BACKGROUND AND PURPOSE:

• Ling et al. (The Lancet Respiratory Medicine, 2022) characterized the incidence of myopericarditis following COVID-19 vaccination vs non-COVID-19 vaccination

METHODS:

• Systematic review and meta-analysis
• Study inclusion criteria
  • Studies that reported on people in the general population who had myopericarditis in temporal relation to receiving vaccines
• Study design
  • GRADE criteria used to assess certainty of evidence
  • The primary outcome was analyzed among subpopulations, stratifying by vaccine (COVID-19 vs non-COVID-19) and age group (adult vs pediatric)
  • The effect of vaccine type (mRNA or non-mRNA), sex, age, and dose were examined
• Primary outcome
  • Incidence of myopericarditis following vaccination

RESULTS:

• 22 studies | 405,272,721 vaccine doses
• Overall incidence of myopericarditis: 33.3 cases per million vaccine doses (95% CI, 15.3 to 72.6)
• The incidence of myopericarditis did not differ significantly between people who received COVID-19 vaccines compared to those who received non-COVID vaccines (P=0.20)
  • COVID vaccines
    • 18.2 cases per million vaccine doses (95% CI, 10.9 to 30.3)
    • 11 studies (395,361,933 doses) | high certainty
  • Non-COVID vaccines
    • 56.0 cases per million vaccine doses (95% CI, 10.7 to 293.7)
    • 11 studies (9,910,788 doses) | moderate certainty
• Compared with COVID-19 vaccination, the incidence of myopericarditis was
  • Significantly higher following smallpox vaccinations
    • 132.1 cases per million vaccine doses (95% CI, 81.3 to 214.6); P<0.0001
  • Not different after influenza vaccination
    • 1.3 cases per million vaccine doses (95% CI, 0.0 to 884.1); P=0.43
  • Not different after various other non-smallpox vaccinations
    • 57.0 cases per million vaccine doses (95% CI, 1.1 to 3036.6); P=0.58
• Among people who received COVID-19 vaccines, the incidence of myopericarditis was significantly higher in
  • Males
  • People <30
  • People receiving an mRNA vaccine
  • People receiving a second dose (compared to a first or third dose)

CONCLUSION:

• The overall incidence of myopericarditis was low following COVID-19 vaccination, at 18.2 cases per million doses and this incidence did not differ significantly from that of the flu vaccine
• The incidence was highest for males, younger people, and those receiving an mRNA vaccine
• The authors state

Our systematic review and meta-analysis shows that the incidence of myopericarditis in people who received COVID-19 vaccines was not significantly different from that in people who received non-COVID-19 vaccines in general, and was lower than that in people who received smallpox vaccines 

Learn More – Primary Sources:

Myopericarditis following COVID-19 vaccination and non-COVID-19 vaccination: a systematic review and meta-analysis

Related ObG Topics:

CDC Reports on the Risk of Myocarditis with COVID-19 Vaccination

CDC Reports: The Latest on COVID-19 and Increased Risk of Myocarditis

More Data on Myocarditis Incidence Following mRNA-Based COVID-19 Vaccination

How Does Myocarditis Risk with COVID-19 Vaccination Compare to Risk associated with SARS-CoV-2 Infection?