A report of 2 cases of myopericarditis after Vaccinia virus (smallpox) immunization

To counter the possibility of smallpox being used as a biological weapon, in 2002 the US government restarted a smallpox vaccination campaign. Myopericarditis is a possible cardiac complication of smallpox vaccination. We report 2 cases of vaccine-associated myopericarditis in military recruits who were treated at our facility. Chest pain, shortness of breath, and electrocardiographic changes of pericarditis, with a recent history of smallpox vaccination, were useful in making the diagnosis of probable post-vaccinial myopericarditis. Nonsteroidal, anti-inflammatory drugs (NSAIDs) were used to manage myopericarditis. Both patients had complete resolution of symptoms and electrocardiographic changes and subsequently returned to active duty.

Myopericarditis should be suspected when patients with recent history of smallpox vaccination present with chest pain or shortness of breath. Nonsteroidal anti-inflammatory drugs are useful in the management of post-vaccinial myopericarditis.