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在新加坡进行mRNA SARS-CoV-2疫苗接种后报告的肌心炎和心膜炎病例的最新分析
Mun Yee Tham1, Cheng Leng Chan1, Dorothy Toh1
1Vigilance and Compliance Branch, Health Sciences Authority, Singapore.
Singapore medical journal
|February 16, 2024
概括
在mRNA COVID-19疫苗接种后,肌心炎/心周炎的风险在第二剂后的青少年男性中最高. 虽然大多数病例都是轻微的,但这种风险应该与接种疫苗的好处和SARS-CoV-2感染的风险进行权衡.
科学领域:
- 心脏病学 心脏病学
- 疫苗学 疫苗学 疫苗学
- 公共卫生 公共卫生
背景情况:
- 针对严重急性呼吸系统综合征冠状病毒2 (SARS-CoV-2) 的信使核糖核酸 (mRNA) 疫苗已与心肌炎/心周炎有关,特别是在年轻男性中.
- 了解与不同疫苗品牌,年龄组,性别和剂量数量相关的特定风险对于知情的公共卫生战略至关重要.
研究的目的:
- 在新加坡进行mRNA SARS-CoV-2疫苗接种后评估心肌炎/心周炎的风险.
- 根据疫苗品牌,患者年龄,性别和剂量数量分析这些风险.
主要方法:
- 对2020年12月至2022年7月期间提交给卫生科学局 (HSA) 的心肌炎/心周炎不良事件报告的分析.
- 案件由一个独立的心脏病专家小组根据CDC标准进行裁决.
- 观察到的报告率与历史背景率 (2018-2020) 的比较.
主要成果:
- 在152个被裁决的案件中,75%是男性,平均年龄为30岁.
- 肌心炎/心周炎的最高报告率在12至17岁的男性中观察到,特别是在第二次初级剂量 (11.5每10万剂量) 和强剂量 (7.1每10万剂量) 后.
- 肌心炎在5至11岁的儿童中仍然非常罕见 (0.2每10万剂);第一剂补充剂的报告率通常与第二剂初级剂量相似或低于其.
结论:
- 在mRNA疫苗接种后,肌心炎/心周炎的风险在第二剂疫苗接种后的青少年男性中最高,超过了历史背景率.
- 大多数确定的心肌炎/心周炎病例在临床上是轻微的.
- 接种疫苗的决定应该平衡心肌炎/心周炎的观察到的风险与与SARS-CoV-2感染相关的重大风险,包括心肌炎/心周炎.
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