Systematic review and meta-analysis of myocarditis and pericarditis in adolescents following COVID-19 BNT162b2 vaccination
Abstract Myocarditis and pericarditis are frequent complications of COVID-19, but have also been reported following vaccination against COVID-19 in adolescents. To build vaccine confidence and inform policy, we characterized the incidence of myocarditis/pericarditis in adolescents following BNT162b2...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2023-06-01
|
| Series: | npj Vaccines |
| Online Access: | https://doi.org/10.1038/s41541-023-00681-3 |
| _version_ | 1797420754629820416 |
|---|---|
| author | Patrick D. M. C. Katoto Liliane N. Byamungu Amanda S. Brand Jacques L. Tamuzi Mireille A. M. Kakubu Charles S. Wiysonge Glenda Gray |
| author_facet | Patrick D. M. C. Katoto Liliane N. Byamungu Amanda S. Brand Jacques L. Tamuzi Mireille A. M. Kakubu Charles S. Wiysonge Glenda Gray |
| author_sort | Patrick D. M. C. Katoto |
| collection | DOAJ |
| description | Abstract Myocarditis and pericarditis are frequent complications of COVID-19, but have also been reported following vaccination against COVID-19 in adolescents. To build vaccine confidence and inform policy, we characterized the incidence of myocarditis/pericarditis in adolescents following BNT162b2 vaccination and explored the association with dose and sex. We searched national and international databases for studies reporting the incidence of myocarditis/pericarditis following BNT162b2 vaccination as the primary endpoint. The intra-study risk of bias was appraised, and random-effects meta-analyses were performed to estimate the pooled incidence by dose stratified by sex. The pooled incidence of myocarditis/pericarditis was 4.5 (95%CI: 3.14–6.11) per 100,000 vaccinations across all doses. Compared to dose 1, the risk was significantly higher after dose 2 (RR: 8.62, 95%CI: 5.71–13.03). However, adolescents experienced a low risk after a booster dose than after dose 2 (RR: 0.06; 95%CI: 0.04–0.09). Males were approximately seven times (RR: 6.66, 95%CI: 4.77–4.29) more likely than females to present myocarditis/pericarditis. In conclusion, we found a low frequency of myocarditis/pericarditis after BNT162b2, which occurred predominantly after the second dose in male adolescents. The prognosis appears to be favorable, with full recovery in both males and females. National programs are recommended to adopt the causality framework to reduce overreporting, which undercuts the value of the COVID-19 vaccine on adolescent life, as well as to extend the inter-dose interval policy, which has been linked to a lower frequency of myocarditis/pericarditis. |
| first_indexed | 2024-03-09T07:06:06Z |
| format | Article |
| id | doaj.art-39b6f18d170649a5982e7e79f5d2fb90 |
| institution | Directory Open Access Journal |
| issn | 2059-0105 |
| language | English |
| last_indexed | 2024-03-09T07:06:06Z |
| publishDate | 2023-06-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | npj Vaccines |
| spelling | doaj.art-39b6f18d170649a5982e7e79f5d2fb902023-12-03T09:30:26ZengNature Portfolionpj Vaccines2059-01052023-06-01811910.1038/s41541-023-00681-3Systematic review and meta-analysis of myocarditis and pericarditis in adolescents following COVID-19 BNT162b2 vaccinationPatrick D. M. C. Katoto0Liliane N. Byamungu1Amanda S. Brand2Jacques L. Tamuzi3Mireille A. M. Kakubu4Charles S. Wiysonge5Glenda Gray6Office of the President and CEO, South African Medical Research CouncilDepartment of Pediatric, Faculty of Medicine and Health Sciences, University of KwaZulu-NatalCentre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch UniversityCentre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch UniversityMinistry of Health and Social Services of NamibiaCentre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch UniversityOffice of the