Cardiovascular Manifestations in Adolescents after the Pfizer-BioNTech COVID-19 Vaccine

Abstract

The BNT162b2 mRNA COVID-19 vaccine against the COVID-19 virus has been clinically proven to be effective and safe with a high-efficiency rate. Minor adverse events such as fatigue and nausea have been reported. However, as more individuals get the vaccine, rarer adverse events have emerged. This case series describes three adolescent males diagnosed with myocarditis or myopericarditis shortly after receiving the second dose of the BNT162b2 mRNA vaccine. Acute COVID-19 was ruled out in all three cases based on negative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and real-time reverse transcription polymerase chain reaction (RT-PCR) tests of specimens obtained using nasopharyngeal swabs. The otherwise healthy patients presented with acute chest discomfort two to three days after receiving their second vaccine dose. All three patients were afebrile with electrocardiogram (ECG) abnormalities, elevated C reactive protein levels ranging from 4.06-6.10 mg/dL, and elevated troponin I levels ranging from 0.26-7.61 ng/dL. No causal relationship has been established between the vaccine and myocarditis or pericarditis. Suspected cases of myocarditis and pericarditis should be reported to the Vaccine Adverse Event Reporting System (VAERS).