-Hispanic; 9 (4.9%) as Asian, non-Hispanic; 45 (24.3%) as Black, non-Hispanic; 59 (31.9%) as Hispanic or Latino; 53 (28.6%) as White, non-Hispanic; 2 (1.1%) as multiracial, non-Hispanic; and 2 (1.1%) as other, non-Hispanic; 14 (7.6%) had unknown or undeclared race and ethnicity. The median time from MIS-C diagnosis to first vaccine dose was 9.0 months (IQR, 5.1-11.9 months); 31 patients (16.8%) received 1 dose, 142 (76.8%) received 2 doses, and 12 (6.5%) received 3 doses. Almost all patients received the BNT162b2 vaccine (347 of 351 vaccine doses [98.9%]). Minor adverse reactions were observed in 90 patients (48.6%) and were most often arm soreness (62 patients [33.5%]) and/or fatigue (32 [17.3%]). In 32 patients (17.3%), adverse reactions were treated with medications, most commonly acetaminophen (21 patients [11.4%]) or ibuprofen (11 [5.9%]). Four patients (2.2%) sought medical evaluation, but none required testing or hospitalization. There were no patients with any serious adverse events, including myocarditis or recurrence of MIS-C. Conclusions and Relevance: In this cross-sectional study of patients with a history of MIS-C, no serious adverse events were reported after COVID-19 vaccination. These findings suggest that the safety profile of COVID-19 vaccination administered at least 90 days following MIS-C diagnosis appears to be similar to that in the general population.
Databáze:	MEDLINE
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