President and CEO, South African Medical Research CouncilAbstract Myocarditis and pericarditis are frequent complications of COVID-19, but have also been reported following vaccination against COVID-19 in adolescents. To build vaccine confidence and inform policy, we characterized the incidence of myocarditis/pericarditis in adolescents following BNT162b2 vaccination and explored the association with dose and sex. We searched national and international databases for studies reporting the incidence of myocarditis/pericarditis following BNT162b2 vaccination as the primary endpoint. The intra-study risk of bias was appraised, and random-effects meta-analyses were performed to estimate the pooled incidence by dose stratified by sex. The pooled incidence of myocarditis/pericarditis was 4.5 (95%CI: 3.14–6.11) per 100,000 vaccinations across all doses. Compared to dose 1, the risk was significantly higher after dose 2 (RR: 8.62, 95%CI: 5.71–13.03). However, adolescents experienced a low risk after a booster dose than after dose 2 (RR: 0.06; 95%CI: 0.04–0.09). Males were approximately seven times (RR: 6.66, 95%CI: 4.77–4.29) more likely than females to present myocarditis/pericarditis. In conclusion, we found a low frequency of myocarditis/pericarditis after BNT162b2, which occurred predominantly after the second dose in male adolescents. The prognosis appears to be favorable, with full recovery in both males and females. National programs are recommended to adopt the causality framework to reduce overreporting, which undercuts the value of the COVID-19 vaccine on adolescent life, as well as to extend the inter-dose interval policy, which has been linked to a lower frequency of myocarditis/pericarditis.https://doi.org/10.1038/s41541-023-00681-3 |
| spellingShingle | Patrick D. M. C. Katoto Liliane N. Byamungu Amanda S. Brand Jacques L. Tamuzi Mireille A. M. Kakubu Charles S. Wiysonge Glenda Gray Systematic review and meta-analysis of myocarditis and pericarditis in adolescents following COVID-19 BNT162b2 vaccination npj Vaccines |
| title | Systematic review and meta-analysis of myocarditis and pericarditis in adolescents following COVID-19 BNT162b2 vaccination |
| title_full | Systematic review and meta-analysis of myocarditis and pericarditis in adolescents following COVID-19 BNT162b2 vaccination |
| title_fullStr | Systematic review and meta-analysis of myocarditis and pericarditis in adolescents following COVID-19 BNT162b2 vaccination |
| title_full_unstemmed | Systematic review and meta-analysis of myocarditis and pericarditis in adolescents following COVID-19 BNT162b2 vaccination |
| title_short | Systematic review and meta-analysis of myocarditis and pericarditis in adolescents following COVID-19 BNT162b2 vaccination |
| title_sort | systematic review and meta analysis of myocarditis and pericarditis in adolescents following covid 19 bnt162b2 vaccination |
| url | https://doi.org/10.1038/s41541-023-00681-3 |
| work_keys_str_mv | AT patrickdmckatoto systematicreviewandmetaanalysisofmyocarditisandpericarditisinadolescentsfollowingcovid19bnt162b2vaccination AT lilianenbyamungu systematicreviewandmetaanalysisofmyocarditisandpericarditisinadolescentsfollowingcovid19bnt162b2vaccination AT amandasbrand systematicreviewandmetaanalysisofmyocarditisandpericarditisinadolescentsfollowingcovid19bnt162b2vaccination AT jacquesltamuzi systematicreviewandmetaanalysisofmyocarditisandpericarditisinadolescentsfollowingcovid19bnt162b2vaccination AT mireilleamkakubu systematicreviewandmetaanalysisofmyocarditisandpericarditisinadolescentsfollowingcovid19bnt162b2vaccination AT charlesswiysonge systematicreviewandmetaanalysisofmyocarditisandpericarditisinadolescentsfollowingcovid19bnt162b2vaccination AT glendagray systematicreviewandmetaanalysisofmyocarditisandpericarditisinadolescentsfollowingcovid19bnt162b2vaccination |