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News From the Centers for Disease Control and Prevention
September 14, 2021

Adolescent Myocarditis After COVID-19 Vaccination Is Rare

JAMA. 2021;326(10):902. doi:10.1001/jama.2021.14237

Postmarketing safety monitoring data suggest that nonserious local and systemic reactions are common among adolescents who receive a SARS-CoV-2 mRNA vaccine, while reports of severe adverse events like myocarditis are rare.

iStock.com/Courtney Hale

Between December 2020 and mid-July of this year, nearly 9 million US adolescents aged 12 to 17 years received Pfizer-BioNTech’s COVID-19 vaccine, the only one approved for use among this age group. During that period, the CDC’s Vaccine Adverse Event Reporting System (VAERS) collected 9246 reports of postvaccination adverse events in this age group, or 1 per 1000 recipients.

More than 90% of the reports were for nonserious symptoms, most commonly dizziness, fainting, nausea, headache, and fever. Among 863 serious adverse events, the most common conditions and findings were chest pain, increased troponin levels, and myocarditis. Myocarditis, which disproportionately affected males, was listed in 397 reports, representing 4.3% of all VAERS reports. Fourteen deaths were reported, but there was no pattern indicating that vaccination caused them. However, cause of death for 6 adolescents was unknown or pending, the authors noted.

Additionally, nearly 130 000 adolescents participated in a series of postvaccination CDC surveys. Participants received recurring text reminders to complete a web-based survey over 12 months. Half of them reported systemic reactions after the first dose, and about two-thirds reported them after the second. Most reactions occurred the first day after vaccination and the most frequently reported symptoms were injection site pain, fatigue, headache, and muscle pain. One-third of adolescents reported a fever in the week after the second dose, and about one-quarter reported they were unable to perform daily activities the day after their second shot.

The VAERS myocarditis reports are being followed up. Other case reports so far suggest the condition improves with time and supportive care.

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    1 Comment for this article
    Injection Site
    Robert Raines, MD. | Teaching Hospital
    The photo appears to show an injection being given mid arm, clearly not in the deltoid which is, I believe, the preferred site. The shot pictured may or may not have reached the triceps or may well have been given subcutaneously. It does raise the question in all studies as to how much injection site affects the vaccine’s effectiveness (and of course, side effects). Many people who are not used to giving shots are giving them around the world.
    CONFLICT OF INTEREST: None Reported
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