New analysis on the risk for myocarditis or pericarditis after mRNA COVID-19 vaccination

A comprehensive review and meta-analysis of published research confirm that young adults (40 years old and younger) have a slightly elevated risk for myocarditis or pericarditis after mRNA COVID-19 vaccination. The analysis is reported in a new study in the American Journal of Preventive Medicine, published by Elsevier.

Our study analyzes data to identify who might be at high risk for myocarditis/pericarditis after COVID-19 vaccination and validates the rare adverse reaction in adults under 40."

Chenyu Sun, MD, MSc, Lead Investigator, AMITA Health Saint Joseph Hospital Chicago, Chicago, IL, USA

Key findings include:

  • A second vaccine dose is associated with a greater risk of the cardiovascular reaction than the first dose.
  • The increased risk is only associated with mRNA (e.g., mRNA-1273 and BNT162b2 – the latter linked to a slightly lower risk than the former), but not other vaccine types (e.g., Corona-Vac.).
  • While males are more likely to develop myocarditis/pericarditis (established by research prior to the pandemic), female susceptibility increases after the COVID-19 vaccine.
  • The incidence of myocarditis/pericarditis for those infected with SARS-CoV-2 is higher than it is after vaccination.

Myocarditis is an inflammation of the cardiac muscle that may present with chest pain, fever, congestive heart failure, or arrhythmias and can lead to death. Pericarditis generally causes severe chest pain behind the sternum. Both are believed to result from autoinflammation and be related to the immune response to viral infection.

Dr. Sun pointed out, "When myocarditis or pericarditis develop after a COVID-19 vaccination, the symptoms are usually less severe and largely self-remitting compared with other cases. As a clinician, I strongly recommend that people get a COVID 19 vaccine unless there are absolute contraindications such as known allergies. The benefits and harms must be carefully assessed to determine the best management option for patients who are in the high risk-group."

Concerns about this rare but dangerous adverse reaction have caused confusion for both the general public and healthcare providers. "By exploring the relationship between COVID-19 vaccine and myocarditis/pericarditis through systemic review and meta-analysis, we hope to clarify the risks and help healthcare providers and public health policy makers to provide a safer vaccination strategy for high-risk groups. Vaccination is one of the most important measures we have in the fight against COVID-19. Different strategies of different doses or different types of COVID-19 vaccine can be adopted according to the characteristics of the population," added co-investigator Linya Feng, MPH, Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China.

The study also explores several pathogenic mechanisms of the association between COVID-19 vaccination and myocarditis/pericarditis, the exact etiology of which remains uncertain. First author Juan Gao, MMS, Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China, commented, "I hope more studies can be done to explore adverse events after vaccination, so healthcare providers and public health professionals can be guided with even better evidence."

The comprehensive literature search identified 1,123 relevant published papers. Of these the investigators selected 11 studies on COVID-19 vaccination and the risk of myocarditis or pericarditis that met their rigorous criteria; eight of them compared the incidence of myocarditis or pericarditis before and after COVID-19 vaccination and three analyzed the effect of different doses of vaccination on the incidence of myocarditis or pericarditis. Based on data on more than 58 million participants in these studies, the investigators analyzed the effects of different sexes, ages, regions, vaccination types, and doses on the risk of myocarditis or pericarditis.

More than 300 SARS-CoV-2 vaccines have been developed and 169 are currently in clinical trials.

Journal reference:

Gao, J., et al. (2022) A Systematic Review and Meta-analysis of the Association Between SARS-CoV-2 Vaccination and Myocarditis or Pericarditis. American Journal of Preventive Medicine.


  1. Charles Fettinger Charles Fettinger United States says:

    That is just something they say to get published.

    The actual story, evidenced from Israel, is that each dose and each infection does cummulative damage to the heart. The body simply has no defense against LNP when they transfect heart tissue and turn it into a spike protein producer.

    So, I see no possible way the damage could be less that damage mitigated by immune response. You may simply get a dose of mRNA vax with less LNP due to quality control issues.

    • MotherToAllDragons MotherToAllDragons United States says:

      So does the small pox vaccine but its not an MRNA vaccine. The reaction is not the vaccine its the immune response to the invader. As a science translator this is the best explanation I can give: Although the long-term outcomes of vaccine-associated myocarditis and pericarditis are unclear, the current knowledge on the short-term clinical trajectories are reassuring. The clinical presentations of myocarditis after COVID-19 mRNA vaccination have been predominantly mild and few patients have required intensive treatment.


       However, one case-series, published in 2022, of adolescent patients found a persistence of radiographic abnormalities at follow-up examinations, which could be cause for concern.


       However, the patients followed up had excellent clinical outcomes, suggesting minimal chronic morbidity attributable to vaccine-associated myocarditis. Nevertheless, the continuous surveillance of this patient group for any increased frequency of heart failure, sudden death, or related cardiac comorbidities is necessary.

      With regard to the underlying disease mechanism, it is necessary to note that myocarditis and pericarditis are not novel side-effects of vaccination. Other vaccinations, especially smallpox vaccination, have previously been associated with a similar increased risk of myocarditis.


