A eficácia da vacina contra a COVID-19 como fator protetivo ao desenvolvimento da SIM-P: uma revisão de literatura

Abstract

The Multisystem Inflammatory Syndrome in Children (MIS-C) is a clinical condition characterized by widespread inflammation in different systems of the body and which manifests 2 to 6 weeks after an acute COVID-19 infection, in the pediatric population. As it is a new topic with little information still available, this literature review aims to verify the evidence regarding the efficacy of the COVID-19 vaccine as a protective factor against the development of Multisystem Inflammatory Syndrome in Children (MIS-C). Using specific descriptors, the research was conducted on the Virtual Health Library platform (VHL), including databases such as MEDLINE, BIGG- GRADE guidelines, PAHO-IRIS, BINACS, medRxiv, and LILACS, covering the period from November 2019 to February 2024. Initially, 86 publications were identified, of which 36 studies were selected based on inclusion criteria. The guiding question was whether COVID-19 vaccination reduces the incidence of MIS-C, the most severe disease related to the SARS-CoV-2 virus, representing a life-threatening risk and a high morbidity rate in children and adolescents.The results were organized into different categories, including case reports, epidemiological studies, and systematic reviews. Then, the pathogenesis of MIS-C was discussed, addressing hypotheses about the pathophysiology behind the disease, as well as the molecular structure of vaccines and the national epidemiological overview. It was concluded that there was a dramatic reduction in rates of symptomatic SARS-CoV-2 infection after the start of the vaccination campaign, as well as in the incidence rates of MIS-C, with protective efficacy against the development of this syndrome reaching 78%-91%. Furthermore, it was found that MIS-C can be triggered by the vaccine itself, however, the risk of this event is 2.9 per 1,000,000 children, while the risk after infection is 113 per 1,000,000 children.