<b>Objectives</b><br/>Age-specific information regarding myocarditis/pericarditis in adolescents following mRNA-based coronavirus disease 2019 (COVID-19) vaccination in Asia remains insufficient. This study investigated the incidence and clinical characteristics of myocarditis/pericarditis in Republic of Korea adolescents after mRNA-based COVID-19 vaccination.
<br/><b>Methods</b><br/>This retrospective descriptive study utilized patient data from the Korea Immunization Management System. Incidence rates were calculated according to age and sex. Clinical characteristics (symptoms/signs, laboratory values, and imaging results) were compared between mild and severe cases.
<br/><b>Results</b><br/>Between July 19, 2021 and September 30, 2022, 3,728,224 individuals aged 12 to 19 years received 6,484,165 mRNA-based COVID-19 vaccines, and 173 cases met the case definition for myocarditis/pericarditis: 151 mild (87.3%) and 22 severe (12.7%). The incidence was 3.8-fold higher in males than in females. Troponin I/ troponin T was elevated in 96% of myocarditis cases, demonstrating higher sensitivity than creatine kinase-myocardial band (67.6%) or C-reactive protein (75.2%). ST-segment or Twave on electrography abnormalities were found in 60.3% (85/141). Paroxysmal/sustained atrial/ventricular arrhythmias were more common in severe than in mild cases (45.5% vs. 16.8%, p=0.008). Edema on T2-weighted magnetic imaging occurred in 21.6% (8/37) and 62.5% (5/8) of mild and severe cases, respectively (p=0.03). Abnormal pericardial fluid collection or pericardial inflammation was found in 75.4% of pericarditis cases (49/65).
<br/><b>Conclusion</b><br/>Myocarditis/pericarditis occurred in rare cases following mRNA-based COVID-19 vaccination. Most cases were mild, but the incidence was higher in adolescent males and after the second dose. As bivalent severe acute respiratory syndrome coronavirus 2 mRNA vaccination started in Republic of Korea in October 2022, the post-vaccination incidence of myocarditis/pericarditis should be closely monitored, considering clinical characteristics.
Citations
Citations to this article as recorded by
Responses to Common Misconceptions Relating to COVID-19 Variant-Adapted mRNA Vaccines George Kassianos, Pauline MacDonald, Ivan Aloysius, Shanti Pather Vaccines.2024; 12(1): 57. CrossRef
Comparative safety of monovalent and bivalent mRNA COVID-19 booster vaccines in adolescents aged 12 to 17 years in the Republic of Korea Mijeong Ko, Seontae Kim, Seok-Kyoung Choi, Seung Hwan Shin, Yeon-Kyeng Lee, Yunhyung Kwon Osong Public Health and Research Perspectives.2024; 15(4): 364. CrossRef
Epidemiological Characteristics and Outcome of Myocarditis and Pericarditis Temporally Associated With BNT162b2 COVID-19 Vaccine in Adolescents: Korean National Surveillance Bin Ahn, Seung Hwan Shin, Myung-Jae Hwang, HyoSug Choi, Sara Na, Sangshin Park, Jue Seong Lee, Young June Choe, Yoonsun Yoon, Kyoungsan Seo, Jong Hee Kim, Hyun Mi Kang Journal of Korean Medical Science.2024;[Epub] CrossRef
To become a more stronger and safer country Jong-Koo Lee Osong Public Health and Research Perspectives.2023; 14(2): 67. CrossRef