mRNA COVID-19 vaccine: Young men aged 16-24 are more likely to develop to “myocarditis”

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mRNA COVID-19 vaccine: Young men aged 16-24 are more likely to develop to “myocarditis”

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mRNA COVID-19 vaccine: Young men aged 16-24 are more likely to develop to “myocarditis”.  mRNA COVID-19 vaccine sequelae “myocarditis” prefers young men aged 16-24.

Multinational pharmacovigilance reports, health system surveillance studies, and case series suggest an association between SARS-CoV-2 vaccination and myocarditis and pericarditis, which is more pronounced after a second dose of mRNA vaccines BNT162b2 and mRNA-1273 .

Severe myocarditis or pericarditis can lead to chronic heart failure and even death, and the harm to health cannot be ignored.

On June 25, 2021, the FDA revised the instructions for Pfizer and Moderna’s COVID-19 mRNA vaccine based on the adverse event report issued by the US Centers for Disease Control and Prevention (CDC), and issued a warning to the public: the above two COVID-19 vaccinations will increase myocarditis and pericarditis (inflammation of the tissue surrounding the heart).

In December 2021, according to a Danish population study of nearly 5 million published by BMJ, mRNA-1273 vaccination was associated with a significantly increased risk of myocarditis or pericarditis in 12-39 year olds, but the absolute incidence after vaccination was very low; The increased risk of these diseases is significantly associated with BNT162b2 vaccination [1].

The study, led by Anders Husby of Imperial College London, UK, collected data from the national vaccination registry in Denmark to analyze the association of SARS-CoV-2 vaccination with myocarditis and pericarditis.

In this regard, the WHO and the European Medicines Agency have stated that considering that vaccines can prevent severe COVID-19s and reduce mortality, the benefits of vaccination outweigh the risks it brings. On February 9 this year, the American College of Cardiology publicly stated that although vaccine-associated myocarditis is a real side effect of mRNA vaccination, the benefits of vaccination still outweigh the risks in view of the small number of such cases [2].

JAMA Cardiology: 16-24 years old Young men at highest risk for mRNA vaccine

Previous case reports and surveillance data from the United States, Israel, and Canada suggest an increased risk of myocarditis in humans following SARS-CoV-2 mRNA vaccination, higher after a second dose, and the association is more pronounced in younger men .

Data from Canada and France suggest that there are more cases of myocarditis after mRNA-1273 than after BNT162b2 vaccination, but the specifics remain to be elucidated.

Recently, JAMA Cardiology released a cohort study entitled “SARS-CoV-2 Vaccination and Myocarditis in a Nordic Cohort Study of 23 Million Residents”. A total of 23.1 million residents from 4 Nordic countries, Denmark, Finland, Norway and Sweden were recruited to participate in the study. After research and analysis, it was found that for individuals who received two doses of the same vaccine, young men aged 16-24 years old were vaccinated. The risk of developing myocarditis is highest after the second dose of the vaccine.

Currently, the European Medicines Agency and the European Commission have approved 4 vaccines against SARS-CoV-2 – BNT162b2 (Pfizer-BioNTech), mRNA-1273 (Moderna), AZD1222 (AstraZeneca) and Ad26.COV2.S (Janssen) .

The Nordic countries mainly use two mRNA vaccines, BNT162b2 and mRNA-1273. Among them, the number of people vaccinated with BNT162b2 in Nordic countries is about 6 times that of mRNA-1273.

From December 27, 2020, to October 5, 2021, the researchers followed up 23,122,522 residents (49.8% male and 50.2% female) aged 12 and older from four Nordic countries. By the end of the follow-up, vaccination data were as follows:

• A total of 17,129,982 residents (74%) received 2 doses of SARS-CoV-2 vaccine and 1,681,930 residents (7%) received 1 dose of SARS-CoV-2 vaccine;
• A total of 1,238,004 people in the 12- to 15-year-old age group, 487,751 (39%) received at least 1 dose of SARS-CoV-2 vaccine;
• A total of 2,675,558 people in the 16-24 age group, and 2,009,995 (75%) received at least 1 dose of SARS-CoV-2 vaccine;
• A total of 5,046,164 people in the 25-39 age group, 3,736,517 (74%) received at least one dose of SARS-CoV-2 vaccine;
• Of the 14,162,796 people aged 40 years or older, 12,579,805 (89%) had received at least 1 dose of the SARS-CoV-2 vaccine.

