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A small increased risk for myopericarditis after COVID-19 vaccination is shown in case reports and population-based studies. To characterize this risk further, particularly in subpopulations, investigators conducted a systematic review and meta-analysis of this complication after both COVID-19 and non–COVID-19 vaccines.
They evaluated 22 studies comprising more than 400 million vaccine doses administered to general populations. Results were as follows:
Risk for myopericarditis was 33 cases per million vaccine doses and did not differ significantly by whether it was a COVID vaccine (18 cases per million doses) or non–COVID-19 vaccine (56 per million).
Myopericarditis risk was lower after COVID vaccination than after smallpox vaccination but not significantly different from risk after influenza vaccination.
In COVID-19 vaccine studies, risk was higher in males, those younger than 30, mRNA vaccine recipients, and those receiving a second dose (vs. first or third dose). For those under 30 years, the risk in males was ten times higher than that in females.
Based on 10 studies, the pooled all-cause mortality following vaccination was 7.8 deaths per million doses, which was not significantly different between COVID-19 and non–COVID-19 vaccines.
Ling RR et al. Myopericarditis following COVID-19 vaccination and non-COVID-19 vaccination: A systematic review and meta-analysis. Lancet Respir Med 2022 Apr 11; [e-pub]. (https://doi.org/10.1016/S2213-2600(22)00059-5)
Comment
This review adds a new twist. While data have consistently shown that myopericarditis rates are low and concentrated in younger people and males, this study adds the comparison with non–COVID-19 vaccines and shows no significant difference in overall rates.