Myocarditis Reported In Adolescents After COVID 19 Vaccination With Pfizer Vaccine

Recently, the FDA issued an Emergency Use Authorization (EUA) for Pfizer-BioNTech COVID-19 mRNA vaccine for 12- to 17-year-old children. The vaccine demonstrated 94-95% efficacy in 16- 55-year-old participants and 100% efficacy in the 12-15-year-old participants. In a recent case series, researchers reported seven cases of acute myocarditis or myopericarditis in healthy male adolescents within four days of receiving the second dose of the PfizerBioNTech COVID-19 vaccination. This case series offers useful preliminary information on clinical and therapeutic details regarding myocarditis among adolescents.

The researchers identified cases through personal communications between colleagues around the country and published their findings. They reported cases of 7 male patients ages 14-19 who were otherwise healthy. All the patients were presented with symptoms of myocarditis or myopericarditis 2-4 days after the second dose of the Pfizer-BioNTech COVID-19 vaccine.

All patients reported chest pain, and five of them had a fever. Other symptoms seen in one or more patients include:

Shortness of breath

  1. Fatigue

  2. Pain in both arms

  3. Nausea

  4. Vomiting

  5. Headache

  6. Anorexia

  7. Weakness

All of the patiens had elevated troponin levels and abnormal electrocardiogram and cardiac MRI results. They were tested negative for COVID 19 or multisystem inflammatory syndrome during their diagnosis of myocarditis. Additional testing did not point to another viral cause of the inflammation.

Treatment Details: Among 7 patients, 6 received non-steroidal anti-inflammatory drug (NSAID) treatment. Four patients received intravenous immunoglobulin and oral prednisone; one of these four patients also initially received high-dose methylprednisolone. All recovered with hospital stays ranging from two to six days. However, there is no definite causal relationship between these cases and vaccine administration. Given the mild nature of the cases and rarity of these events, even if it is (a real connection), authors think the benefits of vaccination continue to outweigh the risks.

Ref: DOI: 10.1542/peds.2021-052478



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