Myocarditis risk higher with COVID-19 than after vaccination

Oxford – The risk of hospital treatment for myocarditis following SARS-CoV-2 infection is significantly higher for most people than a related complication after vaccination.

Pericarditis or Cardiac Arrhythmias Occurred in a “Self-Controlled Case Series” Study nature therapy (2021; DOI: 10.1038/s41591-021-01630-0) occurs significantly more frequently only after infection.

Reports of inflammatory heart diseases following vaccination with mRNA vaccines have made headlines in recent months. Reports the individual case to the pharmaceutical authorities”eudra vigilance,EMA) or thatVaccine Adverse Event Reporting System,FDA And CDC) Do not allow individual risk assessments, as there is no reporting obligation and no control group.

A more suitable tool for this purpose is the analysis of all diseases that have occurred in the population after vaccination. The method of choice is a “self-control case series” (SCCS), which compares the first few days after vaccination with other periods in the same individual. This avoids malformations that can arise when different groups, here vaccinated and non-vaccinated, are compared with each other.

A team led by Julia Hippie-Cox from the University of Oxford investigated in a SCCS analysis whether myocarditis, pericarditis or cardiac arrhythmias occurred more frequently in the first 28 days after vaccination against SARS-CoV-2. Epidemiologists took data on diseases from “Hospital Episode Statistics”, which records all hospital diagnoses in Great Britain, and “national statistics office“In which all deaths are reported. Time of vaccination taken by them”National Immunization Database,

A second SCCS analysis examined whether the 3 diseases occurred more frequently after infection with SARS-CoV-2. Here was the data source”second generation monitoring system“Which records all positive test results.

The first SCCS analysis confirmed observations made by the vigilance systems of pharmaceutical agencies. In the first 28 days after vaccination with 3 vaccines approved for the first time in the UK, there was an increase in heart disease: following the first dose of AZD1222 from AstraZeneca, there were 2 additional myocarditis events (95% confidence interval 0 to 3) of 1 million people vaccination

After the first dose of Biontech/Pfizer’s BNT162b2, 1 (0-2) additional myocarditis was 6 (2-8) additional myocarditis per 1 million vaccinated individuals following the first dose of mRNA-1273 from Moderna.

What is striking is the high incidence according to mRNA-1273 was also evident with additional cases of myocarditis in 10 (7–11) per 1 million after the second dose. In comparison, there were an additional 40 (38–41) incidences of myocarditis per 1 million people in the first 28 days after testing positive.

The situation is somewhat different with young people. Complications to the vigilance systems were mainly reported in the under 40 age group. Oxford epidemiologists can confirm an increase for the two mRNA vaccines.

There were 2 (1–3) after the first dose of BNT162b2 and 8 (4–9) additional cases of myocarditis per 1 million vaccinated individuals after the first dose of mRNA-1273. There were 3 (2–4) additional cases after the second dose of BNT162b2 and 15 (12–16) additional cases after the second dose of mRNA-1273. In comparison, 10 (7-11) additional cases of myocarditis occurred in people under the age of 40 who tested positive for SARS-CoV-2.

It should be noted that an increase in pericarditis and cardiac arrhythmias could not be detected after vaccination, while the risk of SARS-CoV-2 infection increased significantly. The study cannot explain why myocarditis occurred more frequently after mRNA-1273 than after BNT162b2. It is conceivable that this is related to the high dose of mRNA-1273. rme / aerzteblatt.de