Corinne Levy (France)

ACTIV Paediatrics

Author Of 3 Presentations

Conference Calendar

HYPER INFLAMMATORY SYNDROME FOLLOWING COVID-19 MRNA VACCINE IN CHILDREN: A NATIONAL POST-AUTHORIZATION PHARMACOVIGILANCE STUDY

Date

Wed, 11.05.2022

Session Time

10:00 - 11:02

Session Type

Oral Presentations Session

Session Name

0265 - ORAL PRESENTATION SESSION 03: COVID-19 Session I (ID 50)

Room

BANQUETING HALL

Presenter

FRANCOIS ANGOULVANT (France)

Lecture Time

10:02 - 10:12

Abstract

Abstract

Backgrounds:

Multisystem inflammatory syndrome in children (MIS-C) is the most severe clinical entity associated with pediatric SARS-CoV-2 infection with a putative role of the spike protein into the immune system activation. Whether COVID-19 mRNA vaccine can induce this complication in children is unknown. We aimed to assess the risk of hyper-inflammatory syndrome following COVID-19 mRNA vaccine in children.

Methods:

We conducted a post-authorization national population-based surveillance using the French enhanced pharmacovigilance surveillance system for COVID-19 vaccines. All cases of suspected hyper-inflammatory syndrome following COVID-19 mRNA vaccine in 12–17-year-old children between June 15^th, 2021 and January 1^st, 2022, were reported. The reporting rate of this syndrome was compared to the MIS-C rate per 1,000,000 12–17-year-old children infected by SARS-CoV-2.

Results:

Up to January 2022, 8,113,058 COVID-19 mRNA vaccine doses were administered to 4,079,234 12–17-year-old children. Among them, 12 presented a hyper-inflammatory syndrome with multisystemic involvement. Main clinical features included male predominance (10/12, 83%), cardiac involvement (10/12, 83%), digestive symptoms (10/12, 83%), coagulopathy (7/12, 58%), cytolytic hepatitis (6/12, 50%), and shock (5/12, 42%). 4/12 (33%) required intensive care unit transfer, and 3/12 (25%) hemodynamic support. All cases recovered. In eight cases, no evidence of previous SARS-CoV-2 infection was found. The reporting rate was 1.5 (95%CI [0.8; 2.6]) per 1,000,000 doses injected, i.e. 2.9 (95%CI [1.5; 5.1]) per 1,000,000 12–17-year-old vaccinated children. As a comparison, 113 MIS-C (95%CI [95; 135]) occurred per 1,000,000 12–17-year-old children infected by SARS-CoV-2.

Conclusions/Learning Points:

Very few cases of hyper-inflammatory syndrome with multi-organ involvement occurred following COVID-19 mRNA vaccine in 12–17-year-old children. The low reporting rate of this syndrome, compared to the rate of post-SARS-CoV-2 MIS-C in the same age-group, largely supports the vaccination in a context of an important circulation of SARS-CoV-2.

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SARS-COV-2 INFECTION IN CHILDREN YOUNGER THAN 5 YEARS ACCORDING TO PARENT’S VACCINATION STATUS

Date

Thu, 12.05.2022

Session Time

08:00 - 09:30

Session Type

Parallel Symposium

Session Name

0570 - PARALLEL SYMPOSIUM: Precision Vaccinology (ID 80)

Room

NIKOS SKALKOTAS HALL

Presenter

FRANCOIS ANGOULVANT (France)

Lecture Time

09:17 - 09:27

Abstract

Abstract

Backgrounds:

COVID-19 mRNA vaccine immunogenicity and effectiveness are well established in adolescents and children over 5 years of age. To date, COVID-19 mRNA vaccines are not licensed for younger children. The aim of this study was to estimate incidence of SARS-CoV-2 infection in children younger than 5 by parents COVID-19 vaccination status from the start of the general vaccination for all adults.

