A Systematic Review and Meta-analysis of the Association Between SARS-CoV-2 Vaccination and Myocarditis or Pericarditis

• Published in: American journal of preventive medicine Vol. 64; no. 2; pp. 275 - 284
• Main Authors: Gao, Juan, Feng, Linya, Li, Yaru, Lowe, Scott, Guo, Zhichun, Bentley, Rachel, Xie, Chuman, Wu, Birong, Xie, Peng, Xia, Weihang, Ma, Shaodi, Liu, Haixia, Guo, Xianwei, Uy, John Patrick N., Zhou, Qin, Wazir, Hina, Sun, Chenyu
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.02.2023; Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine
• Subjects: 2019-nCoV Vaccine mRNA-1273 - adverse effects; BNT162 Vaccine - adverse effects; COVID-19 - epidemiology; COVID-19 - prevention & control; COVID-19 Vaccines - adverse effects; Humans; Myocarditis - epidemiology; Pericarditis - epidemiology; Review; Vaccination - adverse effects
• ISSN: 0749-3797; 1873-2607
• DOI: 10.1016/j.amepre.2022.09.002

There have been reports of potential negative cardiovascular effects from the COVID-19 vaccine, such as myocarditis or pericarditis. This study sought to ascertain the risk of myocarditis/pericarditis after COVID-19 vaccination by conducting an extensive meta-analysis of published cases. A systematic literature search was conducted in 7 online databases by March 31, 2022. Heterogeneity was tested by I2 index. RR and 95% CI were pooled through either random-effect or fixed-effect models. Sensitivity analysis and publication bias were also conducted. A total of 11 studies with 58,620,611 subjects were included. COVID-19 vaccination correlated with an increased risk of myocarditis or pericarditis (RR=2.04; 95% CI=1.33, 3.14). In addition, an increased risk of myocarditis or pericarditis in people who received the second dose of COVID-19 vaccine compared with that in those who received only the first dose of COVID-19 vaccine was also found (RR=4.06; 95% CI=2.08, 7.92). An increased incidence of pericarditis or myocarditis was noted predominantly in those who received BNT162b2 and mRNA-1273 vaccines (RR=2.19; 95% CI=1.46, 3.29 and RR=4.15; 95% CI=1.87, 9.22, respectively). Study results indicate that a higher incidence of myocarditis or pericarditis was found after COVID-19 vaccination. In addition, the risk of developing myocarditis or pericarditis was greater after the second dose than after the first dose. Nevertheless, the risks of myocarditis and pericarditis in COVID-19 vaccine recipients are still significantly lower than the health risks observed in patients with COVID-19. Therefore, the benefits and harms must be carefully assessed to determine the best management option for patients who are in the high-risk group of myocarditis or pericarditis.