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The risk of developing myocarditis and other inflammatory heart conditions after COVID-19 vaccination is substantially lower than it is after SARS-CoV-2 infection, according to an analysis of electronic health records from 40 US health systems.
Although it’s a rare complication, myocarditis has been associated with both SARS-CoV-2 infection and messenger RNA (mRNA)–based vaccines against the virus. To directly compare the likelihood of developing it and other cardiac complications after vaccination vs infection, the investigators calculated incidence rates of myocarditis; myocarditis or pericarditis; and myocarditis, pericarditis, and multisystem inflammatory syndrome (MIS) among 15.2 million people treated in health systems that participated in the National Patient-Centered Clinical Research Network from early January 2021 through January 2022.
Among males aged 12 to 17 years, the incidence of myocarditis or pericarditis after infection with SARS-CoV-2 was about twice as high as after vaccination with 2 doses of an mRNA-based COVID-19 vaccine. When MIS, a post–COVID-19 syndrome that often includes cardiac complications, was included in the comparison, the risk of cardiac problems was about 2 to 6 times higher after infection than after 2 doses of vaccine. Men aged 18 to 29 years had a 7 to 9 times greater risk of cardiac complications after infection than after 2 doses of vaccine.
In boys and girls aged 5 to 11 years, the incidence of myocarditis after vaccination was 0 or close to it, making a statistically significant comparison between infection- and vaccination-related cardiac complications impossible. For females aged 12 years or older, the risk of cardiac complications ranged from 6 to 63 times higher after infection than after 2 doses of an mRNA-based vaccine.
Kuehn BM. Cardiac Complications More Common After COVID-19 Than Vaccination. JAMA. 2022;327(20):1951. doi:10.1001/jama.2022.8061
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