Pericarditis and myocarditis after COVID-19 mRNA vaccination in a nationwide setting
Jonathan Yap1, Mun Yee Tham, Jalene Poh
1Department of Cardiology, National Heart Centre Singapore, Singapore.
Introduction:
Despite reports suggesting an association between COVID-19 mRNA vaccination and pericarditis and myocarditis, detailed nationwide population-based data are sparsely available. We describe the incidence of pericarditis and myocarditis by age categories and sex after COVID-19 mRNA vaccination from a nationwide mass vaccination programme in Singapore.
Methods:
The incidence of adjudicated cases of pericarditis and myocarditis following COVID-19 mRNA vaccination that were reported to the vaccine safety committee between January to July 2021 was compared with the background incidence of myocarditis in Singapore.
Results:
As of end July 2021, a total of 34 cases were reported (9 pericarditis only, 14 myocarditis only, and 11 concomitant pericarditis and myocarditis) with 7,183,889 doses of COVID-19 mRNA vaccine administered. Of the 9 cases of pericarditis only, all were male except one. The highest incidence of pericarditis was in males aged 12-19 years with an incidence of 1.11 cases per 100,000 doses. Of the 25 cases of myocarditis, 80% (20 cases) were male and the median age was 23 years (range 12-55 years) with 16 cases after the second dose. A higher-than-expected number of cases were seen in males aged 12-19 and 20-29 years, with incidence rates of 3.72 and 0.98 case per 100,000 doses, respectively.
Conclusion:
Data from the national registry in Singapore indicate an increased incidence of pericarditis and myocarditis in younger men after COVID-19 mRNA vaccination.
Insights
COVID-19 mRNA vaccination is associated with an increased incidence of pericarditis and myocarditis, particularly in younger males. This nationwide study in Singapore highlights these rare risks following vaccination.
Area of Science:
- Cardiology
- Vaccinology
- Public Health
Background:
- Reports suggest a link between COVID-19 mRNA vaccines and rare cases of pericarditis and myocarditis.
- Nationwide population-based data on this association remain limited.
Purpose of the Study:
- To determine the incidence of pericarditis and myocarditis following COVID-19 mRNA vaccination.
- To analyze these incidences by age and sex in Singapore's mass vaccination program.
Main Methods:
- Retrospective analysis of adjudicated cases reported to the vaccine safety committee (Jan-July 2021).
- Comparison of post-vaccination incidence with background myocarditis rates in Singapore.
Main Results:
- 34 cases (9 pericarditis, 14 myocarditis, 11 both) reported after 7,183,889 mRNA vaccine doses.
- Highest pericarditis incidence in males aged 12-19 (1.11/100,000 doses).
- Increased myocarditis incidence in males aged 12-19 (3.72/100,000 doses) and 20-29 (0.98/100,000 doses), with 80% of myocarditis cases being male.
Conclusions:
- COVID-19 mRNA vaccination is associated with an increased incidence of pericarditis and myocarditis.
- Younger males, particularly those aged 12-29, show a higher-than-expected incidence of these conditions.
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