       These findings suggest that the disease mechanism is specific neither to the newly developed mRNA vaccines nor to exposure to the SARS-CoV-2 spike protein. Other mechanisms have been suggested, yet hard evidence explaining the association is absent. Future mechanistic studies into potential mechanisms are therefore warranted and could provide valuable insight, leading to even safer COVID-19 mRNA vaccines.

    • merri petersen merri petersen United States says:

      The fact that the virus has never been isolated, and the PCR tests are irrelevant due to that, is really an issue that everyone should think about. What happened to people's ability to critically think about issues. Full disclosure of the true science, not the political science that the MSM owned by the big pharm is only allowed to report, no longer reporting objective news. Only to yield more profit. Not putting the actual CDC VAIRS REPORTING SYSTEM out for the general, and unsuspecting population to view. It's sad, and pathetic what our country is doing to the human population, which to them we are just cattle.

      • Jennifer Jennifer United States says:

        LOL, where do you fill your brain with this, Instagram? Fact: Use Google and you will find many papers, mostly from late 2019 and early 2020.  Read and they will easily show to any thinker that it has been isolated by independent teams or scientists (ooh, just want to alert you that big words will be used in these papers) around the world. Here are some of the earlier ones: Korea National University, Seoul; both the VIDO-InterVac in Saskatoon, and Sunnybrook Health Sciences Centre at University of Toronto, Canada; Regione FVG Laboratory Group/Trieste University, Italy; a consortium of medical and university based researchers in Odense, Demmark.
        Not enough? The virus has also been completely sequenced several times, which is again indicative that it HAS been isolated. Come out of
        your sink hole, or at least quit pretending sharing such obvious lies. Again, Google is your friend, if you actually care.

  2. leslie landberg leslie landberg United States says:

    When millions of people all over the world can see for themselves how prevalent these affects are, simply by watching sports programs, where athletes in superb health are dropping dead in unheard of numbers, I think it's time to admit vaccination against COVID-19 has been one of history's most spectacular medical experimental failures.  Now, since it was known to the manufacturers of these experimental drugs and to the FDA that the spike protein in its envelope migrates and proliferates throughout the body and that hundreds of test subjects died, got gravely ill and had to be dropped as a consequence, that conditional use approval of these drugs and their subsequent deployment constitutes the largest violation of medical ethics in medical history and this violates informed consent and human rights laws.  Therefore this rigorous science must be held as evidence of obfuscation and an attempt to shied all the guilty parties, which includes hospitals, nurses and doctors.  This is accomplished by a huge information blackout in which medical staff are directed by hospital administrators to turn away patients claiming to have been injured by the vaccines and pointedly refusing to collect information on these incidences.  Any report or study based upon these highly gamed metrics should be regarded with extreme suspicion.

    • William Who William Who United States says:

      I turn 60 in a few months. I began participating in sports when I was six. I stopped playing when I was 15. The same year I became a sports official in baseball, football, and basketball.

      Over the decades, I averaged 250 to 350 games per year, including youth leagues, high school, junior college, private colleges, small universities, and industrial leagues. I will not bore you with the names of famous college and pro athletes that I know or know me.

      You said, "...where athletes in superb health are dropping dead in unheard of numbers...," without attributing a source. A quick Google search returns results of disinformation labels. The largest cardiac specialty organization in the world says that no athletes have died as a direct result of the COVID-19 vaccine. The CDC has no data to support the claim, nor does the NIH.

      One claim was that hundreds of FIFA players have died from cardiac-related complications after getting one or more of the vaccines. FIFA said they are "not aware of any scientifically validated link between COVID-19 vaccination and deaths in footballers.” Another FIFA representative doubted that their losses from COVID-19 exceeded or got close to 100.

      Jonathan Drezner, MD (UW Medicine Center for Sports Cardiology, Seattle), editor-in-chief of the British Journal of Sports Medicine and with the National Center for Catastrophic Sport Injury Research, said, "I am not aware of any COVID-19 vaccine-related athletic death that’s occurred." The NCCSIR monitors all cases of sudden cardiac arrest and death among competitive athletes from middle school through the professional level.

      As a sports official and a member of five professional associations, our membership lost about 40 members to COVID-19 and none to the vaccine. By "none," I mean zero. Over 90% of certified sports officials in the US belong to one or more of those five groups.

      My spouse is a nurse working for the Department of the Army in a flight Medicine clinic. The Army reports zero casualties from the vaccine. However, they report that about 100 soldiers showed signs of pericarditis or myocarditis—all of those resolved over time. Locally, no soldiers received a medical discharge due to cardiac complications. I cannot find a source to obtain the number for the Army or other services.

      Since sports and the military comprise the population most at risk for both cardiac complications, I posit that with no deaths attributable to the vaccine reported, your source is fatally flawed. I recommend euthanasia for the misinformation you attempt to propagate.

  3. Richard Lewis Richard Lewis United Kingdom says:

    Many people have asked the people who have supposedly isolated the virus for copies and they say they haven't actually got any. If you want to believe the empires clothes are real then go ahead lol

  4. Richard Lewis Richard Lewis United Kingdom says:

    Talking about sequencing. We all know the pcr test was made from a computer sequence which has been admitted. Wonder why that is lol

The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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