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Multisystem Inflammatory Syndrome in Children by COVID-19 Vaccination Status of Adolescents in France

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1 Credit CME

COVID-19 mRNA vaccine immunogenicity and effectiveness are well established in adolescents.1 However, the effect of vaccination on multisystem inflammatory syndrome in children (MIS-C),2 a severe complication associated with SARS-CoV-2,3 has not yet been described. Summer 2021 in France was marked by both a fourth wave of COVID-19 cases due to the Delta variant, with a peak in August 2021, and by the recommendation of the French Public Health Agency to vaccinate children aged 12 years or older. We estimated the risk of MIS-C among adolescents by COVID-19 vaccination status during September 2021 and October 2021.

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Article Information

Corresponding Author: Michael Levy, MD, PhD, Pediatric Intensive Care Unit, Hôpital Universitaire Robert-Debré, Assistance Publique–Hôpitaux de Paris, 48 boulevard Sérurier, 75019 Paris, France (michael.levy@aphp.fr).

Accepted for Publication: December 8, 2021.

Published Online: December 20, 2021. doi:10.1001/jama.2021.23262

Author Contributions: Drs Levy and Angoulvant had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Levy, Recher, Javouhey, Angoulvant.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Levy, Angoulvant.

Critical revision of the manuscript for important intellectual content: Levy, Recher, Hubert, Javouhey, Fléchelles, Leteurtre.

Statistical analysis: Levy, Angoulvant.

Obtained funding: Hubert, Leteurtre.

Administrative, technical, or material support: Recher, Hubert, Javouhey, Leteurtre, Angoulvant.

Supervision: Levy, Javouhey, Angoulvant.

Conflict of Interest Disclosures: Dr Angoulvant reported receiving lecture fees from Pfizer and being the principal investigator of the PANDOR study, which received an unrestricted grant from Pfizer. No other disclosures were reported.

Additional Contributions: We are grateful to Groupe Francophone de Réanimation et d’Urgences Pédiatriques, Santé Publique France, Société Française de Pédiatrie, Groupe de Pediatrie Générale, Groupe de Pathologie Infectieuse Pédiatrique, Société Française de Cardiologie, Filiale de Cardiologie Pédiatrique et Congénitale, Société Francophone Dédiée à L’étude des Maladies Inflammatoires Pédiatriques, and Filière de Santé des Maladies Auto-immunes et Auto-inflammatoires Rares for their participation in the French COVID-19 Paediatric Inflammation Consortium. We thank Daniel Levy-Bruhl, MD, Denise Antona, MD, and Isabelle Parent-du-Chatelet, MD (Santé Publique France Agence Nationale de Santé Publique, Saint-Maurice); David Skurnik, PhD (INSERM U1151-Equipe 11, Paris); and Naïm Ouldali (Hôpital Universitaire Robert-Debré, Paris) for their advice, as well as all the caregivers who included patients in the study. No compensation was provided to these individuals.

References
1.
Frenck  RW  Jr , Klein  NP , Kitchin  N ,  et al; C4591001 Clinical Trial Group.  Safety, immunogenicity, and efficacy of the BNT162b2 Covid-19 vaccine in adolescents.   N Engl J Med. 2021;385(3):239-250. doi:10.1056/NEJMoa2107456PubMedGoogle ScholarCrossref
2.
Feldstein  LR , Rose  EB , Horwitz  SM ,  et al; Overcoming COVID-19 Investigators; CDC COVID-19 Response Team.  Multisystem inflammatory syndrome in US children and adolescents.   N Engl J Med. 2020;383(4):334-346. doi:10.1056/NEJMoa2021680PubMedGoogle ScholarCrossref
3.
Whittaker  E , Bamford  A , Kenny  J ,  et al; PIMS-TS Study Group and EUCLIDS and PERFORM Consortia.  Clinical characteristics of 58 children with a pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2.   JAMA. 2020;324(3):259-269. doi:10.1001/jama.2020.10369PubMedGoogle ScholarCrossref
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Belot  A , Antona  D , Renolleau  S ,  et al.  SARS-CoV-2-related paediatric inflammatory multisystem syndrome, an epidemiological study, France, 1 March to 17 May 2020.   Euro Surveill. 2020;25(22):2001010. doi:10.2807/1560-7917.ES.2020.25.22.2001010PubMedGoogle Scholar
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Dhar  D , Dey  T , Samim  MM ,  et al.  Systemic inflammatory syndrome in COVID-19-SISCoV study: systematic review and meta-analysis.   Pediatr Res. Published online May 18, 2021. doi:10.1038/s41390-021-01545-zPubMedGoogle Scholar
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Diaz  GA , Parsons  GT , Gering  SK , Meier  AR , Hutchinson  IV , Robicsek  A .  Myocarditis and pericarditis after vaccination for COVID-19.   JAMA. 2021;326(12):1210-1212. doi:10.1001/jama.2021.13443PubMedGoogle ScholarCrossref
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