Çocuklarda COVID-19’a İkincil Gelişen Multisistemik İnflamatuar Sendrom Tanılı Hastaların COVID-19 Aşısına Karşı Tutumları

Yıl 2022, , 468 - 472, 01.09.2022

Eviç Zeynep Akgün , Dicle Aydın , Hafize Emine Sönmez , Kadir Babaoğlu

https://doi.org/10.26453/otjhs.1095563

Öz

Amaç: Çocuklarda multisistemik inflamatuar sendrom (MIS-C); SARS-CoV-2 ile enfekte olduktan sonra ortaya çıkan anormal bir bağışıklık yanıtıdır. Bu hastalarda BNT162b2 mRNA aşısının etkinliğini ve güvenliğini ortaya koyan bir çalışma yoktur. Bu çalışmada MIS-C tanısı almış 12 yaşın üzerindeki hastalarımızın COVID-19 aşısına karşı tutumları ve eğer aşılandılarsa gelişen yan etkileri sunmayı amaçladık.

Materyal ve Metot: Çalışmada Mayıs 2020-Ocak 2022 tarihleri arasında MIS-C tanısı ile takip edilen 12 yaş ve üzeri olguların dosyaları geriye dönük olarak taranarak hasta ve ailesine ait aşılanma bilgileri edinildi.

Bulgular: Çalışmaya 36 hasta (12 kız, 24 erkek) dahil edildi. Ortanca yaşları 13,5 (12-17) yıldı. Sekiz hasta (%22,2) MIS-C tanısından ortanca üç (üç-altı) ay sonra aşı olmuştu. Aşı sonrası herhangi bir yan etki saptanmadı ve hiçbir çocukta hastalık reaktivasyonu olmadı. Hastaların aşı olmayı reddetmelerinin en sık nedenleri; hastalığı geçirmiş olmaları ve hastalığın tekrarlayabileceği korkusuydu.

Sonuç: MIS-C tanılı olguların SARS-CoV-2 aşılarına karşı tutumunu değerlendiren bu çalışmada; çoğu hasta ve ebeveynlerinin COVID-19 aşısı olmaya karşı olduğu, aşı olan grupta ise aşının güvenli olduğu gösterildi.

Anahtar Kelimeler

Aşı güvenliği, BNT162b2 mRNA aşısı, çocuklarda multisistemik inflamatuar sendrom

Destekleyen Kurum

yok

The Attitudes of the Patients with the Multisystem Inflammatory Syndrome in Children Secondary to SARS-CoV-2 Regarding COVID-19 Vaccines

Öz

Objective: Multisystem inflammatory syndrome (MIS-C) in children is an abnormal immune response that occurs after exposure to SARS-CoV-2. To our knowledge, there is no study demonstrating the efficacy and safety of the BNT162b2 mRNA vaccine in children who were diagnosed with MIS-C previously. In this study, we aimed to present the attitudes of MIS-C patients over the age of 12 years towards the COVID-19 vaccine, and the side effects of the vaccine in vaccinated patients.

Materials and Methods: The files of patients who were followed up with the diagnosis of MIS-C between May 2020 and January 2022 aged 12 years and over were reviewed retrospectively.

Results: Thirty-six patients (12 girls, 24 boys) were included in the study. The median age was 13.5 (12-17) years. Eight of the 36 patients (22.2%) were vaccinated at a median of 3 (3-6) months after the diagnosis of MIS-C. No side effects or disease reactivation was observed following vaccination. The most common reasons for patients' refusal to be vaccinated were having had the disease and being concerned about a recurrence.

Conclusion: This study showed that COVID-19 vaccination was safe in children who were diagnosed with MIS-C, although most of our patients were against it.

