Aim: The ongoing COVID-19 pandemic is an acute medical, social, political and economic problem. Acute myocarditis is a rare complication of the widely used mRNA-based vaccines. Case Presentation: 20-year old male with no preexisting disease or cardiovascular risk factor presented in October 2021 with chest pain after receiving the second dose of the Moderna COVID-19 vaccine 2 days previously. He discharged from ward care only a few days after his initial presentation. Conclusion: Despite the meta-analysis results suggesting a higher risk of myocarditis with COVID-19 vaccination, vaccination should still be recommended because benefits of the vaccine likely outweigh its harms.
References
[1]
Harrison, G., Lin, T., Wang, P., et al. (2020) Mechanisms of SARS-COV-2 Transmission and Pathogenesis. Trends in Immunology, 41, 1100-1115. https://doi.org/10.1016/j.it.2020.10.004
[2]
Hu, B., Guo, H., Zhou, P. and Shi, Z.L. (2021) Characteristics of SARS-COV-2 and COVID-19. Nature Reviews Microbiology, 19, 141-154. https://doi.org/10.1038/s41579-020-00459-7
[3]
Polack, F.P., Thomas, S.J., Kitchin, N., et al. (2020) Safety and Efficiency of the BNT162b2 mRNA COVID-19 Vaccine. The New England Journal of Medicine, 383, 2603-2615. https://doi.org/10.1056/NEJMoa2034577
[4]
Baden, L.R., EI Sahly, H.M., Essink, B., et al. (2021) Efficiency and Safety of the mRNA-1273 SARS-CoV-2 Vaccine. The New England Journal of Medicine, 384, 403-416. https://doi.org/10.1056/NEJMoa2035389
[5]
Witberg, G., Barda, N., Hoss, S., et al. (2021) Myocarditis after Covid-19 Vaccination in a Large Health Care Organization. The New England Journal of Medicine, 385, 2132-2139. https://doi.org/10.1056/NEJMoa2110737
[6]
Keinath, K., Church, T. and Kurth, B. (2018) Myocarditis Secondary to Smallpox Vaccination. BMJ Case Reports, 2018, bcr2017223523. https://doi.org/10.1136/bcr-2017-223523
[7]
Wong, H.L., Hu, M., Zhou, C.K., et al. (2022) Risk of Myocarditis and Pericarditis after the COVID-19 mRNA Vaccination in the USA: A Cohort Study in Claims Data Base. The Lancet, 399, 2191-2199. https://doi.org/10.1016/S0140-6736(22)00791-7
[8]
Oster, M.E., Shay, D.K., Su, J.R., et al. (2022) Myocarditis Cases Reported after mRNA-Based COVID-19 Vaccination in the US from December 2020 to August 2021. JAMA, 327, 331-340. https://doi.org/10.1001/jama.2021.24110
[9]
Mahrholdt, H., Wagner, A., Deluigi, C.C., et al. (2006) Presentation, Patterns of Myocardial Damage and Clinical Course of Viral Myocarditis. Circulation, 114, 1581-1590. https://doi.org/10.1161/CIRCULATIONAHA.105.606509
[10]
Mason, J.W., Oconnel, J.B., Herskowitz, A., et al. (1995) Myocarditis Treatment Trial Investigators. A Clinical Trial of Immunosuppressive Therapy for Myocarditis. The New England Journal of Medicine, 333, 262-275. https://doi.org/10.1056/NEJM199508033330501
[11]
Cooper Jr., L.T. (2009) Myocarditis. The New England Journal of Medicine, 360, 1526-1538. https://doi.org/10.1056/NEJMra0800028
[12]
Yonker, L.M., Swank, Z., Bartsch, Y.C., et al (2023) Circulating Spike Protein Detected in Post-COVID19 mRNA Vaccine Myocarditis. Circulation, 47, 867-876. https://doi.org/10.1161/CIRCULATIONAHA.122.061025
