Gill Jashan, Mallari Arvin Junn P, Zahra Farah
Department of Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.
Department of Medicine, Northwestern Medicine McHenry Hospital, McHenry, IL, USA.
J Med Cases. 2022 Feb;13(2):80-84. doi: 10.14740/jmc3876. Epub 2022 Feb 16.
Clinical trials of the messenger ribonucleic acid (mRNA)-1273 vaccine developed by Moderna proved excellent safety and efficacy for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevention. However, the Centers for Disease Control and Prevention (CDC) has been investigating cases of myocarditis and pericarditis reported in the Vaccine Adverse Event Reporting System (VAERS) database. Currently, the CDC is reporting rates of 40.6 cases per million after second doses of mRNA vaccines administered to males 30 years or younger. Notably, the initial vaccine trials consisted of a limited number of adolescents and young adults; therefore, they were likely not powered to detect this rare potential side effect. We present a case of transient myopericarditis occurring in a young and healthy patient within 48 h of his second vaccination dose. Although a definitive causal relationship has yet to be determined, we came to this correlation because of the temporal association seen in our patient, secondary to the second dose of vaccination. Furthermore, we also suspect an autoimmune mechanism as the cause of cardiac injury, augmented by the increased vaccine reactogenicity seen in younger patients.
Moderna公司研发的信使核糖核酸(mRNA)-1273疫苗的临床试验证明,其在预防严重急性呼吸综合征冠状病毒2(SARS-CoV-2)方面具有出色的安全性和有效性。然而,美国疾病控制与预防中心(CDC)一直在调查疫苗不良事件报告系统(VAERS)数据库中报告的心肌炎和心包炎病例。目前,CDC报告称,在给30岁及以下男性接种第二剂mRNA疫苗后,每百万例中有40.6例发病。值得注意的是,最初的疫苗试验仅纳入了有限数量的青少年和年轻人;因此,这些试验可能没有足够的能力检测到这种罕见的潜在副作用。我们报告了一例年轻健康患者在接种第二剂疫苗后48小时内发生短暂性心肌心包炎的病例。尽管尚未确定明确的因果关系,但由于在我们的患者中观察到时间关联,继发于第二剂疫苗接种,我们得出了这种相关性。此外,我们还怀疑自身免疫机制是心脏损伤的原因,年轻患者中疫苗反应原性增加加剧了这种情况。