Anahtar Kelimeler

BNT162b2 mRNA vaccine, multisystem inflammatory syndrome in children, vaccine safety

Kaynakça

• Feldstein LR, Rose EB, Horwitz SM, et al. Multisystem inflammatory syndrome in U.S. children and adolescents. N Engl J Med. 2020;383(4):334-346. doi:10.1056/NEJMoa2021680
• Dufort EM, Koumans EH, Chow EJ, et al. Multisystem inflammatory syndrome in children in New York State. N Engl J Med. 2020;383(4):347-358. doi:10.1056/NEJMoa2021756
• Centers for Disease Control andPrevention. Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with Corona virus Disease 2019 (COVID-19) 2020. https://emergency.cdc.gov/han/2020/han00432.asp. Accessed March 20, 2022.
• Hause AM, Baggs J, Marquez P, et al. COVID-19 Vaccine Safety in Children Aged 5–11 Years — United States, November 3–December19, 2021. MMWR Morb Mortal Wkly Rep. 2021;70(5152):1755–1760. doi:10.15585/mmwr.mm705152a1
• Yousaf AR, Cortese MM, Taylor AW, et al. Reported cases of multisystem inflammatory syndrome in children aged 12-20 years in the USA who received a COVID-19 vaccine, December, 2020, through August, 2021: A surveillance investigation. Lancet Child Adolesc Health. 2022;6(5): 3030-312. doi:10.1016/S2352-4642(22)00028-1
• Levy M, Recher M, Hubert H, et al. Multisystem inflammatory syndrome in children by COVID-19 vaccination status of adolescents in France. JAMA. 2022;327(3):281-283. doi:10.1001/jama.2021.23262
• Zambrano LD, Newhams MM, Olson SM, et al. Effectiveness of BNT162b2 (Pfizer-BioNTech) mRNA vaccination against multisystem inflammatory syndrome in children among persons aged 12–18 years—United States, July–December 2021. MMWR Morb Mortal Wkly Rep. 2022;71(2):52–58. doi:10.155585/mmwr.mm7102e1
• Buchhorn R, Meyer C, Schulze-Forster K, Junker J, Heidecke H. Autoantibody release in children after corona virus mRNA vaccination: A risk factor of multisystem inflammatory syndrome? Vaccines (Basel). 2021;9(11):1353. doi:10.3390/vaccines9111353
• Chin SE, Bhavsar SM, Corson A, Ghersin ZJ, Kim HS. Cardiac complications associated with COVID-19, MIS-C, and mRNA COVID-19 vaccination. Pediatr Cardiol. 2022;43(3):483-488. doi:10.1007/s00246-022-02851-x
• Centers for Disease Control and Prevention. The vaccine adverse event reporting system (VAERS) results 2021. https://wonder.cdc.gov/vaers.html. Accessed December 2, 2021.
• Rostad CA, Chahroudi A, Mantus G, et al. Quantitative SARS-CoV-2 serology in children with multisystem inflammatory syndrome (MIS-C). Pediatrics. 2020;146:e2020018242. doi:10.1542/peds.2020-018242
• Yonker LM, Neilan AM, Bartsch Y, et al. Pediatric severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): clinical presentation, infectivity, and immune responses. J Pediatr. 2020;227:45–52.e5. doi:10.1016/j.jpeds.2020.08.037
• Trougakos IP, Terpos E, Zirou C, et al. Comparative kinetics of SARS-CoV-2 anti-spike protein RBD IgG s and neutralizing antibodies in convalescent and naïve recipients of the BNT162b2 mRNA vaccine versus COVID-19 patients. BMC Med. 2021;19:208. doi:10.1186/s129-021-02090-6
• T.C. Sağlık Bakanlığı COVID-19 aşısı bilgilendirme platformu 2022. https://covid19asi.saglik.gov.tr/. Accessed March 24, 2022.
• Türkiye Nüfusu Yaş Gruplarına Göre Dağılımı 2021. https://www.nufusu.com/turkiye-nufusu-yas-gruplari. Accessed March 24, 2022.
• Akgün Ö, Çakmak F, Guliyeva V, Demirkan FG, Tanatar A, Hançerli Torun S, Çin D, Meşe S, Ağaçfidan A, Aktay Ayaz N. Rheumatology (Oxford). 2022. doi:10.1093/rheumatology/keac140