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Myocarditis Following COVID-19 mRNA Vaccine: A Case Series and Incidence Rate Determination.
Perez, Yalile; Levy, Emily R; Joshi, Avni Y; Virk, Abinash; Rodriguez-Porcel, Martin; Johnson, Matthew; Roellinger, Daniel; Vanichkachorn, Greg; Huskins, W Charles; Swift, Melanie D.
  • Perez Y; Department of Pediatric and Adolescent Medicine, Division of Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota, USA.
  • Levy ER; Department of Pediatric and Adolescent Medicine, Division of Pediatric Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA.
  • Joshi AY; Department of Pediatric and Adolescent Medicine, Division of Pediatric Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA.
  • Virk A; Department of Pediatric and Adolescent Medicine, Division of Pediatric Allergy and Immunology, Mayo Clinic, Rochester, Minnesota, USA.
  • Rodriguez-Porcel M; Department of Pediatric and Adolescent Medicine, Division of Pediatric Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA.
  • Johnson M; Department of Cardiovascular Medicine, Division of Ischemic Heart Disease and Critical Care, Mayo Clinic, Rochester, Minnesota, USA.
  • Roellinger D; Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
  • Vanichkachorn G; Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
  • Huskins WC; Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, Rochester, Minnesota, USA.
  • Swift MD; Department of Pediatric and Adolescent Medicine, Division of Pediatric Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA.
Clin Infect Dis ; 2021 Nov 03.
Article in English | MEDLINE | ID: covidwho-1852978
ABSTRACT

BACKGROUND:

Myocarditis following COVID-19 mRNA vaccines (Pfizer-BioNTech and Moderna) have been increasingly reported. Incidence rates in the general population are lacking, with pericarditis rather than myocarditis diagnostic codes being used to estimate background rates. This comparison is critical to balance the risk of vaccination with the risk of no vaccination.

METHODS:

A retrospective case-series was performed utilizing the Mayo Clinic COVID-19 Vaccine Registry. We measured the incidence rate ratio for myocarditis temporally related to COVID-19 mRNA vaccination compared to myocarditis in a comparable population from 2016 through 2020. Clinical characteristics and outcomes of the affected patients was collected. A total of 21 individuals were identified, but ultimately 7 patients met the inclusion criteria for vaccine-associated myocarditis.

RESULTS:

The overall incidence rate ratio (IRR) of COVID-19 related myocarditis was 4.18 (CI95% 1.63, 8.98) which was entirely attributable to an increased IRR among adult males (IRR 6.69, CI95% 2.35, 15.52) compared to females (IRR 1.41, CI95% 0.03, 8.45).All cases occurred within 2 weeks of a dose of the COVID-19 mRNA vaccine with the majority occurring within 3 days (range 1-13 days) following the second dose (6/7 patients, 86%). Overall, cases were mild, and all patients survived.

CONCLUSIONS:

Myocarditis is a rare adverse event associated with COVID-19 mRNA vaccines, and in adult males it occurs with significantly higher incidence than the background population rate. Recurrence of myocarditis after a subsequent mRNA vaccine dose is not known at this time.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Incidence study / Observational study / Prognostic study / Risk factors Topics: Vaccines Language: English Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: Cid

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Incidence study / Observational study / Prognostic study / Risk factors Topics: Vaccines Language: English Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: Cid