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Carditis After COVID-19 Vaccination With a Messenger RNA Vaccine and an Inactivated Virus Vaccine : A Case-Control

Francisco Tsz Tsun Lai1, Xue Li2, Kuan Peng3

  • 1Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, and Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China (F.T.T., E.W.Y.).

Annals of Internal Medicine
|January 24, 2022
PubMed

Insights

The BNT162b2 vaccine is associated with an increased risk of carditis, particularly in males and adolescents, with the highest risk observed after the second dose. This finding highlights the need to balance vaccination benefits against potential risks.

Area of Science:

  • Cardiology
  • Vaccinology
  • Public Health

Background:

  • Reports of carditis following BNT162b2 vaccination are increasing globally.
  • Understanding the association between COVID-19 vaccines and carditis is crucial for public health strategies.

Purpose of the Study:

  • To investigate the link between BNT162b2 (Pfizer-BioNTech) and CoronaVac (Sinovac) vaccinations and the incidence of carditis.
  • To quantify the risk of carditis associated with each vaccine type.

Main Methods:

  • A territory-wide case-control study was conducted using Hong Kong's public healthcare database.
  • Inpatients diagnosed with carditis (cases) were matched with hospitalized individuals without carditis (controls) by age, sex, and admission date.
  • Vaccination records were linked to identify BNT162b2 and CoronaVac recipients.

Main Results:

  • The incidence of carditis was higher following BNT162b2 vaccination (0.57 per 100,000 doses) compared to CoronaVac (0.31 per 100,000 doses).
  • BNT162b2 recipients had significantly higher odds of carditis (adjusted OR, 3.57) compared to unvaccinated individuals.
  • The elevated risk was more pronounced in males (OR, 4.68) and adolescents (OR, 13.79), primarily after the second vaccine dose. Myocarditis showed a stronger association (OR, 9.29) than pericarditis (OR, 1.06).

Conclusions:

  • BNT162b2 vaccination is associated with an increased risk of carditis, although the absolute risk remains low.
  • The findings necessitate careful consideration of the elevated carditis risk alongside the established benefits of BNT162b2 vaccination.
Abstract

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