Key result
COVID-19 mRNA vaccination is linked to rare myopericarditis, highest in adolescent males at ~127 per million.
Why the study?
An extended interval between the two primary doses may reduce the risk of myocarditis/pericarditis after COVID-19 mRNA vaccination, but nationwide data were lacking.
Does the interval between COVID-19 mRNA vaccine doses or the vaccine combination affect the risk of myocarditis/pericarditis?
Observational
Yes
Does the interval between COVID-19 mRNA vaccine doses or the vaccine combination affect the risk of myocarditis/pericarditis?
Myocarditis and pericarditis are rare following COVID-19 mRNA vaccination but occur at higher rates in young males after the second dose, with no apparent risk reduction from extended dosing intervals.
Supports risk-benefit discussions for mRNA vaccination in adolescent males; leaves open questions on causality and long-term outcomes.
BACKGROUND: An extended interval between the two primary doses may reduce the risk of myocarditis/pericarditis after COVID-19 mRNA vaccination. Taiwan has implemented a two-dose regimen with a 12-week interval for adolescents. Here we present nationwide data of myocarditis/pericarditis following COVID-19 vaccinations. METHODS: Data on adverse events of myocarditis/pericarditis were from the Taiwan Vaccine Adverse Events Reporting System between March 22, 2021, and February 9, 2022. The reporting rates according to sex, age, and vaccine type were calculated. We investigated the rates among young individuals under different two-dose intervals and among those who received two doses of different vaccines. RESULTS: Among 204 cases who met the case definition of myocarditis/pericarditis, 75 cases occurred after the first dose and 129 after the second. The rate of myocarditis/pericarditis after COVID-19 vaccination varied across sex and age groups and was highest after the second dose in males aged 12-17 years (126.79 cases per million vaccinees) for the BNT162b2 vaccine and in males aged 18-24 years (93.84 cases per million vaccinees) for the mRNA-1273 vaccine. The data did not suggest an association between longer between-dose interval and lower rate of myocarditis/pericarditis among males and females aged 18-24 or 25-29 years who received two doses of the BNT162b2 or mRNA-1273 vaccine. Rates of myocarditis/pericarditis in males and females aged 18-49 years after receiving ChAdOx1-S - mRNA-1273 vaccination was significantly higher than after ChAdOx1-S - ChAdOx1-S vaccination. CONCLUSIONS: Myocarditis and pericarditis are rare following mRNA vaccination, with higher risk occurring in young males after the second dose.
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Su et al. (2023) conducted an observational in Myocarditis and pericarditis. COVID-19 mRNA vaccination was evaluated on Reporting rates of myocarditis/pericarditis. COVID-19 mRNA vaccination is associated with a rare risk of myocarditis and pericarditis, with the highest rate occurring after the second dose in males aged 12-17 years (126.79 cases per million).
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