Symptomatic acute myocarditis in 7 adolescents after pfizer-biontech covid-19 vaccination

Mayme Marshall, Ian D. Ferguson, Paul Lewis, Preeti Jaggi, Christina Gagliardo, James Stewart Collins, Robin Shaughnessy, Rachel Caron, Cristina Fuss, Kathleen Jo E. Corbin, Leonard Emuren, Erin Faherty, E. Kevin Hall, Cecilia Di Pentima, Matthew E. Oster, Elijah Paintsil, Saira Siddiqui, Donna M. Timchak, Judith A. Guzman-Cottrill

Research output: Contribution to journalArticlepeer-review

250 Scopus citations


Trials of coronavirus disease 2019 (COVID-19) vaccination included limited numbers of children, so they may not have detected rare but important adverse events in this population. We report 7 cases of acute myocarditis or myopericarditis in healthy male adolescents who presented with chest pain all within 4 days after the second dose of Pfizer-BioNTech COVID-19 vaccination. Five patients had fever around the time of presentation. Acute COVID-19 was ruled out in all 7 cases on the basis of negative severe acute respiratory syndrome coronavirus 2 real-time reverse transcription polymerase chain reaction test results of specimens obtained by using nasopharyngeal swabs. None of the patients met criteria for multisystem inflammatory syndrome in children. Six of the 7 patients had negative severe acute respiratory syndrome coronavirus 2 nucleocapsid antibody assay results, suggesting no previous infection. All patients had an elevated troponin. Cardiac MRI revealed late gadolinium enhancement characteristic of myocarditis. All 7 patients resolved their symptoms rapidly. Three patients were treated with nonsteroidal antiinflammatory drugs only, and 4 received intravenous immunoglobulin and corticosteroids. In this report, we provide a summary of each adolescent’s clinical course and evaluation. No causal relationship between vaccine administration and myocarditis has been established. Continued monitoring and reporting to the US Food and Drug Administration Vaccine Adverse Event Reporting System is strongly recommended.

Original languageEnglish (US)
Article numbere2021052478
Issue number3
StatePublished - Sep 1 2021

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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