Comparative Risk of Myocarditis/Pericarditis Following Second Doses of BNT162b2 and mRNA-1273 Coronavirus Vaccines

Naveed, Zaeema; Li, Julia; Wilton, James; Spencer, Michelle; Naus, Monika; García, Héctor Alexander Velásquez; Kwong, Jeffrey C.; Rose, Caren; Otterstatter, Michael; Janjua, Naveed

doi:10.1016/j.jacc.2022.08.799

Cited by 20 publications

(16 citation statements)

References 19 publications

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“…A statistical analysis of the data in both studies uncovered an increased risk of suffering myocarditis after the first dose of ChAdOx1 and BNT162b2 vaccine than after the further booster doses of the mRNA-1273 vaccine [ 117 , 118 ]. These studies indicated that especially males under 40 years of age had an elevated risk [ 119 ]. A study carried out in the USA over large-scale databases reported an elevated occurrence of myocarditis or pericarditis in mRNA-vaccinated people between 18 and 25 years of age following the second dose, without significant differences between BNT162b2 and mRNA-1273 vaccine formulations [ 120 ].…”

Section: Advantages and Caveats Of Efficacy And Safety Of Mrna Sars-c...mentioning

confidence: 99%

mRNA Vaccines against SARS-CoV-2: Advantages and Caveats

Echaide

Chocarro

Bocanegra

et al. 2023

IJMS

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The application of BNT162b2 and mRNA-1273 vaccines against SARS-CoV-2 infection has constituted a determinant resource to control the COVID-19 pandemic. Since the beginning of 2021, millions of doses have been administered in several countries of North and South America and Europe. Many studies have confirmed the efficacy of these vaccines in a wide range of ages and in vulnerable groups of people against COVID-19. Nevertheless, the emergence and selection of new variants have led to a progressive decay in vaccine efficacy. Pfizer–BioNTech and Moderna developed updated bivalent vaccines—Comirnaty and Spikevax—to improve responses against the SARS-CoV-2 Omicron variants. Frequent booster doses with monovalent or bivalent mRNA vaccines, the emergence of some rare but serious adverse events and the activation of T-helper 17 responses suggest the need for improved mRNA vaccine formulations or the use of other types of vaccines. In this review, we discuss the advantages and limitations of mRNA vaccines targeting SARS-CoV-2 focusing on the most recent, related publications.

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Section: Advantages and Caveats Of Efficacy And Safety Of Mrna Sars-c...mentioning

confidence: 99%

mRNA Vaccines against SARS-CoV-2: Advantages and Caveats

Echaide

Chocarro

Bocanegra

et al. 2023

IJMS

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“…See eTable 1 in Supplement 1 for more information on integrated data sets. The British Columbia COVID-19 Cohort was established as a public health surveillance system under the British Columbia Centre for Disease Control public health mandate …”

