Booster vaccination with SARS-CoV-2 mRNA vaccines and myocarditis in adolescents and young adults: a Nordic cohort study
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Booster vaccination with SARS-CoV-2 mRNA vaccines and myocarditis in adolescents and young adults : a Nordic cohort study. / Hviid, Anders; Nieminen, Tuomo A.; Pihlström, Nicklas; Gunnes, Nina; Dahl, Jesper; Karlstad, Øystein; Gulseth, Hanne Løvdal; Sundström, Anders; Husby, Anders; Hansen, Jørgen Vinsløv; Ljung, Rickard; Hovi, Petteri.
In: European Heart Journal, Vol. 45, No. 15, 2024, p. 1327-1335.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Booster vaccination with SARS-CoV-2 mRNA vaccines and myocarditis in adolescents and young adults
T2 - a Nordic cohort study
AU - Hviid, Anders
AU - Nieminen, Tuomo A.
AU - Pihlström, Nicklas
AU - Gunnes, Nina
AU - Dahl, Jesper
AU - Karlstad, Øystein
AU - Gulseth, Hanne Løvdal
AU - Sundström, Anders
AU - Husby, Anders
AU - Hansen, Jørgen Vinsløv
AU - Ljung, Rickard
AU - Hovi, Petteri
N1 - Publisher Copyright: © 2024 Oxford University Press. All rights reserved.
PY - 2024
Y1 - 2024
N2 - Background and aims: The SARS-CoV-2 mRNA vaccines are associated with an increased risk of myocarditis. This association appears to be strongest in male adolescents and younger males and after the second dose. The aim was to evaluate the risk of myocarditis following SARS-CoV-2 mRNA booster vaccination in 12-to-39-year-olds.Methods: A multinational cohort study was conducted using nationwide register data in Denmark, Finland, Norway, and Sweden and comprising all 8.9 million individuals residing in each of the four countries. Participants were followed for an inpatient diagnosis of myocarditis. In each of the four countries, Poisson regression was used to estimate adjusted incidence rate ratios (IRRs) of myocarditis comparing vaccination schedules, with associated 95% confidence intervals (CIs). Country-specific results were combined in meta-analyses.Results: A total of 8.9 million residents were followed for 12 271 861 person-years and 1533 cases of myocarditis were identified. In 12-to-39-year-old males, the 28-day acute risk period following the third dose of BNT162b2 or mRNA-1273 was associated with an increased incidence rate of myocarditis compared to the post-acute risk period 28 days or more after the second dose [IRR 2.08 (95% CI 1.31-3.33) and 8.89 (2.26-35.03), respectively]. For females, the corresponding IRR was only estimable for BNT162b2, 3.99 (0.41-38.64). The corresponding absolute risks following the third dose of BNT162b2 and mRNA-1273 in males were 0.86 (95% CI 0.53-1.32) and 1.95 (0.53-4.99) myocarditis events within 28 days per 100 000 individuals vaccinated, respectively. In females, the corresponding absolute risks following the third dose of BNT162b2 were 0.15 (0.04-0.39) events per 100 000 individuals vaccinated. No deaths occurred within 30 days of vaccine-related cases.Conclusions: The results suggest that a booster dose is associated with increased myocarditis risk in adolescents and young adults. However, the absolute risk of myocarditis following booster vaccination is low.
AB - Background and aims: The SARS-CoV-2 mRNA vaccines are associated with an increased risk of myocarditis. This association appears to be strongest in male adolescents and younger males and after the second dose. The aim was to evaluate the risk of myocarditis following SARS-CoV-2 mRNA booster vaccination in 12-to-39-year-olds.Methods: A multinational cohort study was conducted using nationwide register data in Denmark, Finland, Norway, and Sweden and comprising all 8.9 million individuals residing in each of the four countries. Participants were followed for an inpatient diagnosis of myocarditis. In each of the four countries, Poisson regression was used to estimate adjusted incidence rate ratios (IRRs) of myocarditis comparing vaccination schedules, with associated 95% confidence intervals (CIs). Country-specific results were combined in meta-analyses.Results: A total of 8.9 million residents were followed for 12 271 861 person-years and 1533 cases of myocarditis were identified. In 12-to-39-year-old males, the 28-day acute risk period following the third dose of BNT162b2 or mRNA-1273 was associated with an increased incidence rate of myocarditis compared to the post-acute risk period 28 days or more after the second dose [IRR 2.08 (95% CI 1.31-3.33) and 8.89 (2.26-35.03), respectively]. For females, the corresponding IRR was only estimable for BNT162b2, 3.99 (0.41-38.64). The corresponding absolute risks following the third dose of BNT162b2 and mRNA-1273 in males were 0.86 (95% CI 0.53-1.32) and 1.95 (0.53-4.99) myocarditis events within 28 days per 100 000 individuals vaccinated, respectively. In females, the corresponding absolute risks following the third dose of BNT162b2 were 0.15 (0.04-0.39) events per 100 000 individuals vaccinated. No deaths occurred within 30 days of vaccine-related cases.Conclusions: The results suggest that a booster dose is associated with increased myocarditis risk in adolescents and young adults. However, the absolute risk of myocarditis following booster vaccination is low.
KW - Cohort study
KW - COVID-19
KW - mRNA vaccination
KW - Myocarditis
KW - SARS-CoV-2 vaccination
U2 - 10.1093/eurheartj/ehae056
DO - 10.1093/eurheartj/ehae056
M3 - Journal article
C2 - 38365960
AN - SCOPUS:85190387868
VL - 45
SP - 1327
EP - 1335
JO - European Heart Journal
JF - European Heart Journal
SN - 0195-668X
IS - 15
ER -
ID: 389900628