Myocarditis and pericarditis are rare following live viral vaccinations in adults

Kuntz, Jennifer L; Crane, Bradley; Weinmann, Sheila; Naleway, Allison L.; Team, Vaccine Safety Datalink

doi:10.1016/j.vaccine.2018.02.030

Cited by 57 publications

(55 citation statements)

References 16 publications

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“…Myocarditis as an adverse reaction to the COVID-19 vaccine : In general, myocarditis, is considered an uncommon adverse event following immunization [6] , [7] , [8] . An exception to this generalization is myocarditis following smallpox vaccination in adults with a reported incidence of 1:10,000 [7] , [9] , [10] , [11] , [12] .in a prospective safety surveillance study of perimyocarditis following smallpox vaccine , the authors report that most of the identified cases of perimyocarditis were subclinical and were identified through routine pre and post vaccination troponin level measurments [13] . This finding raises concern that we identified only the “tip of the icberg” i.e.…”

Section: Discussionmentioning

confidence: 99%

Myocarditis following COVID-19 mRNA vaccination

Mouch

Roguin

Hellou

et al. 2021

Vaccine

246

249

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Background Clinical trials of the BNT162b2 vaccine, revealed efficacy and safety. We report six cases of myocarditis, which occurred shortly after BNT162b2 vaccination. Methods Patients were identified upon presentation to the emergency department with symptoms of chest pain/discomfort. In all study patients, we excluded past and current COVID-19. Routine clinical and laboratory investigations for common etiologies of myocarditis were performed. Laboratory tests also included troponin and C- reactive protein levels.The diagnosis of myocarditis was established after cardiac MRI. Findings Five patients presented after the second and one after the first dose of the vaccine. All patients were males with a median age of 23 years. Myocarditis was diagnosed in all patients.there was no evidence of COVID-19 infection. Laboratory assays excluded concomitant infection; autoimmune disorder was considered unlikely. All patients responded to the BNT162b2 vaccine. The clinical course was mild in all six patients. Interpretation Our report of myocarditis after BNT162b2 vaccination may be possibly considered as an adverse reaction following immunization. We believe our information should be interpreted with caution and further surveillance is warranted.

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Section: Discussionmentioning

confidence: 99%

Myocarditis following COVID-19 mRNA vaccination

Mouch

Roguin

Hellou

et al. 2021

Vaccine

246

249

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“…However, this cardiac association appears unique to the smallpox vaccine as Kuntz and colleagues recently found the occurrence of myopericarditis following other live viral vaccines is rare with an estimated incidence of 0.24 per 100,000 vaccinated which is not higher than the background rate and is much lower than the incidence rates reported following smallpox vaccination. 44 Interestingly, a recent report of an automated study conducted using data on 11,374 insured patients in Taiwan aged 20 years and older found influenza infection was significantly associated with the development of atrial fibrillation, with an 18% increase in the risk, which could be reduced through influenza vaccination. 23 A follow up study from the same research group has also suggested influenza vaccination may be effective in reducing the risk of ischemic stroke in patients aged greater than 65 years with atrial fibrillation.…”

Section: Discussionmentioning

confidence: 99%

Vaccination and risk of lone atrial fibrillation in the active component United States military

