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Review
. 2023 May 19:37:100797.
doi: 10.1016/j.lanwpc.2023.100797. Online ahead of print.

Benefits v. risks of COVID-19 vaccination: an examination of vaccination policy impact on the occurrence of myocarditis and pericarditis

Bruce C Carleton  1   2   3 , Daniel A Salmon  4   5   6 , Patrick Ip  7   8   9 , Ian C K Wong  10   11 , Francicso T T Lai  12
Affiliations
Review

Benefits v. risks of COVID-19 vaccination: an examination of vaccination policy impact on the occurrence of myocarditis and pericarditis

Bruce C Carleton et al. Lancet Reg Health West Pac. .

Abstract

Studies of myocarditis/pericarditis following mRNA COVID-19 vaccines in Hong Kong have been published. Data are consistent with data from other active surveillance or healthcare databases. The mRNA COVID-19 vaccines have been shown to rarely increase risk of myocarditis, with the highest risk among males aged 12-17 after the second dose. An increased risk of pericarditis has also been shown after the second dose, though less common than myocarditis and more evenly distributed among different sex and age groups. Because of the increased risk of post-vaccine myocarditis, Hong Kong implemented a single dose mRNA COVID-19 vaccine policy on September 15, 2021 for adolescents (age 12-17 years). Post-policy, there were no cases of carditis. 40,167 first dose patients did not receive a second dose. This policy was highly successful in the reduction of carditis, but the trade-off is the potential risk of disease and cost to population-level immunity. This commentary brings forward some important global policy considerations.

Keywords: Adolescents; COVID-19; Hong Kong; Males; Myocarditis; Pericarditis.

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Conflict of interest statement

Bruce C. Carleton receives federal grant funds from the Canadian Institutes of Health Research, Genome Canada, Genome BC, and the Global Vaccine Data Network with additional support provided by the British Columbia Provincial Health Services Authority, BC Children's Hospital Foundation, and Health Canada. In the past three years he has also had research funding from Dynacare Next Specialized Diagnostics as part of a Genome Canada federal grant, and provided consultation services to the Canadian Agency for Drugs and Technologies in Health, and UnitedHealth Group. He is also a Board member of the Rare Disease Foundation (unpaid position). Ian Wong reports research funding from the Health and Medical Research Fund to investigate the safety of COVID-19 vaccines. He also reports research funding outside the submitted work from Amgen, Bristol-Myers Squibb, Pfizer, Janssen, Bayer, GSK, Novartis, the Hong Kong Research Grants Council, the Hong Kong Health and Medical Research Fund, National Institute for Health Research in England, European Commission, National Health and Medical Research Council in Australia. He is also a non-executive director of Jacobson Medical in Hong Kong. He has received consulting fees from the World Health Organization and IQVIA. He is a member of the Expert Committee on Clinical Events Assessment Following COVID-19 Immunization, Department of Health, The Government of the Hong Kong Special Administrative Region, Hong Kong Special Administrative Region, China. Patrick Ip reports research funding from the University Grant Council (UGC) on study of long term impact of COVID-19 pandemic on health and well-being of children and families in Hong Kong, the Health and Medical Research Fund on Vitamin D Deficiency and Insufficiency among Pregnancy Women and Children, and Hong Kong Jockey Club Charities Trust on Interventions to support health and development of disadvantaged children. Daniel Salmon has received research funding from the Centers for Disease Control and Prevention and advisory committee remuneration from Merck and remuneration as an advisor on policy boards for Janssen Pharmaceuticals, Sanofi and Moderna. He has reports payment for expert testimony on COVID vaccination among health workers. He also reports other research funding outside the submitted work from the Vaccine Confidence Project, National Institutes of Health, GAVI and WHO as well as support for attending meetings from the National Association of Country and City Health Officials Health Summit and World Vaccine Congress. Francisco Lai has been supported by the RGC Postdoctoral Fellowship under the Hong Kong Research Grants Council and has received research grants from the Health Bureau of the Government of the Hong Kong Special Administrative Region, outside the submitted work. He is also is partially supported by the Laboratory of Data Discovery for Health (D24H) funded by the by AIR@InnoHK administered by Innovation and Technology Commission.

References

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