Combined Myopericarditis and Pneumonitis Post–Pfizer Vaccine Against Coronavirus Disease 2019 in a Healthy Caucasian Middle-Aged Man

A generally healthy middle-aged Caucasian man developed significant cough, fever, chest tightness, dyspnea, and orthopnea after second dose of Pfizer-BioNTech coronavirus disease 2019 (COVID-19) vaccine. He was hypoxemic and had bilateral patchy ground glass opacities and mediastinal adenopathy. Those objective signs indicated an acute pneumonitis. His acute heart failure, new onset dilated cardiomyopathy with an left ventricular ejection fraction of 25% are consistent with the diagnosis of suspected myopericarditis despite normal troponin. Autoimmune event and acute viral or bacterial infection were ruled out. With steroid, diuretic, and supportive treatment, the patient clinically improved after 3 days of hospitalization and discharged to home on taper dose steroid and oral diuretic. This case is the first reported case with combined myopericarditis and pneumonitis post–Pfizer COVID-19 vaccine on Vaccine Adverse Event Reporting System. The available scientific data on COVID-19 vaccines indicate that they are generally safe and effective. A long-term postmarketing surveillance on COVID-19 vaccine is warranted.