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The very low risk of myocarditis and pericarditis after mRNA COVID-19 vaccination should not discourage vaccination

Philip Haaf1,2, Gabriela M Kuster1,3, Christian Mueller1

  • 1Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Switzerland.

Swiss Medical Weekly
|October 20, 2021
PubMed

Insights

COVID-19 vaccination benefits outweigh risks, including rare heart inflammation. Early diagnosis and management of vaccine-associated myocarditis generally lead to good outcomes.

Area of Science:

  • Cardiology
  • Immunology
  • Public Health

Background:

  • COVID-19 vaccination offers significant benefits in preventing infection, transmission, and complications.
  • Rare risks of vaccine-associated myocarditis and pericarditis exist but generally have favorable outcomes.
  • Physicians require guidance for diagnosing and managing potential cardiac adverse events post-vaccination.

Purpose of the Study:

  • To provide a clinical review guiding physicians in the early diagnosis and management of suspected myocarditis following mRNA COVID-19 vaccination.
  • To outline recommended diagnostic work-up and follow-up protocols.
  • To emphasize the importance of reporting and ongoing research.

Main Methods:

  • Review of current clinical practice guidelines and literature on vaccine-associated myocarditis.
  • Description of initial diagnostic work-up including history, ECG, and biomarkers.
  • Recommendation for advanced imaging (echocardiography, CMR) and follow-up protocols.

Main Results:

  • The benefits of COVID-19 vaccination significantly outweigh the risks of adverse events like myocarditis.
  • Early diagnosis and appropriate management of vaccine-associated myocarditis typically result in good patient outcomes.
  • Follow-up is crucial to rule out chronic inflammation and assess cardiac function.

Conclusions:

  • Physicians should be prepared to diagnose and manage mRNA vaccine-associated myocarditis using established protocols.
  • Reporting of cases to regulatory bodies like Swissmedic is mandatory.
  • Further prospective studies in young populations are needed to understand pathogenesis and risk factors.

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