Methods

In this French national prospective surveillance, 66 pediatric departments enrolled children hospitalized with SARS-CoV-2 infection and/or or Multisystem Inflammatory Syndrome in Children (MIS-C). All children younger than 5 years admitted from 12/05/21 to 21/12/2021 with available data regarding parent’s vaccination status were included. To account for the increasing numbers of vaccinated parents over time including during the period in which cases were measured, hazard ratio (HR) of unvaccinated versus vaccinated parents was estimated using Cox proportional hazards model.

Results:

From 12/05/2021 to 21/12/2021, the number of French adults, 18 to 59 years, fully vaccinated rose from 7% to 90%. Among the 214 enrolled children, 164 (77%) were younger than 5 years, and parent’s vaccination was available for 81 (38%). Overall, 61 children with available parent’s vaccination status were included with 33 (65%) younger than 3 months, 7 (14%) aged from 3 to <12 months, and 11 (22%) aged from 12 to <60 months. Among them, 10 had at least one parent vaccinated, and 51 had none of their parents vaccinated. The HR for COVID-19 infection in children younger than 5 years was 0.03 (95% CI 0.02 to 0.07, p<.001) with vaccinated parents compared with unvaccinated.

Conclusions/Learning Points:

Parent’s COVID-19 vaccination was associated with a dramatic decrease risk of admission related to COVID-19 infection in children younger than 5.

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UNRAVELLING THE FUNDAMENTAL LINK BETWEEN PNEUMOCOCCAL CARRIAGE, RESPIRATORY VIRAL INFECTION, AND PEDIATRIC INVASIVE PNEUMOCOCCAL DISEASES: A TIME SERIES ANALYSIS BASED ON MULTIPLE NATIONAL SURVEILLANCE SYSTEMS

Date

Fri, 13.05.2022

Session Time

11:40 - 13:10

Session Type

Parallel Symposium

Session Name

0920 - PARALLEL SYMPOSIUM: Effects of the COVID-19 Pandemic (ID 118)

Room

DIMITRIS MITROPOULOS HALL

Presenter

Alexis Rybak (France)

Lecture Time

12:57 - 13:05

Abstract

Abstract

Backgrounds:

An unbreakable relationship has been established between pneumococcal carriage and invasive pneumococcal disease (IPD), with IPD supposed to be the direct consequence of carriage dynamics. We aimed to assess the role of pneumococcal carriage dynamics and the viral epidemiology in the unprecedented IPD epidemiology related to non-pharmaceutical interventions (NPIs) implemented during the COVID-19 pandemic.

Methods

We performed a quasi-experimental interrupted time series analysis based on multiple national surveillance systems of pneumococcal carriage, respiratory syncytial virus (RSV) and influenza-related diseases, and IPD in children <15 years old in France. We estimated the fraction of IPD change after NPIs that was attributable to RSV, influenza and pneumococcal carriage dynamics, analyzed by a quasi-Poisson regression model.

Results:

Between November 2006 and April 2021, 5113 IPD cases were included and 6831 healthy children had a swab test. After NPI implementation, the IPD incidence decreased 63% (95%CI, -82% to -43%, P<.001, Figure) while the overall pneumococcal carriage rate did not significantly change (-12%, 95%CI, -37% to 12%, P=.32). We estimated that 53% (95%CI, 28% to 78%, P<.001) and 40% (95%CI, 15% to 65%, P=.002) of the decrease in IPD in the NPI period was attributable to the change in influenza and RSV epidemiology, respectively. Only 4% (95%CI, -7% to 15%, P=.49) was attributable to a change in pneumococcal carriage. We found similar results when analyzing only high and low-disease potential serotypes.

figure espid basse qualité.png

Conclusions/Learning Points:

The major decrease in pediatric IPD incidence after NPIs was related to a change in viral dynamics rather than pneumococcal carriage. The fundamental link between pneumococcal carriage and IPD is highly affected by viral epidemiology. Interventions targeting respiratory viruses, such as immunoprophylaxis or vaccines against RSV and influenza, may prevent a large part of pediatric IPD.

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