Key result
COVID-19 vaccination carries far lower myocarditis risk than SARS-CoV-2 infection, with ~20 cases per million doses.
Why the study?
The authors sought to review the most recent data on myocarditis following COVID-19 vaccination, including its epidemiology, clinical presentation, diagnosis, management, relative risk compared with SARS-CoV-2 infection, potential mechanisms, and follow-up outcomes.
What is the incidence, clinical course, and relative risk of myocarditis following COVID-19 vaccination compared to SARS-CoV-2 infection?
What is the incidence, clinical course, and relative risk of myocarditis following COVID-19 vaccination compared to SARS-CoV-2 infection?
COVID-19 mRNA vaccine-induced myocarditis is a rare, generally benign condition primarily affecting young males, carrying a substantially lower risk and better clinical outcomes than myocarditis caused by SARS-CoV-2 infection.
Supports vaccination given lower myocarditis risk than infection; leaves open need for prospective long-term outcome data.
Myocarditis after the COVID-19 vaccine is one of the important adverse events following immunization, observed mainly after mRNA-based vaccines. Importantly, post-vaccination myocarditis was less common than myocarditis after SARS-CoV-2 infection, as it was scored at 19.7 per 1,000,000 doses and 2.76 per 1000 infections. Predominantly, its course was benign and, compared with the myocarditis after COVID-19 infection, significantly fewer patients developed heart failure or died among patients with post-vaccination myocarditis. The group at highest risk of myocarditis related to COVID-19 vaccination were young males who received a second dose of an mRNA vaccine. It was observed that, among mRNA vaccines, specifically mRNA-1273 was associated with a higher risk of myocarditis. The mechanism underlying myocarditis after COVID-19 vaccination is still under investigation and certain processes are being considered. Currently, some follow-up assessments of patients who developed vaccine-induced myocarditis are available and suggest a favorable prognosis. The aim of this review is to discuss the most recent data on myocarditis after COVID-19 vaccination considering its epidemiology, clinical presentation, diagnosis, management, relative risk of myocarditis compared with SARS-CoV-2 infection, potential underlying mechanism, and follow-up data of patients who developed post-vaccination myocarditis.
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Florek et al. (2024) conducted a review in Myocarditis. COVID-19 vaccination vs. SARS-CoV-2 infection was evaluated on Incidence of myocarditis. Myocarditis following COVID-19 vaccination was rare (19.7 per 1,000,000 doses) and predominantly benign, occurring significantly less frequently than after SARS-CoV-2 infection (2.76 per 1000).
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