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Elias MD, Truong DT, Oster ME, Trachtenberg FL, Mu X, Jone PN, Mitchell EC, Dummer KB, Sexson Tejtel SK, Osakwe O, Thacker D, Su JA, Bradford TT, Burns KM, Campbell MJ, Connors TJ, D’Addese L, Forsha D, Frosch OH, Giglia TM, Goodell LR, Handler SS, Hasbani K, Hebson C, Krishnan A, Lang SM, McCrindle BW, McHugh KE, Morgan LM, Payne RM, Sabati A, Sagiv E, Sanil Y, Serrano F, Newburger JW, Dionne A. Examination of Adverse Reactions After COVID-19 Vaccination Among Patients With a History of Multisystem Inflammatory Syndrome in Children. JAMA Netw Open 2023; 6:e2248987. [PMID: 36595296 PMCID: PMC9857632 DOI: 10.1001/jamanetworkopen.2022.48987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 11/10/2022] [Indexed: 01/04/2023] Open
Abstract
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.
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Affiliation(s)
- Matthew D. Elias
- Division of Cardiology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Dongngan T. Truong
- Division of Pediatric Cardiology, University of Utah, Primary Children’s Hospital, Salt Lake City
| | - Matthew E. Oster
- Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia
| | | | | | - Pei-Ni Jone
- Department of Pediatrics, Pediatric Cardiology, Children’s Hospital Colorado, University of Colorado, Anschutz Medical Campus, Aurora
| | | | - Kirsten B. Dummer
- Division of Pediatric Cardiology, Department of Pediatrics, University of California, San Diego, School of Medicine and Rady Children’s Hospital, San Diego, California
| | | | | | | | - Jennifer A. Su
- Division of Cardiology, Children’s Hospital Los Angeles, Los Angeles, California
| | | | - Kristin M. Burns
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - M. Jay Campbell
- Division of Pediatric Cardiology, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina
| | - Thomas J. Connors
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian Morgan Stanley Children’s Hospital, New York, New York
| | - Laura D’Addese
- The Heart Institute, Joe DiMaggio Children’s Hospital, Hollywood, Florida
| | - Daniel Forsha
- Ward Family Heart Center, Children’s Mercy Kansas City, Kansas City, Missouri
| | - Olivia H. Frosch
- Division of Pediatric Cardiology, C.S. Mott Children’s Hospital, University of Michigan, Ann Arbor
| | - Therese M. Giglia
- Division of Cardiology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Lauren R. Goodell
- Heart Center, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - Stephanie S. Handler
- Department of Pediatrics, Division of Pediatric Cardiology, Medical College of Wisconsin, Milwaukee
| | - Keren Hasbani
- Dell Children’s Medical Center, The University of Texas at Austin
| | - Camden Hebson
- Department of Pediatrics, Division of Pediatric Cardiology, University of Alabama at Birmingham, Birmingham
| | - Anita Krishnan
- Division of Cardiology, Children’s National Hospital, Washington, DC
| | - Sean M. Lang
- The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Brian W. McCrindle
- Department of Pediatrics, University of Toronto, Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Canada
| | - Kimberly E. McHugh
- Department of Pediatrics, Medical University of South Carolina, Charleston
| | | | - R. Mark Payne
- Riley Hospital for Children, Indiana University School of Medicine, Indianapolis
| | - Arash Sabati
- Center for Heart Care, Phoenix Children’s Hospital, Phoenix, Arizona
| | - Eyal Sagiv
- Division of Pediatric Cardiology, Seattle Children’s Hospital and the University of Washington School of Medicine, Seattle, Washington
| | - Yamuna Sanil
- Division of Pediatric Cardiology, Department of Pediatrics, Children’s Hospital of Michigan, Central Michigan University, Detroit, Michigan
| | - Faridis Serrano
- Baylor College of Medicine, Texas Children’s Hospital, Houston
| | - Jane W. Newburger
- Department of Cardiology, Boston Children’s Hospital, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Audrey Dionne
- Department of Cardiology, Boston Children’s Hospital, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
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