Klamer T A, Linschoten M, Asselbergs F W
Department of Cardiology, Division of Heart and Lungs, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.
Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, UK.
Neth Heart J. 2022 Apr;30(4):190-197. doi: 10.1007/s12471-022-01677-9. Epub 2022 Mar 9.
Vaccines against coronavirus 2019 disease (COVID-19) have shown to be greatly effective in preventing viral spread, serious illness and death from this infectious disease and are therefore critical for the management of the COVID-19 pandemic. However, the listing of myocarditis and pericarditis as possible rare side effects of the messenger RNA (mRNA) vaccines against COVID-19 by regulatory agencies has sparked discussion on the vaccines' safety. The most important published cohort studies to date demonstrat that myocarditis is a very rare side effect after COVID-19 mRNA vaccination, with an incidence of approximately 1-4 cases per 100,000 vaccinated persons. Young males (16-29 years) appear to be at highest risk, predominantly after receiving the second dose. The disease course is self-limiting in a vast majority of cases: 95% of patients show a rapid resolution of symptoms and normalisation of cardiac biomarkers, electro- and echocardiographic findings within days. Importantly, the available data suggest that the incidence rate of myocarditis in the context of COVID-19 is much greater than the risk of this side effect following vaccination. We conclude that the benefit of vaccination against COVID-19 outweighs the potential risk of myocarditis and pericarditis in both adolescents and adults. Prospective follow-up of patients who have developed these complications after vaccination is required to assess long-term outcomes.
2019冠状病毒病（COVID-19）疫苗已被证明在预防该传染病的病毒传播、严重疾病和死亡方面非常有效，因此对于COVID-19大流行的管理至关重要。然而，监管机构将心肌炎和心包炎列为COVID-19信使核糖核酸（mRNA）疫苗可能的罕见副作用，引发了关于疫苗安全性的讨论。迄今为止最重要的已发表队列研究表明，心肌炎是COVID-19 mRNA疫苗接种后非常罕见的副作用，每10万名接种者中约有1 - 4例发病。年轻男性（16 - 29岁）似乎风险最高，主要是在接种第二剂疫苗后。在绝大多数情况下，病程是自限性的：95%的患者症状迅速缓解，心脏生物标志物、心电图和超声心动图检查结果在数天内恢复正常。重要的是，现有数据表明，COVID-19背景下的心肌炎发病率远高于接种疫苗后出现这种副作用的风险。我们得出结论，在青少年和成年人中接种COVID-19疫苗的益处大于心肌炎和心包炎的潜在风险。需要对接种疫苗后出现这些并发症的患者进行前瞻性随访，以评估长期结果。
