Myocarditis and pericarditis after mRNA vaccination against COVID-19
Keywords:
mRNA vaccine, myocarditis, pericarditis, myopericarditisAbstract
COVID-19 pandemic has been occurring since 2019. SARS-CoV-2 virus, especially Delta strain, leads to lots of disasters to several countries around the world including Thailand. Therefore, scientists have been trying to develop many platforms of COVID-19 vaccine. To the best of our knowledge, mRNA vaccine is thought to be the most effective platform which can prevent COVID-19 infection and reduce severity of the disease.
Nowadays, there are 2 types of mRNA vaccine, BNT162b2 by Pfizer company and mRNA-1273 by Moderna company, that have been approved by several organizations. It is recommended to use BNT162b2 and mRNA-1273 in patients more than 12 years old. After significant amount of mRNA vaccine usage worldwide, myocarditis has been reported with the incidence of 16 cases per 1 million doses of vaccinations with unknown mechanism. Moreover, male who are 12-17-year-old possess the highest risk for myocarditis which occur in 56-69 patients per 1 million doses. However, the vaccine can prevent covid-19 infection up to 5,700 patients. Most myocarditis cases are mild in severity and completely reversible with unknown mechanism. There is some assumption of the mechanism of myocarditis which is stimulation and increase in immunity by molecular mimicry or lipid nanoparticle covering the mRNA.
In summary, mRNA vaccine can prevent COVID-19 infection and reduce severity of the disease. Although myocarditis has been reported in some population, benefit of mRNA vaccination is still outweighed this risk. However, the awareness of complication and follow-up after vaccination are still recommended.
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