Myocarditis or pericarditis events after BNT162b2 vaccination in individuals aged 12 to 17 years in Ontario, Canada

Buchan, Sarah A.; Alley, Sarah; Seo, Chi Yon; Johnson, Caitlin; Kwong, Jeffrey C.; Nasreen, Sharifa; Thampi, Nisha; Lu, Diane; Harris, Tara M.; Calzavara, Andrew; Wilson, Sarah E.

doi:https://open-science.canada.ca/handle/123456789/3363

Myocarditis or pericarditis events after BNT162b2 vaccination in individuals aged 12 to 17 years in Ontario, Canada

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dc.contributor.author: Buchan, Sarah A.; Alley, Sarah; Seo, Chi Yon; Johnson, Caitlin; Kwong, Jeffrey C.; Nasreen, Sharifa; Thampi, Nisha; Lu, Diane; Harris, Tara M.; Calzavara, Andrew; Wilson, Sarah E.
dc.date.accessioned: 2025-01-27T19:22:06Z
dc.date.available: 2025-01-27T19:22:06Z
dc.date.issued: 2023-02-27
dc.description.abstract - en: Importance The risk of myocarditis or pericarditis after COVID-19 messenger RNA vaccines varies by age and sex, and there is some evidence to suggest increasing risk with shorter intervals between dose 1 and 2 (ie, interdose interval). Objective To estimate the incidence of reported myocarditis or pericarditis after BNT162b2 vaccine among adolescents and to describe the clinical information associated with these events. Design, Setting, and Participants This was a population-based cohort study using passive vaccine safety surveillance data linked to the provincial COVID-19 vaccine registry. Included in the study were all adolescents aged 12 to 17 years in Ontario, Canada, who received 1 or more doses of BNT162b2 vaccine between December 14, 2020, and November 21, 2021, and reported an episode of myocarditis or pericarditis. Data were analyzed from December 15, 2021, to April 22, 2022. Exposure Receipt of BNT162b2 (Comirnaty [Pfizer-BioNTech]) vaccine. Main Outcomes and Measure Reported incidence of myocarditis or pericarditis meeting level 1 to 3 of the Brighton Collaboration case definition per 100 000 doses of BNT162b2 administered by age group (12-15 years vs 16-17 years), sex, dose number, and interdose interval. All clinical information associated with symptoms, health care usage, diagnostic test results, and treatment at the time of the acute event were summarized. Results There were approximately 1.65 million doses of BNT162b2 administered and 77 reports of myocarditis or pericarditis among those aged 12 to 17 years, which met the inclusion criteria during the study period. Of the 77 adolescents (mean [SD] age, 15.0 [1.7] years; 63 male individuals [81.8%]), 51 (66.2%) developed myocarditis or pericarditis after dose 2 of BNT162b2. Overall, 74 individuals (96.1%) with an event were assessed in the emergency department, and 34 (44.2%) were hospitalized (median [IQR] length of stay, 1 [1-2] day). The majority of adolescents (57 [74.0%]) were treated with nonsteroidal anti-inflammatory drugs only, and 11 (14.3%) required no treatment. The highest reported incidence was observed among male adolescents aged 16 to 17 years after dose 2 (15.7 per 100 000; 95% CI, 9.7-23.9). Among those aged 16 to 17 years, the reporting rate was highest in those with a short (ie, ≤30 days) interdose interval (21.3 per 100 000; 95% CI, 11.0-37.2). Conclusions and Relevance Results of this cohort study suggest that there was variation in the reported incidence of myocarditis or pericarditis after BNT162b2 vaccine among adolescent age groups. However, the risk of these events after vaccination remains very rare and should be considered in relation to the benefits of COVID-19 vaccination.
dc.description.sponsorship: This work was supported in part by Public Health Ontario; the Canadian Immunization Research Network through grant CNF 151944 from the Public Health Agency of Canada and the Canadian Institutes of Health Research; the Public Health Agency of Canada, through the Vaccine Surveillance Working Party and the COVID-19 Immunity Task Force; ICES, which is funded by an annual grant from the Ontario Ministry of Health and the Ministry of Long-Term Care; and a Clinician-Scientist Award from the University of Toronto Department of Family and Community Medicine (Dr Kwong).
dc.identifier.doi: https://doi.org/10.1001/jamapediatrics.2022.6166
dc.identifier.issn: 2168-6211
dc.identifier.pubmedID: 36848096
dc.identifier.uri: https://open-science.canada.ca/handle/123456789/3363
dc.language.iso: en
dc.publisher - en: American Medical Association
dc.rights - en: Creative Commons Attribution 4.0 International (CC BY 4.0)
dc.rights - fr: Creative Commons Attribution 4.0 International (CC BY 4.0)
dc.rights.openaccesslevel - en: Gold
dc.rights.openaccesslevel - fr: Or
dc.rights.uri - en: https://creativecommons.org/licenses/by/4.0/
dc.rights.uri - fr: https://creativecommons.org/licenses/by/4.0/deed.fr
dc.subject - en: Health; Immunization; Epidemiology; Coronavirus diseases
dc.subject - fr: Santé; Immunisation; Épidémiologie; Maladie à coronavirus
dc.subject.en - en: Health; Immunization; Epidemiology; Coronavirus diseases
dc.subject.fr - fr: Santé; Immunisation; Épidémiologie; Maladie à coronavirus
dc.title - en: Myocarditis or pericarditis events after BNT162b2 vaccination in individuals aged 12 to 17 years in Ontario, Canada
dc.type - en: Article
dc.type - fr: Article
local.article.journalissue: 4
local.article.journaltitle - en: JAMA Pediatrics
local.article.journalvolume: 177
local.pagination: 410-418
local.peerreview - en: Yes
local.peerreview - fr: Oui

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