Post-Vax myocarditis, the most prevalent in high school boys

Increasing data on mRNA vaccination against COVID-19 continued to suggest a slight excess risk of myocarditis, especially in young men and adolescent boys.

Based on voluntary reporting to the Passive Surveillance Vaccine Adverse Event Reporting System (VAERS), the number of reported cases of myocarditis after mRNA vaccination from December 2020 to August 2021 was in several groups. More than expected, Matthew Oster, MD, MPH said. Atlanta’s CDC, and of colleagues.

Myocarditis that occurred within 7 days of the second vaccination was the most common:

• Adolescent men aged 16 to 17 years: 105.9 per million doses of Pfizer vaccine
• Adolescent men aged 12 to 15 years: 70.7 per million doses of Pfizer vaccine
• Young men aged 18-24 years: 52.4 and 56.3 per million doses of Pfizer and Moderna vaccines, respectively

Almost all people with post-vaccination myocarditis were hospitalized and clinically monitored (95%), but usually of discharge symptoms after receiving only nonsteroidal anti-inflammatory drugs (87%). Researchers reported experiencing recovery (87%) of JAMA..

They regarded myocarditis as a “rare but serious adverse event” and urged the public to weigh the benefits of COVID-19 vaccination. Against risk..

This study confirms previous reports From CDC When others Baylor College of Medicine cardiologists Biykem Bozkurt, MD, PhD have a high risk of myocarditis in boys and young men, a high risk after the second vaccination, a reduced risk with age, and self. I commented that the limited symptoms can be resolved by support measures. Of Houston’s medicine.

Notably, they are at increased risk of myocarditis not in the 12-15 year old group, but in the 16-17 year old group, where the mechanism is testosterone, an dysregulated immune response, or in certain patients. We have found that it increases the likelihood that it is associated with a genetic predisposition. In addition to molecular mimicry and autoantibody production, Bozkult said.

Oster et al. Admitted two VAERS reports of people under the age of 30 who died of possible myocarditis and were vaccinated against mRNA. However, these cases are under investigation and are not included in the number of paper cases.

“Given the high validation rate of reports of myocarditis to VAERS after mRNA-based COVID-19 vaccination, the likelihood of underreporting is high. Therefore, the practice of myocarditis per million doses of vaccine. Rate can be higher than estimated, “they pointed out.

Harlan Krumholz, MD, SM, a cardiologist at the Yale School of Medicine in New Haven, Connecticut, emphasized this limitation. Passive monitoring..

“But the takeaway message throughout the study is very consistent. Myocarditis appears to be associated with the mRNA vaccine, with a very low incidence, Lower major complications.. Especially young and adolescent men after the second dose have the highest risk, but still quite low, “he wrote in an email.

Three to six months after VAERS reported myocarditis, the CDC began an aggressive follow-up study to assess cardiac outcomes in adolescents, Oster’s group said.

At the time of the study, VAERS reported 1,991 myocarditis cases (1,626 cases that meet the myocarditis case definition) after COVID-19 vaccination of more than 192 million people over the age of 12. ) Was collected.

The median age of patients with myocarditis was 21 years. Boys and men accounted for 82% of cases.

The time to onset of symptoms is approximately 2 days, and 90% of myocarditis events have been reported to occur within 7 days of the second dose.

Myocarditis rates in women and girls remained lower than in their peers in men under the age of 50.

For people under the age of 30, Oster et al. Reported some clinical information available from medical record reviews and clinician interviews.

• Symptoms included chest pain, pressure, or discomfort in 89% of cases.
• Troponin levels increased by 98% of those tested
• Abnormal results were observed in 72% of ECG
• Abnormal results were observed in 72% of cardiac MRI scans

“In contrast, typical viral cases of myocarditis may have a more diverse clinical course. For example, up to 6% of typical viral myocarditis cases in adolescence undergo heart transplantation. It is necessary or leads to death, “they said.

They warned that the quality of VAERS reports varies and tends to lack important clinical information such as previous SARS-CoV-2 infections.