McNeil

Duderstadt

Sabatier

et al. 2019

Human Vaccines & Immunotherapeutics

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Purpose: To evaluate the hypothesis that receipt of anthrax vaccine adsorbed (AVA) increases the risk of atrial fibrillation in the absence of identifiable underlying risk factors or structural heart disease (lone atrial fibrillation). Methods: We conducted a retrospective population-based cohort study among U.S. military personnel who were on active duty during the period from January 1, 1998 through December 31, 2006. International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes were used to identify individuals diagnosed with atrial fibrillation in the Defense Medical Surveillance System, and electronic records were screened to include only individuals without evidence of predisposing medical conditions. We used multivariable Poisson regression to estimate the risk of lone atrial fibrillation after exposure to AVA. We also evaluated possible associations with influenza and smallpox vaccines. Results: Our study population consisted of 2,957,091individuals followed for 11,329,746 person-years of service. Of these, 2,435 met our case definition for lone atrial fibrillation, contributing approximately 8,383 person-years of service. 1,062,176 (36%) individuals received at least one dose of AVA; the median person time observed post-exposure was 3.6 years. We found no elevated risk of diagnosed lone atrial fibrillation associated with AVA (adjusted risk ratio = 0.99; 95% confidence interval = 0.90, 1.09; p = 0.84). No elevated risk was observed for lone atrial fibrillation associated with influenza or smallpox vaccines given during military service. Conclusions: We did not find an increased risk of lone atrial fibrillation after AVA, influenza or smallpox vaccine. These findings may be helpful in planning future vaccine safety research.

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“…Myocarditis has also been reported following live viral vaccinations, most notably the smallpox vaccine. From the early 1950s until 2003, six cases of cardiac complications following smallpox vaccination were reported in the United States [ 4 ]. A campaign to vaccinate U.S. military personnel against smallpox with the DryVax vaccine between 2002 and 2003 resulted in 67 cases of myocarditis or pericarditis out of the 540,824 personnel vaccinated [ 5 ].…”

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confidence: 99%

“…A campaign to vaccinate U.S. military personnel against smallpox with the DryVax vaccine between 2002 and 2003 resulted in 67 cases of myocarditis or pericarditis out of the 540,824 personnel vaccinated [ 5 ]. Due to concern for cardiac complications following smallpox vaccination, a study was conducted to evaluate risk of myocarditis and pericarditis in live viral vaccinations [ 4 ]. Of the 416,629 vaccinated adults studied, only one case of pericarditis and zero cases of myocarditis were identified following vaccination [ 4 ].…”

mentioning

confidence: 99%

“…Due to concern for cardiac complications following smallpox vaccination, a study was conducted to evaluate risk of myocarditis and pericarditis in live viral vaccinations [ 4 ]. Of the 416,629 vaccinated adults studied, only one case of pericarditis and zero cases of myocarditis were identified following vaccination [ 4 ]. The authors concluded there was no increased risk of myopericarditis following live viral vaccination [ 4 ].…”

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confidence: 99%

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Myocarditis after BNT162b2 vaccination in a healthy male

Watkins

Griffin

Septaric

et al. 2021

The American Journal of Emergency Medicine

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Myocarditis following mRNA COVID-19 vaccination has recently been reported to health authorities in the United States and other countries. Cases predominately occur in young adult males within four days following the second dose of either the Moderna (mRNA-1273) or Pfizer-BioNTech (BNT162b2) vaccines. Although the number of cases reported have been small in comparison with the large number of people vaccinated, myocarditis may be a rare adverse reaction to the COVID-19 vaccination that is now only becoming apparent due to the widespread use of the vaccine. In this article, we present a case of a 20-year-old male with no prior medical history who presented to the emergency department (ED) with chest pain. He had received the BNT162b2 vaccine two days prior to his presentation to the ED. The patient had an elevated troponin at 89 ng/L which increased on repeat examination. His electrocardiogram showed diffuse concave ST segment elevations and a later MRI confirmed the diagnosis of myocarditis. Based on these findings, the patient was diagnosed with myocarditis. The patient had a previous infection with SARS-CoV-2 approximately two months prior to the onset of his symptoms, but since he had fully recovered before the time of his presentation to the ED, it is unlikely that the infection caused the myocarditis. To our knowledge, this is the first published case of myocarditis following BNT162b3 vaccination.

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Myocarditis and pericarditis are rare following live viral vaccinations in adults

Cited by 57 publications

References 16 publications

Myocarditis following COVID-19 mRNA vaccination

Myocarditis following COVID-19 mRNA vaccination

Vaccination and risk of lone atrial fibrillation in the active component United States military

Myocarditis after BNT162b2 vaccination in a healthy male

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