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      COVID-19 Vaccine Provider Access and Vaccination Coverage Among Children Aged 5–11 Years — United States, November 2021–January 2022

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      , PhD 1 , 2 , , , MEng, MSc 2 , , PhD 2 , , PharmD 1 , 2 , , MPH 2 , , PhD 2 , , MPH, MS 3 , , MS 3 , , MS 3 , , PhD 2 , , MA, MSc 2 , , MPH 2 , , MD 2 , , MBA 2 , , PhD 4 , , DrPH 4 , , PhD 4 , , PhD 4 , , MBA 5 , 5 , 5 , , MPH 6 , , MS 3 , , MA 3 , , MPH, MBA 7 , , MD 2 , * , , PharmD 2 , *
      Morbidity and Mortality Weekly Report
      Centers for Disease Control and Prevention

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          Underlying Medical Conditions Associated With Severe COVID-19 Illness Among Children

          Question Among children with a COVID-19 diagnosis, what conditions are common, and which are associated with severe COVID-19 illness? Findings In this cross-sectional study of 43 465 patients aged 18 years or younger with COVID-19, more than one-quarter had 1 or more underlying condition; asthma, obesity, neurodevelopmental disorders, and certain mental health conditions were most common. Certain conditions as well as medical complexity were associated with a higher risk of severe COVID-19 illness. Meaning These findings expand the knowledge available regarding children with COVID-19 and could inform pediatric clinical practice and public health priorities, such as prevention and mitigation of COVID-19. This cross-sectional study examines the risk of severe COVID-19 illness among children associated with underlying medical conditions and medical complexity. Importance Information on underlying conditions and severe COVID-19 illness among children is limited. Objective To examine the risk of severe COVID-19 illness among children associated with underlying medical conditions and medical complexity. Design, Setting, and Participants This cross-sectional study included patients aged 18 years and younger with International Statistical Classification of Diseases, Tenth Revision, Clinical Modification code U07.1 (COVID-19) or B97.29 (other coronavirus) during an emergency department or inpatient encounter from March 2020 through January 2021. Data were collected from the Premier Healthcare Database Special COVID-19 Release, which included data from more than 800 US hospitals. Multivariable generalized linear models, controlling for patient and hospital characteristics, were used to estimate adjusted risk of severe COVID-19 illness associated with underlying medical conditions and medical complexity. Exposures Underlying medical conditions and medical complexity (ie, presence of complex or noncomplex chronic disease). Main Outcomes and Measures Hospitalization and severe illness when hospitalized (ie, combined outcome of intensive care unit admission, invasive mechanical ventilation, or death). Results Among 43 465 patients with COVID-19 aged 18 years or younger, the median (interquartile range) age was 12 (4-16) years, 22 943 (52.8%) were female patients, and 12 491 (28.7%) had underlying medical conditions. The most common diagnosed conditions were asthma (4416 [10.2%]), neurodevelopmental disorders (1690 [3.9%]), anxiety and fear-related disorders (1374 [3.2%]), depressive disorders (1209 [2.8%]), and obesity (1071 [2.5%]). The strongest risk factors for hospitalization were type 1 diabetes (adjusted risk ratio [aRR], 4.60; 95% CI, 3.91-5.42) and obesity (aRR, 3.07; 95% CI, 2.66-3.54), and the strongest risk factors for severe COVID-19 illness were type 1 diabetes (aRR, 2.38; 95% CI, 2.06-2.76) and cardiac and circulatory congenital anomalies (aRR, 1.72; 95% CI, 1.48-1.99). Prematurity was a risk factor for severe COVID-19 illness among children younger than 2 years (aRR, 1.83; 95% CI, 1.47-2.29). Chronic and complex chronic disease were risk factors for hospitalization, with aRRs of 2.91 (95% CI, 2.63-3.23) and 7.86 (95% CI, 6.91-8.95), respectively, as well as for severe COVID-19 illness, with aRRs of 1.95 (95% CI, 1.69-2.26) and 2.86 (95% CI, 2.47-3.32), respectively. Conclusions and Relevance This cross-sectional study found a higher risk of severe COVID-19 illness among children with medical complexity and certain underlying conditions, such as type 1 diabetes, cardiac and circulatory congenital anomalies, and obesity. Health care practitioners could consider the potential need for close observation and cautious clinical management of children with these conditions and COVID-19.
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            Severe COVID-19 Infection and Pediatric Comorbidities: A Systematic Review and Meta-Analysis

            Highlights What is known • Adults with comorbidities are more likely to suffer from severe manifestations of COVID-19 • Children with COVID-19 have less severe disease manifestations than adults • Children may experience multisystem inflammatory syndrome due to COVID-19 What is new • Children with comorbidities may be at an increased risk for PICU admission and/or severe COVID-19 • Children with comorbidities may be at an increased risk of mortality during COVID-19 infection • Childhood obesity likely contributes to more serious manifestations of COVID-19
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              Effectiveness of BNT162b2 (Pfizer-BioNTech) mRNA Vaccination Against Multisystem Inflammatory Syndrome in Children Among Persons Aged 12–18 Years — United States, July–December 2021

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                Author and article information

                Journal
                MMWR Morb Mortal Wkly Rep
                MMWR Morb Mortal Wkly Rep
                WR
                Morbidity and Mortality Weekly Report
                Centers for Disease Control and Prevention
                0149-2195
                1545-861X
                11 March 2022
                11 March 2022
                : 71
                : 10
                : 378-383
                Affiliations
                Epidemic Intelligence Service, CDC; CDC COVID-19 Emergency Response Team; Countermeasures Acceleration Group, U.S. Department of Health and Human Services Coordination Operations and Response Element, Washington, DC; Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland; Palantir Technologies, Palo Alto, California; Optum Serve, Falls Church, Virginia; Strategic Innovative Solutions, LLC, Clearwater, Florida.
                Author notes
                Corresponding author: Christine Kim, ckim3@ 123456cdc.gov .
                Article
                mm7110a4
                10.15585/mmwr.mm7110a4
                8911999
                35271559
                0b6d13a8-c849-4aaa-b6e7-92236a13d61b

                All material in the MMWR Series is in the public domain and may be used and reprinted without permission; citation as to source, however, is appreciated.

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