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Influence of mRNA Covid-19 vaccine dosing interval on the risk of myocarditis

Stéphane Le Vu1, Marion Bertrand2, Laura Semenzato2

  • 1EPIPHARE Scientific Interest Group in Epidemiology of Health Products (French National Agency for the Safety of Medicines and Health Products - ANSM, French National Health Insurance - CNAM), Saint-Denis, France. stephane.le-vu@ansm.sante.fr.

Nature Communications
|September 4, 2024
PubMed

Insights

Longer intervals between messenger RNA Covid-19 vaccine doses, including boosters, may significantly reduce the risk of myocarditis, particularly for individuals under 50. A minimum 6-month interval is suggested for subsequent booster vaccinations.

Area of Science:

  • Immunology
  • Vaccinology
  • Cardiovascular Medicine

Background:

  • Myocarditis is a recognized serious adverse event linked to mRNA COVID-19 vaccines.
  • The risk of myocarditis appears dose-dependent, with higher incidence after the second primary dose compared to the first.

Purpose of the Study:

  • To investigate the relationship between dosing intervals and the risk of myocarditis following mRNA COVID-19 vaccination.
  • To evaluate the impact of extended intervals for both primary series and booster doses on myocarditis occurrence.

Main Methods:

  • A matched case-control study design was employed.
  • The study analyzed 7911 cases of myocarditis in individuals aged 12 and above.
  • Data encompassed a period with approximately 130 million administered vaccine doses.

Main Results:

  • Extended dosing intervals between vaccine doses (primary and booster) were associated with a reduced risk of vaccine-associated myocarditis.
  • The risk reduction could be as high as a factor of 4 with longer intervals, especially in individuals under 50.
  • Risk varied between the first and second primary doses and subsequent boosters.

Conclusions:

  • Increasing the interval between mRNA COVID-19 vaccine doses may mitigate the risk of myocarditis.
  • A minimum interval of 6 months between vaccine doses, including boosters, is suggested to minimize myocarditis risk.

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