Section: Methodsmentioning

confidence: 99%

Association of COVID-19 Infection With Incident Diabetes

et al. 2023

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ImportanceSARS-CoV-2 infection may lead to acute and chronic sequelae. Emerging evidence suggests a higher risk of diabetes after infection, but population-based evidence is still sparse.ObjectiveTo evaluate the association between COVID-19 infection, including severity of infection, and risk of diabetes.Design, Setting, and ParticipantsThis population-based cohort study was conducted in British Columbia, Canada, from January 1, 2020, to December 31, 2021, using the British Columbia COVID-19 Cohort, a surveillance platform that integrates COVID-19 data with population-based registries and administrative data sets. Individuals tested for SARS-CoV-2 by real-time reverse transcription-polymerase chain reaction (RT-PCR) were included. Those who tested positive for SARS-CoV-2 (ie, those who were exposed) were matched on sex, age, and collection date of RT-PCR test at a 1:4 ratio to those who tested negative (ie, those who were unexposed). Analysis was conducted January 14, 2022, to January 19, 2023.ExposureSARS-CoV-2 infection.Main Outcomes and MeasuresThe primary outcome was incident diabetes (insulin dependent or not insulin dependent) identified more than 30 days after the specimen collection date for the SARS-CoV-2 test with a validated algorithm based on medical visits, hospitalization records, chronic disease registry, and prescription drugs for diabetes management. Multivariable Cox proportional hazard modeling was performed to evaluate the association between SARS-CoV-2 infection and diabetes risk. Stratified analyses were performed to assess the interaction of SARS-CoV-2 infection with diabetes risk by sex, age, and vaccination status.ResultsAmong 629 935 individuals (median [IQR] age, 32 [25.0-42.0] years; 322 565 females [51.2%]) tested for SARS-CoV-2 in the analytic sample, 125 987 individuals were exposed and 503 948 individuals were unexposed. During the median (IQR) follow-up of 257 (102-356) days, events of incident diabetes were observed among 608 individuals who were exposed (0.5%) and 1864 individuals who were not exposed (0.4%). The incident diabetes rate per 100 000 person-years was significantly higher in the exposed vs nonexposed group (672.2 incidents; 95% CI, 618.7-725.6 incidents vs 508.7 incidents; 95% CI, 485.6-531.8 incidents; P &lt; .001). The risk of incident diabetes was also higher in the exposed group (hazard ratio [HR], 1.17; 95% CI, 1.06-1.28) and among males (adjusted HR, 1.22; 95% CI, 1.06-1.40). The risk of diabetes was higher among people with severe disease vs those without COVID-19, including individuals admitted to the intensive care unit (HR, 3.29; 95% CI, 1.98-5.48) or hospital (HR, 2.42; 95% CI, 1.87-3.15). The fraction of incident diabetes cases attributable to SARS-CoV-2 infection was 3.41% (95% CI, 1.20%-5.61%) overall and 4.75% (95% CI, 1.30%-8.20%) among males.Conclusions and RelevanceIn this cohort study, SARS-CoV-2 infection was associated with a higher risk of diabetes and may have contributed to a 3% to 5% excess burden of diabetes at a population level.

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“…Despite mRNA vaccine efficacy, the adverse effects should not be overlooked. Even though lesser incidences of Myocarditis and pericarditis have been reported, the incidence rate in young adults in age range of 18–30 years is considerable [ 71 ]. Furthermore, either with booster doses or after bivalent immunization, there was a higher rate of inability to work, and the use of PRN (pro re nata) medications in healthcare workers are reported [ 72 ].…”

Section: Expert Opinionmentioning

confidence: 99%

Recent Advances in the Lipid Nanoparticle-Mediated Delivery of mRNA Vaccines

et al. 2023

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Lipid nanoparticles (LNPs) have recently emerged as one of the most advanced technologies for the highly efficient in vivo delivery of exogenous mRNA, particularly for COVID-19 vaccine delivery. LNPs comprise four different lipids: ionizable lipids, helper or neutral lipids, cholesterol, and lipids attached to polyethylene glycol (PEG). In this review, we present recent the advances and insights for the design of LNPs, as well as their composition and properties, with a subsequent discussion on the development of COVID-19 vaccines. In particular, as ionizable lipids are the most critical drivers for complexing the mRNA and in vivo delivery, the role of ionizable lipids in mRNA vaccines is discussed in detail. Furthermore, the use of LNPs as effective delivery vehicles for vaccination, genome editing, and protein replacement therapy is explained. Finally, expert opinion on LNPs for mRNA vaccines is discussed, which may address future challenges in developing mRNA vaccines using highly efficient LNPs based on a novel set of ionizable lipids. Developing highly efficient mRNA delivery systems for vaccines with improved safety against some severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants remains difficult.

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Comparative Risk of Myocarditis/Pericarditis Following Second Doses of BNT162b2 and mRNA-1273 Coronavirus Vaccines

Cited by 20 publications

References 19 publications

mRNA Vaccines against SARS-CoV-2: Advantages and Caveats

mRNA Vaccines against SARS-CoV-2: Advantages and Caveats

Association of COVID-19 Infection With Incident Diabetes

Recent Advances in the Lipid Nanoparticle-Mediated Delivery of mRNA Vaccines

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