Risks of myocarditis, pericarditis, and cardiac arrhythmias associated with COVID-19 vaccination or SARS-CoV-2 infection
Although myocarditis and pericarditis were not observed as adverse events in coronavirus disease 2019 (COVID-19) vaccine trials, there have been numerous reports of suspected cases following vaccination in the general population. We undertook a self-controlled case series study of people aged 16 or...
| Hauptverfasser: | , , , , , , , , , , , , , |
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| Format: | Journal article |
| Sprache: | English |
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Springer Nature
2021
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| _version_ | 1826308085659992064 |
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| author | Patone, M Mei, XW Handunnetthi, L Dixon, S Zaccardi, F Shankar-Hari, M Watkinson, P Khunti, K Harnden, A Coupland, CAC Channon, KM Mills, NL Sheikh, A Hippisley-Cox, J |
| author_facet | Patone, M Mei, XW Handunnetthi, L Dixon, S Zaccardi, F Shankar-Hari, M Watkinson, P Khunti, K Harnden, A Coupland, CAC Channon, KM Mills, NL Sheikh, A Hippisley-Cox, J |
| author_sort | Patone, M |
| collection | OXFORD |
| description | Although myocarditis and pericarditis were not observed as adverse events in coronavirus disease 2019 (COVID-19) vaccine trials, there have been numerous reports of suspected cases following vaccination in the general population. We undertook a self-controlled case series study of people aged 16 or older vaccinated for COVID-19 in England between 1 December 2020 and 24 August 2021 to investigate hospital admission or death from myocarditis, pericarditis and cardiac arrhythmias in the 1–28 days following adenovirus (ChAdOx1, n = 20,615,911) or messenger RNA-based (BNT162b2, n = 16,993,389; mRNA-1273, n = 1,006,191) vaccines or a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive test (n = 3,028,867). We found increased risks of myocarditis associated with the first dose of ChAdOx1 and BNT162b2 vaccines and the first and second doses of the mRNA-1273 vaccine over the 1–28 days postvaccination period, and after a SARS-CoV-2 positive test. We estimated an extra two (95% confidence interval (CI) 0, 3), one (95% CI 0, 2) and six (95% CI 2, 8) myocarditis events per 1 million people vaccinated with ChAdOx1, BNT162b2 and mRNA-1273, respectively, in the 28 days following a first dose and an extra ten (95% CI 7, 11) myocarditis events per 1 million vaccinated in the 28 days after a second dose of mRNA-1273. This compares with an extra 40 (95% CI 38, 41) myocarditis events per 1 million patients in the 28 days following a SARS-CoV-2 positive test. We also observed increased risks of pericarditis and cardiac arrhythmias following a positive SARS-CoV-2 test. Similar associations were not observed with any of the COVID-19 vaccines, apart from an increased risk of arrhythmia following a second dose of mRNA-1273. Subgroup analyses by age showed the increased risk of myocarditis associated with the two mRNA vaccines was present only in those younger than 40. |
| first_indexed | 2024-03-07T07:14:15Z |
| format | Journal article |
| id | oxford-uuid:b6279f67-c9c7-4ccd-ba4e-e2bc54f64bcb |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T07:14:15Z |
| publishDate | 2021 |
| publisher | Springer Nature |
| record_format | dspace |
| spelling | oxford-uuid:b6279f67-c9c7-4ccd-ba4e-e2bc54f64bcb2022-07-20T11:16:27ZRisks of myocarditis, pericarditis, and cardiac arrhythmias associated with COVID-19 vaccination or SARS-CoV-2 infectionJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:b6279f67-c9c7-4ccd-ba4e-e2bc54f64bcbEnglishSymplectic ElementsSpringer Nature2021Patone, MMei, XWHandunnetthi, LDixon, SZaccardi, FShankar-Hari, MWatkinson, PKhunti, KHarnden, ACoupland, CACChannon, KMMills, NLSheikh, AHippisley-Cox, JAlthough myocarditis and pericarditis were not observed as adverse events in coronavirus disease 2019 (COVID-19) vaccine trials, there have been numerous reports of suspected cases following vaccination in the general population. We undertook a self-controlled case series study of people aged 16 or older vaccinated for COVID-19 in England between 1 December 2020 and 24 August 2021 to investigate hospital admission or death from myocarditis, pericarditis and cardiac arrhythmias in the 1–28 days following adenovirus (ChAdOx1, n = 20,615,911) or messenger RNA-based (BNT162b2, n = 16,993,389; mRNA-1273, n = 1,006,191) vaccines or a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive test (n = 3,028,867). We found increased risks of myocarditis associated with the first dose of ChAdOx1 and BNT162b2 vaccines and the first and second doses of the mRNA-1273 vaccine over the 1–28 days postvaccination period, and after a SARS-CoV-2 positive test. We estimated an extra two (95% confidence interval (CI) 0, 3), one (95% CI 0, 2) and six (95% CI 2, 8) myocarditis events per 1 million people vaccinated with ChAdOx1, BNT162b2 and mRNA-1273, respectively, in the 28 days following a first dose and an extra ten (95% CI 7, 11) myocarditis events per 1 million vaccinated in the 28 days after a second dose of mRNA-1273. This compares with an extra 40 (95% CI 38, 41) myocarditis events per 1 million patients in the 28 days following a SARS-CoV-2 positive test. We also observed increased risks of pericarditis and cardiac arrhythmias following a positive SARS-CoV-2 test. Similar associations were not observed with any of the COVID-19 vaccines, apart from an increased risk of arrhythmia following a second dose of mRNA-1273. Subgroup analyses by age showed the increased risk of myocarditis associated with the two mRNA vaccines was present only in those younger than 40. |
| spellingShingle | Patone, M Mei, XW Handunnetthi, L Dixon, S Zaccardi, F Shankar-Hari, M Watkinson, P Khunti, K Harnden, A Coupland, CAC Channon, KM Mills, NL Sheikh, A Hippisley-Cox, J Risks of myocarditis, pericarditis, and cardiac arrhythmias associated with COVID-19 vaccination or SARS-CoV-2 infection |
| title | Risks of myocarditis, pericarditis, and cardiac arrhythmias associated with COVID-19 vaccination or SARS-CoV-2 infection |
| title_full | Risks of myocarditis, pericarditis, and cardiac arrhythmias associated with COVID-19 vaccination or SARS-CoV-2 infection |
| title_fullStr | Risks of myocarditis, pericarditis, and cardiac arrhythmias associated with COVID-19 vaccination or SARS-CoV-2 infection |
| title_full_unstemmed | Risks of myocarditis, pericarditis, and cardiac arrhythmias associated with COVID-19 vaccination or SARS-CoV-2 infection |
| title_short | Risks of myocarditis, pericarditis, and cardiac arrhythmias associated with COVID-19 vaccination or SARS-CoV-2 infection |
| title_sort | risks of myocarditis pericarditis and cardiac arrhythmias associated with covid 19 vaccination or sars cov 2 infection |
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