The researchers used Poisson regression to estimate incidence rate ratios (IRRs) with 95% CIs for the number of events, comparing the incidence in the risky period after vaccination with the incidence in the unvaccinated period.

RESULTS:

• The risk of developing myocarditis within 28 days after vaccination with BNT162b2 and mRNA-1273 was higher compared to unvaccinated individuals and was higher after the second dose than the first dose;
• The risk after a second dose of mRNA-1273 was more pronounced than after a second dose of BNT162b2, and was highest among men aged 16 to 24 years.

The specific data are as follows:

1. During the follow-up period, the incidence of myocarditis and pericarditis

A total of 1077 cases of myocarditis and 1149 cases of pericarditis were observed in the unvaccinated and post-vaccinated 28-day risk period (13 million person-years in total);

During the unvaccinated period, the incidence of myocarditis was 9.7 per 100,000 person-years in men and 4.3 per 100,000 person-years in women. Among people aged 16 to 24, the incidence was 18.8/100,000-years in men and 4.4/100,000-years in women. The incidence of pericarditis increases with age, ie the risk of myocarditis is highest in older age groups. The risk of developing myocarditis was highest in younger people after vaccination.

**Ten Thousand Years: A Statistical Calculation Data Unit

2. During the risk period, the relationship between vaccination and the incidence of myocarditis

During the 28-day risk period after vaccination, the researchers observed 105 and 115 cases of myocarditis after the first and second doses of BNT162b2, respectively; 15 after the first and second doses of mRNA-1273, respectively cases and 60 myocarditis cases;

In young men 16 to 24 years old, the adjusted IRR for myocarditis was 5.31 (95% CI, 3.68-7.68) for the second dose of BNT162b2 and 13.83 (95% CI, 8.08) for the second dose of mRNA-1273 -23.68). Relative to women, younger men have lower rates of vaccinating (Figure 2);

After comparing IRR data across age groups, the researchers found that young men between the ages of 16 and 24 who received the BNT162b2 and mRNA-1273 vaccines had a higher risk of developing myocarditis, and the second dose had a higher risk than the first one dose.

3. The relationship between vaccination and the incidence of pericarditis during the risk period

For men aged 16 to 24 years who had received the second dose of mRNA-1273 during the 28-day risk period, there were 7.39 pericarditis events per 100,000 vaccine recipients. The pattern of pericarditis in men is similar to that found in myocarditis, but the overall IRR is lower; pericarditis is rare in women aged 12 to 39 years.

Figure 2 Incidence data of myocarditis or pericarditis by sex and age within 28 days of vaccination (Source: [3])

The above study showed that the incidence of myocarditis and pericarditis was higher within 28 days after vaccination with SARS-CoV-2 mRNA vaccine compared with those without SARS-CoV-2 mRNA vaccine.

The risk of developing myocarditis and pericarditis was highest within the first 7 days of vaccination and was more pronounced after the second dose.

The second dose of mRNA-1273 was associated with the highest risk of myocarditis and pericarditis, with the highest risk in young men aged 16 to 24 years.

References:

[1]Husby A, Hansen JV, Fosbøl E, et al. SARS-CoV-2 vaccination and myocarditis or myopericarditis: population based cohort study[J].British Medical Journal,2021,375:e068665.

[2] https://www.acc.org/Latest-in-Cardiology/Articles/2022/02/09/12/56/Vaccine-Associated-Myocarditis-Risk-in-Context

[3] Karlstad Ø, Hovi P, Husby A, et al. SARS-CoV-2 Vaccination and Myocarditis in a Nordic Cohort Study of 23 Million Residents. JAMA Cardiol. 2022 Apr 20. doi: 10.1001/jamacardio.2022.0583. Epub ahead of print. PMID: 35442390.

[4] https://healthcare.utah.edu/healthfeed/postings/2022/01/myocarditis-covid19.php

mRNA COVID-19 vaccine: Young men aged 16-24 are more likely to develop to “myocarditis”. 

(source:internet, reference only)

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