1. Myocarditis and pericarditis associated with SARS-CoV-2 vaccines: A population-based descriptive cohort and a nested self-controlled risk interval study using electronic health care data from four European countries.
- Author
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Bots, Sophie H., Riera-Arnau, Judit, Belitser, Svetlana V., Messina, Davide, Aragón, Maria, Alsina, Ema, Douglas, Ian J., Durán, Carlos E., García-Poza, Patricia, Gini, Rosa, Herings, Ron M. C., Huerta, Consuelo, Sisay, Malede Mequanent, Martín-Pérez, Mar, Martin, Ivonne, Overbeek, Jetty A., Paoletti, Olga, Pallejà-Millán, Meritxell, Schultze, Anna, and Souverein, Patrick
- Subjects
COVID-19 vaccines ,MYOCARDITIS ,PERICARDITIS ,DRUG side effects ,MESSENGER RNA - Abstract
Background: Estimates of the association between COVID-19 vaccines and myo-/pericarditis risk vary widely across studies due to scarcity of events, especially in age- and sex-stratified analyses. Methods: Population-based cohort study with nested self-controlled risk interval (SCRI) using healthcare data from five European databases. Individuals were followed from 01/01/2020 until end of data availability (31/12/2021 latest). Outcome was first myo-/pericarditis diagnosis. Exposures were first and second dose of Pfizer, AstraZeneca, Moderna, and Janssen COVID-19 vaccines. Baseline incidence rates (IRs), and vaccine- and dose-specific IRs and rate differences were calculated from the cohort The SCRI calculated calendar time-adjusted IR ratios (IRR), using a 60-day pre-vaccination control period and dose-specific 28-day risk windows. IRRs were pooled using random effects meta-analysis. Findings: Over 35 million individuals (49-2% women, median age 39-49 years) were included, of which 57-4% received at least one COVID-19 vaccine dose. Baseline incidence of myocarditis was low. Myocarditis IRRs were elevated after vaccination in those aged < 30 years, after both Pfizer vaccine doses (IRR = 3-3, 95%CI 1-2-9.4; 7-8, 95%CI 2-6-23-5, respectively) and Moderna vaccine dose 2 (IRR = 6-1,95%CI 1-1-33-5). An effect of AstraZeneca vaccine dose 2 could not be excluded (IRR = 2-42, 95%CI 0-96-6-07). Pericarditis was not associated with vaccination. Interpretation: mRNA-based COVID-19 vaccines and potentially AstraZeneca are associated with increased myocarditis risk in younger individuals, although absolute incidence remains low. More data on children (< 11 years) are needed. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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