COVID-19 vaccination safe with prior history of myocarditis
Adults with a history of confirmed acute myocarditis did not experience recurrence or serious adverse events after COVID-19 vaccination, researchers reported.
The data were presented at ESC Acute CardioVascular Care Congress 2022, a scientific congress of the European Society of Cardiology.
“We showed that SARS-CoV-2 vaccination in patients with a history of acute myocarditis is not associated with a risk of recurrent myocarditis or other serious side effects,” Iyad Abou Saleh, MD, a resident in the ICU of Hospices Civils de Lyon, France, told Healio. “Our results should be interpreted with caution due to the small number of patients and the predominant use of one type of vaccine.”
Rare cases of myocarditis after SARS-CoV-2 vaccination have been reported. As Healio previously reported, despite low absolute rates, researchers observed elevated odds of cardiac injury among male adolescents and young adults after messenger RNA (mRNA)-based COVID-19 vaccination in a large U.S. study, as well as a smaller study in Hong Kong. Among 192.4 million vaccinated adolescents and young adults in the U.S., researchers observed 1,991 cases of myocarditis after at least one dose.
However, there are a lack of data regarding the risk for myocarditis recurrence after SARS-CoV-2 vaccination in patients with a history of the condition.
“Our experience shows that, in some situations, patients have avoided vaccination because they, or their GP, were afraid it could cause another bout of myocarditis,” Abou Saleh told Healio. “We hypothesized that SARS-CoV-2 vaccination would not increase the risk of myocarditis recurrence in patients who had the condition in the past.”
Abou Saleh and colleagues analyzed data from 142 patients who were hospitalized at Hospices Civils de Lyon with a diagnosis of acute myocarditis from 2016 to June 2021. Researchers contacted patients by phone to respond to a questionnaire on vaccination status and events related to vaccination to assess safety of the COVID-19 vaccine.
The average age of patients was 31 years and 20% were women. Among respondents, 55 patients were vaccinated and 16 patients refused vaccination, with 12 citing a fear of myocarditis recurrence. Vaccination status was unknown for 66 patients and five patients died before the COVID-19 pandemic.
Most patients (96.4%) were vaccinated with the BNT162b2 mRNA vaccine (Comirnaty, Pfizer-BioNTech).
There were no serious adverse events among those who received the COVID-19 vaccine, including death, arrhythmias and recurrent myocarditis.
“Our results were expected since the myocarditis caused by COVID-19 vaccination uses a different pathway from the viral myocarditis, the most common cause of myocarditis,” Abou Saleh said in a press release. “Our study could provide reassuring data for the vaccination of patients with a history of myocarditis.”
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Abou Saleh I, et al. Abstract 20248. Presented at: ESC Acute CardioVascular Care Congress 2022; March 18-19, 2022 (virtual meeting).
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