The DOI matches its Crossref record; 17 of the 18 references it cites were found in a registry or an index.
Symptomatic Acute Myocarditis in 7 Adolescents After Pfizer-BioNTech COVID-19 Vaccination
Abstract
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.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“multiple cases of myocarditis after Covid-19 vaccination have recently been reported in the literature,21-25”
From Safety of the BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Setting (2021) · cites this paper as [23]
Citations
Cites
1 retracted
Ammirati, E., Cavalotti, C., Milazzo, A., Pedrotti, P., Soriano, F., Schroeder, J. W., Morici, N., Giannattasio, C., Frigerio, M., Metra, M., et al. (2021) · IJC Heart & Vasculature · doi:10.1016/j.ijcha.2021.100774 · Cited by 86
RetractedSafety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine
Polack, F. P., Thomas, S. J., Kitchin, N., Absalon, J., Gurtman, A., Lockhart, S., Perez, J. L., Pérez Marc, G., Moreira, E. D., Zerbini, C., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmoa2034577 · Cited by 14,592
2015 ESC Guidelines for the diagnosis and management of pericardial diseases
Adler, Y., Charron, P., Imazio, M., Badano, L. P., Barón‐Esquivias, G., Bogaert, J. G., Brucato, A. L., Guéret, P., Klingel, K., Lionis, C. D., et al. (2015) · European Heart Journal · doi:10.1093/eurheartj/ehv318 · Cited by 2,727
Cardiovascular Magnetic Resonance in Nonischemic Myocardial Inflammation
Ferreira, V. M., Schulz-Menger, J., Holmvang, G., Kramer, C. M., Carbone, I., Sechtem, U., Kindermann, I., Gutberlet, M., Cooper, L. T., Liu, P., et al. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.09.072 · Cited by 2,059
Maron, B. J., Udelson, J. E., Bonow, R. O., Nishimura, R. A., Ackerman, M. J., Estes, N. A. M., Cooper, L. T., Link, M. S., & Maron, M. S. (2015) · Circulation · doi:10.1161/cir.0000000000000239 · Cited by 462
Myopericarditis Following Smallpox Vaccination Among Vaccinia-Naive US Military Personnel
Halsell, J. S. (2003) · JAMA · doi:10.1001/jama.289.24.3283 · Cited by 333
Myopericarditis versus viral or idiopathic acute pericarditis
Imazio, M., Cecchi, E., Demichelis, B., Chinaglia, A., Ierna, S., Demarie, D., Ghisio, A., Pomari, F., Belli, R., & Trinchero, R. (2007) · Heart · doi:10.1136/hrt.2006.104067 · Cited by 267
Pathological Evidence for SARS-CoV-2 as a Cause of Myocarditis
Kawakami, R., Sakamoto, A., Kawai, K., Gianatti, A., Pellegrini, D., Nasr, A., Kutys, B., Guo, L., Cornelissen, A., Mori, M., et al. (2021) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2020.11.031 · Cited by 235
Cardiac MRI in Children with Multisystem Inflammatory Syndrome Associated with COVID-19
Blondiaux, É., Parisot, P., Redheuil, A. B., