![]() ![]() This report summarizes the relevant scientific knowledge, uncertainties, and suggested priority actions regarding rare cases of heart inflammation consistent with myocarditis and pericarditis linked to mRNA COVID-19 vaccines. Providing balanced and transparent messaging to the general public and outreach to specific subgroups who may be at potential higher risk for cardiac adverse effects.Urgently developing and disseminating clinical guidance for healthcare professionals to effectively recognize and manage those affected and to counsel those potentially at higher risk.Active, coordinated and longer-term post-vaccine surveillance, including prospective cohort studies that monitor cardiac and immune parameters.Establishing whether vaccine platform affects the risk for vaccine-associated myocarditis and pericarditis.Targeted biomedical and clinical research to better understand disease pathophysiology and develop preventive and therapeutic measures. ![]() Timely efforts are required to address scientific gaps, engage with healthcare providers to raise awareness of the condition and standards of care, and build ongoing trusted communications with the public, including targeted approaches with younger adults. Priority considerations: The benefits of vaccination, including prevention of COVID-19 infection and transmission as well as post-COVID complications such as long-COVID and MIS-C, outweigh the potential risk of vaccine-associated myocarditis and pericarditis but active monitoring and research are needed to understand and prevent vaccine-associated cardiac damage, now and in the future. The mechanisms for these vaccine-associated heart conditions need to be uncovered in order to understand risk factors and develop prevention and treatment. The potential biological mechanisms underlying COVID-19 vaccine-associated myocarditis and pericarditis are currently unknown but hospitalized individuals have generally responded well to anti-inflammatory interventions. Additionally, because fewer young adults have been fully vaccinated with other types of COVID-19 vaccines, it is uncertain whether vaccine-associated cardiac inflammation is specific to the mRNA platform. Further post-vaccine surveillance data are required to determine the incidence frequency and distribution across age groups and gender. For now, most vaccine-associated myocarditis reports are derived from Israel and the USA, the first countries to use mRNA vaccines in their mass vaccination campaigns. Scientific uncertainties: Data from COVID-19 mass vaccination are rapidly evolving with more countries stepping up vaccine rollouts among their populations. Most cases resolved quickly with supportive treatment only. Pericarditis was seen across the age spectrum. Symptoms generally manifested a few days post-vaccination and were reported in all age groups, but predominantly in male adolescents and young adults. Cases of myocarditis and pericarditis are being reported in association with COVID-19 mRNA vaccination, mostly following the second vaccine dose. In most cases, pericarditis and myocarditis resolve with no further heart damage but persistent heart inflammation can increase the risk of serious and irreversible organ damage. Myocarditis is also a reported rare side effect of certain vaccines. Viral infections, including with SARS-CoV-2, the virus responsible for the COVID-19 pandemic, are known inducers of myocarditis. Scientific knowns: Inflammation of the muscle (myocardium) or outer layer (pericardium) of the heart can be caused by multiple agents and conditions. This report builds on the expert discussion, summarizes scientific knowns and uncertainties, and suggests priority areas for consideration. The Chief Science Advisor convened a meeting with scientific experts on June 25, 2021, to discuss the reported incidence, presentation and possible causes of myocarditis and pericarditis associated with mRNA COVID-19 vaccines. ![]() While these vaccines have proved safe and remarkably effective, mass vaccination has uncovered rare but potentially significant side effects such as heart inflammation consistent with myocarditis and pericarditis. The timely development and deployment of COVID-19 vaccines are playing a key role in limiting disease severity and overcoming the pandemic. ![]() COVID-19 vaccine-associated myocarditis/pericarditis ![]()
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