Publication related to RSI or an RSI staff member
Risk of myocarditis and pericarditis in mRNA COVID-19-vaccinated and unvaccinated populations: a systematic review and meta-analysis.
Authors
- Alami, Abdallah, Alami A, School of Mathematics and Statistics, Faculty of Science, Carleton University, Ottawa, Ontario, Canada abdallahalami@cmail.carleton.ca.
- Krewski, Daniel, Krewski D, School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.; Risk Sciences International, Ottawa, Ontario, Canada.
- Farhat, Nawal, Farhat N, School of Mathematics and Statistics, Faculty of Science, Carleton University, Ottawa, Ontario, Canada.
- Mattison, Donald, Mattison D, School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.; Risk Sciences International, Ottawa, Ontario, Canada.; Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.
- Wilson, Kumanan, Wilson K, Bruyère Research Institute, University of Ottawa, Ottawa, Ontario, Canada.; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
- Gravel, Christopher A, Gravel CA, School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Québec, Canada.; Department of Mathematics and Statistics, University of Ottawa, Ottawa, Ontario, Canada.
- Farrell, Patrick J, Farrell PJ, School of Mathematics and Statistics, Faculty of Science, Carleton University, Ottawa, Ontario, Canada.
- Crispo, James A G, Crispo JAG, Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada.; Division of Human Sciences, NOSM University, Sudbury, Ontario, Canada.
- Haddad, Nisrine, Haddad N, School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
- Perez-Lloret, Santiago, Perez-Lloret S, Consejo Nacional de Investigaciones CientÃficas y Técnicas (CONICET), Buenos Aires, Argentina.; Observatorio de Salud Pública, Pontificia Universidad Católica Argentina, Buenos Aires, Argentina.; Department of Physiology, Faculty of Medicine, University of Buenos Aires, Buenos Aires, Argentina.
- Villeneuve, Paul J, Villeneuve PJ, Department of Neurosciences, Faculty of Science, Carleton University, Ottawa, Ontario, Canada.
OBJECTIVE: To summarise the available evidence on the risk of myocarditis and/or pericarditis following mRNA COVID-19 vaccination, compared with the risk among unvaccinated individuals in the absence of COVID-19 infection. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Electronic databases (Medline, Embase, Web of Science and WHO Global Literature on Coronavirus Disease), preprint repositories (medRxiv and bioRxiv), reference lists and grey literature were searched from 1 December 2020 until 31 October 2022. STUDY SELECTION: Epidemiological studies of individuals of any age who received at least one dose of an mRNA COVID-19 vaccine, reported a risk of myo/pericarditis and compared the risk of myo/pericarditis to individuals who did not receive any dose of an mRNA COVID-19 vaccine. DATA EXTRACTION AND SYNTHESIS: Two reviewers independently conducted screening and data extraction. The rate of myo/pericarditis among vaccinated and unvaccinated groups was recorded, and the rate ratios were calculated. Additionally, the total number of individuals, case ascertainment criteria, percentage of males and history of SARS-CoV-2 infection were extracted for each study. Meta-analysis was done using a random-effects model. RESULTS: Seven studies met the inclusion criteria, of which six were included in the quantitative synthesis. Our meta-analysis indicates that within 30-day follow-up period, vaccinated individuals were twice as likely to develop myo/pericarditis in the absence of SARS-CoV-2 infection compared to unvaccinated individuals, with a rate ratio of 2.05 (95% CI 1.49-2.82). CONCLUSION: Although the absolute number of observed myo/pericarditis cases remains quite low, a higher risk was detected in those who received mRNA COVID-19 vaccinations compared with unvaccinated individuals in the absence of SARS-CoV-2 infection. Given the effectiveness of mRNA COVID-19 vaccines in preventing severe illnesses, hospitalisations and deaths, future research should focus on accurately determining the rates of myo/pericarditis linked to mRNA COVID-19 vaccines, understanding the biological mechanisms behind these rare cardiac events and identifying those most at risk.
