RE: Racial and Ethnic Disparities in Multisystem Inflammatory Syndrome in Children Free

We read with interest the article “Socioeconomic and Racial and/or Ethnic Disparities in Multisystem Inflammatory Syndrome” by Javalkar et al.¹  Multisystem inflammatory syndrome in children (MIS-C) is a potentially fatal complication of severe acute respiratory syndrome coronavirus 2 infection (coronavirus disease 2019 [COVID-19]) because patients can develop myocarditis, coronary artery abnormalities, arrhythmias, myocardial ischemia, cardiogenic shock, and death.²  Javalkar et al demonstrated that children in Massachusetts with lower socioeconomic status and higher social vulnerability index (SVI) had higher odds of developing MIS-C and that, of the children with lower socioeconomic status and higher SVI, those with Hispanic ethnicity and Black race had between 8.7 and 49.8 times higher odds of developing MIS-C than their non-Hispanic white counterparts.¹ 

This is in line with a recent study by Payne et al revealing that from April to June 2020, the incidence of MIS-C was 9.26, 8.92, and 2.94 times higher in Black, Hispanic or Latino, and Asian American or Pacific Islander persons, respectively, than white persons.³  These findings are of great importance because the Black (24%) and Hispanic (27%) populations have the lowest vaccination rates thus far, and there is still significant hesitancy among parents to vaccinate their children against COVID-19, with only 21% of those aged 12 to 15 years and 32% of those 16 to 17 years being fully vaccinated to date.^4,5  Furthermore, the vaccine is still not available to children <12 years of age.

There needs to be increased vaccine access to all populations but in particular to ethnic and racial minority children of all ages. In addition, all parents should be informed about the serious complications of COVID-19 in children, such as MIS-C. With misinformation on COVID-19 vaccines emerging on Internet sites and social media, vaccination hesitancy has become more pronounced. Addressing vaccine hesitancy is important because the success of preventing COVID-19 and its serious complications will depend on high vaccine acceptance. Parents should be encouraged to openly express their fears about COVID-19 and the vaccine itself. As providers, we need to listen engaged, provide support, and continue to seek to understand and address such fears while building parental trust.

As the vaccine becomes available to children of all ages, we cannot leave the ethnic and racial minority groups without adequate information and protection against a potentially fatal disease and its associated complications. It is important to start conversing with parents now about COVID-19 and the risk of MIS-C. Every effort should be made to make the vaccine accessible to all ethnic and racial minority children to prevent fatal outcomes when prevention is finally available and to, once and for all, end the prolonged pandemic that has shaken the entire world in multiple and personal ways.