Fast Five Quiz: COVID-19 Vaccines

Glenn Wortmann, MD

Disclosures

August 02, 2022

Cases of myocarditis and pericarditis in adolescents and young adults were reported starting in spring 2021 after mRNA vaccination. Reported cases have occurred predominantly in boys and young men aged 16 years or older. The typical onset has been within several days after mRNA COVID-19 vaccination, more often after the second than the first dose. Symptoms and diagnostic findings have included chest pain, elevated cardiac enzymes, and ST- or T-wave changes. Available outcome data indicate that patients generally recover from symptoms of myocarditis or pericarditis. In a systematic review involving 106 studies, Ilonze and Gugline reported a low mortality rate of 1.7% among 238 myocarditis cases after COVID-19 vaccination. There is still uncertainty about the true rates of myocarditis after mRNA vaccines, but a benefit-risk assessment from the CDC concluded in favor of vaccination for all age and sex groups.

Guillain-Barré syndrome is an adverse event that has been reported in people who have received a viral vector vaccine. The cases have largely been reported about 2 weeks after vaccination, mostly in men aged 50 years or older. Rare cases of thrombosis and thrombocytopenia syndrome have also been reported after viral vector vaccination. Women younger than 50 years are at increased risk for this rare event. Reports of death after any form of COVID-19 vaccination are also rare, and a causal link to the vaccines has not been established.

According to a recent meta-analysis, most vaccine-associated myocarditis events have been mild and self-limited. Conversely, SARS-CoV-2 infection was associated with a substantial increase in the risk for hospitalization or death from myocarditis, pericarditis, and cardiac arrhythmia. Other data have demonstrated that risks for myocarditis and related complications were higher after SARS-CoV-2 infection than after vaccination among males and females in all age groups.

Learn more about COVID-19 vaccine safety.

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