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Myocarditis, COVID, and Vaccines

Myocarditis is inflammation of the heart muscle. Myocarditis can occur when the body’s immune system causes inflammation in response to an infection or some other trigger. Myocarditis can result in hospitalization, heart failure, and sudden death.

A recent article in the New England Journal of Medicine shares a study examining the association between the development of myocarditis and the receipt of (mRNA) vaccines for Covid-19.  Of the more than 2.5 million vaccinated individuals in the study who were 16 years of age or older, 54 cases were diagnosed with myocarditis. The highest incidence of myocarditis was in male patients between the ages of 16 and 29. Most cases of myocarditis were mild in severity. 

The C.D.C. reports that vaccines are safe for people with a history of heart disease. Individuals with heart disease are at increased risk of severe complications from COVID-19 and should be vaccinated.  During March 2020–January 2021, hospital data showed patients with COVID-19 had close to 16 times the risk for myocarditis than patients who did not have COVID-19, and the risk varied by sex and age. C.D.C.

From the Cardiology Department, Rabin Medical Center, Beilinson Hospital, Petah Tikva (G.W., S.H., I.R., M.W., Y.A., T.G., R.K.), the Faculty of Medicine, Tel Aviv University (G.W., S.H., I.R., M.W., Y.A., T.G., R.K.), and the Innovation Division, Clalit Research Institute, Clalit Health Services (N.B., O.A., N.D., R.D.B.), Tel Aviv, and the Department of Software and Information Systems Engineering (N.B., N.D.) and the School of Public Health, Faculty of Health Sciences (R.D.B.), Ben Gurion University, Be’er Sheva — all in Israel; and the Depart- ment of Biomedical Informatics, Harvard Medical School (N.B., N.D.), and the Ivan and Francesca Berkowitz Family Living Laboratory Collaboration at Harvard Medical School and Clalit Research Insti- tute (N.B., N.D., R.D.B.) — both in Boston. Dr. Witberg can be contacted at guywi@ or at the Cardiology Depart- ment, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.

Drs. Witberg and Barda and Drs. Balicer and Kornowski contributed equally to this article.

This article was published on October 6, 2021, at

N Engl J Med 2021;385:2132-9.

DOI: 10.1056/NEJMoa2110737

Copyright © 2021 Massachusetts Medical Society.