A study supports individualized pediatric COVID-19 strategies that weigh protection against severe disease vs risks of vaccine-associated myo/pericarditis. The results appeared in the European Journal of Clinical Investigation.
In this study, the researchers used the the Vaccine Adverse Event Reporting System (VAERS) to identify 253 cases of myo/pericarditis occurrence according to Centers for Disease Control and Prevention criteria. The outcomes of interest were defined as post-vaccination myo/pericarditis crude incidence in adolescents aged 12 to 15 and 16 to 17, and 2 risk-benefit analyses by age, sex, comorbidity, and history of infection.
In total, the investigators identified 129 cases of myo/pericarditis after dose 1 and 124 cases following dose 2, of which approximately 87% were hospitalized. They observed that incidence per million after dose 2 in males aged 12 to 15 and 16 to 17 was 162.2 and 93.0, respectively. The risk benefit analysis indicated that among 12 to 17-year-olds, a 2-dose vaccination was uniformly favorable only in non-immune girls with a comorbidity. In boys with prior infection and no comorbidities, the findings suggest that even one dose carried more risk than benefit according to international estimates. “In the setting of omicron, one dose may be protective in non-immune children, but dose 2 does not appear to confer additional benefit at a population level,” the researchers wrote of the results.
The researchers concluded that the findings “strongly support individualized pediatric COVID-19 vaccination strategies which weigh protection against severe disease vs risks of vaccine-associated myo/pericarditis.” They added that research “is needed into the nature and implications of this adverse effect as well as immunization strategies which reduce harms in this overall low-risk cohort.”
Keywords: COVID-19, SARS-CoV-2, drug-related adverse reactions, myocarditis, pediatrics, vaccination