Surveillance and follow up outcomes of myocarditis after mRNA COVID-19 vaccination in Australia

Lucy Deng^{1

2}, Amanda Van Eldik³, Megan O'Moore⁴, Jim Buttery^{5

6}, Abigail Cheung⁷, Nicholas Cox^{8

9}, Carla Drake-Brockman¹⁰, Nathan Dwyer¹¹, Paul Effler¹², Michael Gold^{7

13}, Pravin Hissaria^{13

14}, Andrew Kelly⁷, Sarah Khanlari¹⁵, Claire Larter⁴, Shannon Melody¹⁶, Michael Nissen¹⁷, Rajesh Puranik¹⁸, James Rankin¹⁹, Sally Singleton²⁰, Liza Thomas^{21

22}, Sudhir Wahi²³, Gavin Wheaton⁷, Dominica Zentner^{9

24}, Kristine Macartney^{3

25}, Clara K Chow^{22

26}, Nicholas Wood^{3

25}

Affiliations

¹ National Centre for Immunisation Research and Surveillance, Children's Hospital at Westmead, Westmead, NSW, Australia. lucy.deng@health.nsw.gov.au.
² The University of Sydney Children's Hospital Westmead Clinical School, Westmead, NSW, Australia. lucy.deng@health.nsw.gov.au.
³ National Centre for Immunisation Research and Surveillance, Children's Hospital at Westmead, Westmead, NSW, Australia.
⁴ Therapeutic Goods Administration, Department of Health, Disability and Ageing, Canberra, ACT, Australia.
⁵ Murdoch Children's Research Institute, Parkville, Victoria, Australia.
⁶ Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.
⁷ Women's and Children's Health Network, Adelaide, South Australia, Australia.
⁸ Western Health, Victoria, Australia.
⁹ Royal Melbourne Hospital Clinical School, Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.
¹⁰ Perth Children's Hospital, Nedlands, Western Australia, Australia.
¹¹ Royal Hobart Hospital, Hobart, Tasmania, Australia.
¹² Western Australia Department of Health, Perth, Western Australia, Australia.
¹³ School of Medicine, Adelaide University, Adelaide, South Australia, Australia.
¹⁴ South Australia Pathology, Adelaide, South Australia, Australia.
¹⁵ New South Wales Ministry of Health, St Leonards, NSW, Australia.
¹⁶ Public Health Services, Department of Health Tasmania, Hobart, Tasmania, Australia.
¹⁷ Queensland Adult Specialist Immunisation Service, The Prince Charles Hospital, Chermside, Queensland, Australia.
¹⁸ Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
¹⁹ Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
²⁰ Australian Capital Territory Health Directorate, Canberra, ACT, Australia.
²¹ The University of Sydney's Westmead Clinical School, Westmead, NSW, Australia.
²² Westmead Hospital, Westmead, NSW, Australia.
²³ Princess Alexandra Hospital, Brisbane, Queensland, Australia.
²⁴ Royal Melbourne Hospital, Parkville, Victoria, Australia.
²⁵ The University of Sydney Children's Hospital Westmead Clinical School, Westmead, NSW, Australia.
²⁶ Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia.

PMID: 40670372
PMCID: PMC12267834
DOI: 10.1038/s41541-025-01206-w

Surveillance and follow up outcomes of myocarditis after mRNA COVID-19 vaccination in Australia

Lucy Deng et al. NPJ Vaccines. 2025.

. 2025 Jul 16;10(1):155.

doi: 10.1038/s41541-025-01206-w.

Authors

Affiliations

¹ National Centre for Immunisation Research and Surveillance, Children's Hospital at Westmead, Westmead, NSW, Australia. lucy.deng@health.nsw.gov.au.
² The University of Sydney Children's Hospital Westmead Clinical School, Westmead, NSW, Australia. lucy.deng@health.nsw.gov.au.
³ National Centre for Immunisation Research and Surveillance, Children's Hospital at Westmead, Westmead, NSW, Australia.
⁴ Therapeutic Goods Administration, Department of Health, Disability and Ageing, Canberra, ACT, Australia.
⁵ Murdoch Children's Research Institute, Parkville, Victoria, Australia.
⁶ Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.
⁷ Women's and Children's Health Network, Adelaide, South Australia, Australia.
⁸ Western Health, Victoria, Australia.
⁹ Royal Melbourne Hospital Clinical School, Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.
¹⁰ Perth Children's Hospital, Nedlands, Western Australia, Australia.
¹¹ Royal Hobart Hospital, Hobart, Tasmania, Australia.
¹² Western Australia Department of Health, Perth, Western Australia, Australia.
¹³ School of Medicine, Adelaide University, Adelaide, South Australia, Australia.
¹⁴ South Australia Pathology, Adelaide, South Australia, Australia.
¹⁵ New South Wales Ministry of Health, St Leonards, NSW, Australia.
¹⁶ Public Health Services, Department of Health Tasmania, Hobart, Tasmania, Australia.
¹⁷ Queensland Adult Specialist Immunisation Service, The Prince Charles Hospital, Chermside, Queensland, Australia.
¹⁸ Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
¹⁹ Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
²⁰ Australian Capital Territory Health Directorate, Canberra, ACT, Australia.
²¹ The University of Sydney's Westmead Clinical School, Westmead, NSW, Australia.
²² Westmead Hospital, Westmead, NSW, Australia.
²³ Princess Alexandra Hospital, Brisbane, Queensland, Australia.
²⁴ Royal Melbourne Hospital, Parkville, Victoria, Australia.
²⁵ The University of Sydney Children's Hospital Westmead Clinical School, Westmead, NSW, Australia.
²⁶ Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia.

PMID: 40670372
PMCID: PMC12267834
DOI: 10.1038/s41541-025-01206-w

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.

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Conflict of interest statement

Competing interests: The authors declare no competing interests. Ethics approval: This study was conducted as part of the AusVaxSafety Adverse Event of Special Interest Program of Research, approved by The Sydney Children’s Hospital Network Human Research Ethics Committee (2021/ ETH11149).

Figures

**Fig. 1**
Study population and follow up recruitment.

**Fig. 2. Ongoing symptoms in myocarditis following a COVID-19 mRNA vaccine.**
A Cases who completed any follow-up: discharge (n = 256), 3-6 months (n = 221) and 12-18months (n = 231). B Cases who completed all follow-up timepoints (n = 196).

**Fig. 3**
Progression of symptoms, exercise restrictions, medications, re-presentations and further COVID-19 vaccinations by sex and age, in myocarditis cases following mRNA COVID-19 vaccination who completed both 3-6 and 12-18 month follow up (n = 196).

Fig. 4. Self-assessment of health-related quality of life among myocarditis cases following mRNA COVID-19 vaccination who completed EuroQol 5-dimension, 5-level (EQ-5D-5L) questionnaire at both 3–6 and 12–18 month follow up (n = 152).
A Health-related quality of life. B Weighted quality of life measure. C Self-assessed overall health.

See this image and copyright information in PMC

References

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Surveillance and follow up outcomes of myocarditis after mRNA COVID-19 vaccination in Australia

Affiliations

Surveillance and follow up outcomes of myocarditis after mRNA COVID-19 vaccination in Australia

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

LinkOut - more resources

Full Text Sources

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