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February 2, 2022

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Journal Club

First Comes COVID, Then Comes MIS-C: Can Vaccination Slow MIS-C Rates?

By Terri Stillwell, MD

As we enter the third year of the COVID-19 pandemic, we have seen a significant increase in the number of pediatric COVID-19 cases compared to previous waves. With an increase in pediatric cases comes the concern that we will also see a rise in multisystem inflammatory syndrome in children (MIS-C), a post-COVID hyperinflammatory process.

A recent study, published in the Morbidity and Mortality Weekly Report, offers evidence that COVID vaccination may also provide protection against MIS-C. In a multicenter study, using a test-negative case-control design, vaccine effectiveness (VE) of the 2-dose Pfizer-BioNTech series against MIS-C in 12-to-18-year-olds was evaluated. VE was calculated comparing the odds of full vaccination in MIS-C cases to those in matched hospitalized controls.

The analysis comprised 102 MIS-C case patients and 181 matched controls. Of those with MIS-C, 95% were unvaccinated (5% were vaccinated), while all MIS-C cases that required life support were unvaccinated. The vaccination rate among hospitalized controls was 36%. VE against MIS-C was calculated to be 91%.

This article adds to the body of literature showing the effectiveness of COVID vaccination (Pfizer-BioNTech mRNA vaccine) in the pediatric population. With previous studies showing its effectiveness against prevention of severe infection and hospitalization, this study shows its effectiveness against severe COVID-19–related complications, such as MIS-C. As pediatric COVID case numbers continue to rise, we can expect that a rise in MIS-C cases will soon follow. The pediatric population remains woefully unvaccinated and at risk for both acute disease and long-term complications. Vaccination is our best preventative strategy.

(Zambrano et al. MMWR Morb Mortal Wkly Rep. 2022;71:52–58.)

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