Myocarditis and Pericarditis After Vaccination for COVID-19

Abstract

Rare cases of cardiac inflammation following SARS-CoV-2 vaccination have been reported. [1][2][3][4] We reviewed the clinical records of vaccine recipients to identify cases of postvaccination myocarditis or pericarditis.Methods | Forty hospitals in Washington, Oregon, Montana, and Los Angeles County, California, that were part of the Providence health care system and used the same electronic medical record (EMR) were included. All patients with documented COVID-19 vaccinations administered inside the system or recorded in state registries at any time through May 25, 2021, were identified. Vaccinated patients who subsequently had emergency department or inpatient encounters with diagnoses of myocarditis, myopericarditis, or pericarditis were ascertained from EMRs (see eTables 1 and 2 in the Supplement for exclusions and definitions).The monthly rates of first-time hospital diagnoses (excluding patients with previous diagnoses in January 2018-January 2019) in January 2019 through January 2021 (prevaccine period) and February through May 2021 (vaccine period) were compared.The Wilson method was used to calculate 95% confidence intervals for single proportions. Change in incidence between periods and 95% confidence intervals for incidence were assessed using an exact rate ratio test assuming Poisson distribution, with a 2-sided P < .05 defining statistical significance. R version 2021 statistical software (R Foundation) was used. The Providence institutional review board approved the study with a waiver of informed consent.

COVID-19 Vaccinations: A Comprehensive Review of Their Safety and Efficacy in Special Populations

“…There have been reports on post-vaccination myocarditis, pericarditis, vasculitis, and cardiac arrhythmia in patients with good general past health after mRNA vaccination for both Pfizer and Moderna [90,93,94]. The incidence rate of myocarditis or pericarditis is reported to be 12.6 cases per million doses of second-dose mRNA vaccine among individuals 12 to 39 years of age without a history of COVID-19 infections or comorbidities.…”

“…The incidence rate of myocarditis or pericarditis is reported to be 12.6 cases per million doses of second-dose mRNA vaccine among individuals 12 to 39 years of age without a history of COVID-19 infections or comorbidities. These typically happen 2 to 3 days after the second dose of mRNA vaccination [94,95]. The median duration of myocarditis-related admission is 2 days (inter-quartile range of 2-3 days), with no readmissions or deaths [94].…”

“…These typically happen 2 to 3 days after the second dose of mRNA vaccination [94,95]. The median duration of myocarditis-related admission is 2 days (inter-quartile range of 2-3 days), with no readmissions or deaths [94]. With a median of 23.5 days of follow-up, the majority (65%) of patients experience symptoms resolution, and the remaining (35%) experience symptomatic improvements [94].…”

The syndrome of inappropriate antidiuresis after vaccination against COVID-19: case report

“…Unfortunately, there are also rare cases of anaphylactic shock after receiving either of the mentioned vaccines. Recently, a case series of Myocarditis and Pericarditis associated with COVID-19 vaccination was published [ 7 ]. Since vaccination programs started, a lot of case reports were published describing a multitude of pathologies possibly related to the vaccination.…”

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“…For us as cardiovascular specialists few reports on myocarditis and pericarditis are of particular interest. Myocarditis is reported in 1 per 100 000 in young and pericarditis 1.8 per 100 000 in older among 2 000 287 vaccinated population in US; all cases are recovered and received 2 nd vaccination dose (8). CDC reported myocarditis as 4.8 per 1 000 000 in younger males (9).…”