Cardiac Complications After SARS-CoV-2 Infection and MRNA COVID-19 Vaccination — PCORnet, United States, January 2021–January 2022

Details

• Personal Author:
  Block, Jason P. ; Boehmer, Tegan K. ; Forrest, Christopher B. ; Carton, Thomas W. ; Lee, Grace M. ; Ajani, Umed A. ; Christakis, Dimitri A. ; Cowell, Lindsay G. ; Draper, Christine ; Ghildayal, Nidhi ; Harris, Aaron M. ; Kappelman, Michael D. ; Ko, Jean Y. ; Mayer, Kenneth H. ; Nagavedu, Kshema ; Oster, Matthew E. ; Paranjape, Anuradha ; Puro, Jon ; Ritchey, Matthew D. ; Shay, David K. ; Thacker, Deepika ; Gundlapalli, Adi V.
• Corporate Authors:
  Harvard Pilgrim Health Care Institute. Department of Population Medicine. ; CDC COVID-19 Emergency Response Team. ; Children’s Hospital of Philadelphia. Applied Clinical Research Center. Department of Pediatrics. ; Louisiana Public Health Institute. ; Stanford University School of Medicine. Department of Pediatrics. ; Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle Children’s Hospital, Seattle, Washington ; University of Texas Southwestern Medical Center at Dallas. Department of Population and Data Sciences and Department of Immunology. ; University of North Carolina at Chapel Hill. School of Medicine. Center for Gastrointestinal Biology and Disease. ; Fenway Institute. ; Children’s Healthcare of Atlanta. ; Lewis Katz School of Medicine. Department of Medicine. ; OCHIN, Inc. ; Nemours Children’s Health System. Nemours Cardiac Center. ; National Patient-Centered Clinical Research Network.
• Description:
  What is already known about this topic? Studies have found an increased risk for cardiac Complications after SARS-CoV-2 infection and mRNA COVID-19 vaccination, but few have compared these risks.
  
  What is added by this report? Data from 40 health care systems participating in a large network found that the risk for cardiac Complications was significantly higher after SARS-CoV-2 infection than after mRNA COVID-19 vaccination for both males and females in all age groups.
  
  What are the implications for public health practice? These findings support continued use of recommended mRNA COVID-19 vaccines among all eligible persons aged ≥5 years.
  
  Cardiac Complications, particularly myocarditis and pericarditis, have been associated with SARS-CoV-2 (the Virus that causes COVID-19) infection (1–3) and mRNA COVID-19 vaccination (2–5). Multisystem inflammatory syndrome (MIS) is a rare but serious complication of SARS-CoV-2 infection with frequent cardiac involvement (6). Using electronic health record (EHR) data from 40 U.S. health care systems during January 1, 2021–January 31, 2022, investigators calculated incidences of cardiac outcomes (myocarditis; myocarditis or pericarditis; and myocarditis, pericarditis, or MIS) among persons aged ≥5 years who had SARS-CoV-2 infection, stratified by sex (male or female) and age group (5–11, 12–17, 18–29, and ≥30 years). Incidences of myocarditis and myocarditis or pericarditis were calculated after first, second, unspecified, or any (first, second, or unspecified) dose of mRNA COVID-19 (BNT162b2 [Pfizer-BioNTech] or mRNA-1273 [Moderna]) vaccines, stratified by sex and age group. Risk ratios (RR) were calculated to compare risk for cardiac outcomes after SARS-CoV-2 infection to that after mRNA COVID-19 vaccination. The incidence of cardiac outcomes after mRNA COVID-19 vaccination was highest for males aged 12–17 years after the second vaccine dose; however, within this demographic group, the risk for cardiac outcomes was 1.8–5.6 times as high after SARS-CoV-2 infection than after the second vaccine dose. The risk for cardiac outcomes was likewise significantly higher after SARS-CoV-2 infection than after first, second, or unspecified dose of mRNA COVID-19 vaccination for all other groups by sex and age (RR 2.2–115.2). These findings support continued use of mRNA COVID-19 vaccines among all eligible persons aged ≥5 years.
  
  Suggested citation for this article: Block JP, Boehmer TK, Forrest CB, et al. Cardiac Complications After SARS-CoV-2 Infection and mRNA COVID-19 Vaccination — PCORnet, United States, January 2021–January 2022. MMWR Morb Mortal Wkly Rep. ePub: 1 April 2022.
  
  mm7114e1.htm?s_cid=mm7114e1_w
  
  mm7114e1-H.pdf
  
  
• Subjects:
  2019-nCoV Vaccine MRNA-1273 Arrhythmias, Cardiac BNT162 Vaccine / Adverse Effects COVID-19 MRNA Vaccines Myocarditis Pericarditis SARS-CoV-2 Vaccination
• Source:
  MMWR: Morbidity and Mortality Weekly Report 2022; v. 71 Early Release
• Series:
  Weekly Report: Morbidity and Mortality Weekly Report (MMWR)
• ISSN:
  0149-2195 (print) ; 1545-861X (digital)
• Document Type:
  Journal Article
• Name as Subject:
  Moderna Covid-19 Vaccine ; Pfizer-BioNTECH vaccine ; PCORnet
• Place as Subject:
  Colorado ; Ohio ; North Carolina ; Maryland ; Wisconsin ; South Carolina ; New York ; Florida ; Pennsylvania ; Iowa ; Louisiana ; Kansas ; Michigan ; Missouri ; Nebraska ; Texas ; Utah ; Tennessee
• Pages in Document:
  7 pdf pages
• Volume:
  71
• Collection(s):
  Morbidity and Mortality Weekly Report (MMWR)
• Main Document Checksum:
  urn:sha-512:a64d5056ac1169f7646359b8ebf3d8bba617309e80ac7b029704b2500a9699564ee93f68aba9d0fc18d1f9dd29985f8045ed83abad61e9d3a15aee9614ae5a4a
• Download URL:
  https://stacks.cdc.gov/view/cdc/115913/cdc_115913_DS1.pdf
• File Type:
  [PDF - 401.26 KB ]