AAP updates COVID-19 guidance for testing, face masks, MIS-C
The AAP updated its COVID-19 guidelines for testing, wearing face masks and vaccinating patients who have been treated for multisystem inflammatory syndrome in children.
The AAP said fully vaccinated people who were in close contact with someone with COVID-19 should be tested between 5 and 7 days after the initial exposure, and people who are not fully vaccinated should be tested immediately after they learn of an exposure. If they test negative, they should be tested again 5 to 7 days after their last exposure or immediately after symptoms develop, the AAP said.
It recommended that vaccinated people wear a mask indoors in public if they are in an area with substantial or high transmission, and that there be universal indoor masking for all teachers, staff, students, and visitors to schools regardless of vaccination status.
The AAP recommended that patients treated for multisystem inflammatory syndrome in children (MIS-C) wait at least 90 days after the diagnosis to receive a COVID-19 vaccine. It said children with a history of MIS-C “should consider delaying vaccination until after they have recovered from illness (including return to normal cardiac function).”
“Currently, there are limited data about the safety and efficacy of COVID-19 vaccine in patients with a history of MIS-C,” the guidance says. “Pediatricians and patients/families should participate in shared decision making in weighing risks and benefits of COVID-19 vaccination for each individual patient.”
The FDA last month authorized the Pfizer-BioNTech pediatric COVID-19 vaccine for emergency use in children aged 5 to 11 years, opening vaccination to 28 million children in the country.
The regimen for children is two 10 µg shots given 21 days apart. According to Pfizer and BioNTech, the vaccine was 90.7% effective in a clinical trial at preventing laboratory-confirmed symptomatic COVID-19 occurring at least 7 days after a second dose (two-sided 95% CI, 67.7%-98.3%), with no reported cases of severe COVID-19, myocarditis, pericarditis or MIS-C.
References:
AAP. COVID-19 Testing Guidance. https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/covid-19-testing-guidance/. Accessed Nov. 17, 2021.
AAP. Face masks. https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/cloth-face-coverings/. Accessed Nov. 17, 2021.
AAP. Multisystem inflammatory syndrome in children (MIS-C) interim guidance. https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/multisystem-inflammatory-syndrome-in-children-mis-c-interim-guidance/. Accessed Nov. 17, 2021.