Key result
BNT162b1/2 vaccination linked to ~64% higher myocarditis risk vs mRNA-1273.
Why the study?
Reports of myocarditis after mRNA-based COVID-19 vaccination vary across studies, and the specific mRNA vaccine types with the potential to cause myocarditis remained unidentified.
Does the type of mRNA-based COVID-19 vaccine affect the risk of developing myocarditis?
Meta-Analysis
Does the type of mRNA-based COVID-19 vaccine affect the risk of developing myocarditis?
Effect estimate: 1.64-fold increase
Absolute Event Rate: 1.9% vs 1.2%
This network meta-analysis demonstrates that while the overall prevalence of myocarditis following mRNA COVID-19 vaccination is low (1.7 per 100,000), the risk is relatively higher with BNT162b2 compared to mRNA-1273.
May inform mRNA-1273 preference to minimize myocarditis risk; leaves open guideline impact pending prospective confirmation.
Background: Cases of myocarditis development have been reported after administration of messenger ribonucleic acid (mRNA)-based coronavirus disease (COVID-19) vaccines. However, the reports vary among the studies, and the types of mRNA vaccines with potential to cause myocarditis remain unidentified. The objective was to assess the cumulative prevalence of myocarditis and determine the association between myocarditis and mRNA-based COVID-19 vaccination. Methods: We performed a network meta-analysis by searching articles in PubMed, Scopus, and Web of Science. Information on the prevalence of myocarditis after the mRNA-based COVID-19 vaccination was collected from each study. Analysis was performed by calculating the pooled prevalence rate, and the association was determined using the Z-test. Data networking was performed using the Bayesian method. Results: A total of 18 papers was included in our analysis. We found that the cumulative prevalence of myocarditis was 1.7, 1.9, 1.2, and 1.1 per 100,000 population after vaccination with different types of mRNA-based COVID-19 vaccines, namely all mRNA COVID-19 vaccines, BNT162b1, mRNA-1273, and the combination of BNT162b1 and mRNA-1273, respectively. Moreover, the results revealed that BNT162b1 vaccination increased the risk of myocarditis by 1.64- and 1.71-folds compared to mRNA-1273 and the combination of BNT162b2 and mRNA-1273, respectively. Similar risks of developing myocarditis were observed after mRNA-1273 and the combination of BNT162b1 and mRNA-1273 vaccination. Conclusions: Our findings suggest the cumulative prevalence of myocarditis after mRNA-based COVID-19 vaccination with maximum prevalence was observed after BNT162b2 administration. BNT162b2 was associated with a higher risk of developing myocarditis than the other mRNA-based COVID-19 vaccines.
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Rohman et al. (2022) conducted a meta-analysis in Myocarditis. BNT162b1/2 vaccination vs. mRNA-1273 vaccination was evaluated on Myocarditis (1.64-fold increase). BNT162b1/2 vaccination was associated with a higher risk of developing myocarditis (1.9 per 100,000) compared to mRNA-1273 (1.2 per 100,000), representing a 1.64-fold increased risk.
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