key: cord-0958643-wq454pcg
authors: Nevet, Alon
title: Acute myocarditis associated with anti-COVID-19 vaccination
date: 2021-05-31
journal: Clin Exp Vaccine Res
DOI: 10.7774/cevr.2021.10.2.196
sha: 6e3a365ef609bdeb3f336cb64d79b51758153816
doc_id: 958643
cord_uid: wq454pcg

Novel anti-coronavirus disease 2019 mRNA vaccines are rapidly implemented worldwide. Therefore, attention should be given to potentially life-threatening adverse reactions. We report on three young male patients, who developed acute myocarditis 2 days after receiving the second dose of the BNT162b2 vaccine. Primary acute myocarditis was not previously reported in association with vaccines that do not include adjuvants. A high index of suspicion should be maintained in order to diagnose and treat patients who develop auto-inflammatory vaccine-related complications in a timely manner. Further research is required in order to explore the significance of this phenomenon and its underlying molecular mechanism.

also lead to life-threatening arrhythmias, cardiomyopathy, and acute or chronic heart failure.

Autoinflammatory myocarditis had been reported as a presumed rare adverse reaction to vaccine-related adjuvants [4] . However, BNT162b2 is a novel mRNA vaccine and does not contain adjuvants. Therefore, other ingredients of BNT162b2 may be related to this adverse reaction. According to the FDA [5] , in addition to a nucleoside-modified mRNA, the vaccine includes the lipids: ((4-Hydroxybutyl)azanediyl) bis(hexane-6, 1-diyl) bis(2-hexyldecanoate), 2-[(polyethylene glycol)-2000]-N,N-ditetradecylacetamide, 1,2-distearoyl-snglycero-3-phosphocholine, and cholesterol, potassium chloride, monobasic potassium phosphate, sodium chloride, dibasic sodium phosphate dihydrate, and sucrose.

Although this limited series does not prove causation, the immediate time relation and the similarities between the cases should trigger further evaluation and systematic screening for the described phenomena in the population, as the novel anti-COVID-19 vaccines are globally implemented.

Alon Nevet https://orcid.org/0000-0002-0922-2166 

Safety and efficacy of the BNT162b2 mRNA COVID-19 vaccine

Silver Spring (MD): Food and Drug Administration

Gov.il; 2021

Post-vaccination myositis and myocarditis in a previously healthy male

Vaccines and Related Biological Products Advisory Committee Meeting: FDA briefing document: Pfizer-BioNTech COVID-19 Vaccine