Top 5 Takeaways

1. Higher Risk After Infection: The risk for cardiac complications, including myocarditis and pericarditis, was significantly higher after SARS-CoV-2 infection compared to after mRNA COVID-19 vaccination across all age groups and sexes.
2. Age and Sex Variations: Males aged 12–17 years had the highest incidence of cardiac complications after the second vaccine dose, but the risk was still 1.8–5.6 times higher after infection.
3. Support for Vaccination: These findings support the continued use of mRNA COVID-19 vaccines among all eligible persons aged ≥5 years.
4. Data Source: The study used electronic health record (EHR) data from 40 U.S. health care systems participating in PCORnet, the National Patient-Centered Clinical Research Network.
5. Incidence Rates: Incidences of myocarditis, pericarditis, or multisystem inflammatory syndrome (MIS) were calculated within specific risk windows and stratified by sex and age group.

Original Article Author and Citation

Corresponding Author

Jason P. Block, jblock1@partners.org

Suggested Citation

Block JP, Boehmer TK, Forrest CB, et al. Cardiac Complications After SARS-CoV-2 Infection and mRNA COVID-19 Vaccination — PCORnet, United States, January 2021–January 2022. MMWR Morb Mortal Wkly Rep 2022;71:517-523. DOI: http://dx.doi.org/10.15585/mmwr.mm7114e1

Summary

This study compared the risks of cardiac complications after SARS-CoV-2 infection and mRNA COVID-19 vaccination using EHR data from 40 U.S. health care systems. The findings indicate that the risk for cardiac complications was significantly higher after SARS-CoV-2 infection than after mRNA COVID-19 vaccination for both males and females in all age groups. These results support the continued use of mRNA COVID-19 vaccines among all eligible persons aged ≥5 years.

Methods

The study utilized EHR data from 40 health care systems within PCORnet, covering the period from January 1, 2021, to January 31, 2022. Five cohorts were created based on SARS-CoV-2 infection and mRNA COVID-19 vaccination status. Incidences of myocarditis, pericarditis, and MIS were calculated within specific risk windows and stratified by sex and age group. Risk ratios (RR) were computed to compare the risks of cardiac outcomes after infection versus vaccination.

Discussion

The analysis revealed that while cardiac complications were rare overall, the risk was higher after SARS-CoV-2 infection compared to mRNA COVID-19 vaccination. These findings are consistent with previous studies from Israel and the United Kingdom. The study’s results provide important context for balancing the risks and benefits of mRNA COVID-19 vaccination among eligible individuals.

Conclusion

The study concludes that the risk for cardiac complications is higher after SARS-CoV-2 infection than after mRNA COVID-19 vaccination among males and females in all age groups. These findings support the continued use of mRNA COVID-19 vaccines among all eligible persons aged ≥5 years to mitigate the higher risks associated with SARS-CoV-2 infection.

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