Surveillance and follow up outcomes of myocarditis after mRNA COVID-19 vaccination in Australia
Lucy Deng, Amanda Van Eldik, Megan O'Moore, Jim Buttery, Abigail Cheung, Nicholas Cox, Carla Drake-Brockman, Nathan Dwyer, Paul V. Effler, Michael R. Gold, Pravin Hissaria, Andrew Kelly, Sarah Khanlari, Claire Z. Larter, Shannon Melody, Michael D. Nissen, Rajesh Puranik, James M. Rankin, Sally Singleton, L. Thomas, S. Wahi, Gavin Wheaton, Dominica Zentner, Kristine Macartney, Clara K Chow, Nicholas Wood
Abstract
Clinical progression and medium-long term morbidity from myocarditis following mRNA COVID-19 vaccinations remains an important but undefined public health concern. We conducted prospective follow-up of individuals with either confirmed or probable myocarditis following monovalent Pfizer-BioNTech BNT162b2 or Moderna mRNA-1273 vaccination between 21 April 2021 and 5 July 2022 in Australia. Of 256 individuals who consented to follow up, mostly males following a second dose, 60% (133/221) had ongoing symptoms at 3-6 months and 35% (81/231) at 12-18 months. Self-reported ongoing exercise restrictions, medication requirements, and hospital re-presentations were associated with ongoing symptoms, as was a lower self-reported health status and quality of life. Clinical severity remained mild, with low hospitalisation rates and no deaths in the follow-up period and health-related quality of life improved over time. These findings support ongoing use of mRNA COVID-19 vaccines in at-risk individuals to prevent disease caused by SARS-CoV-2 infection.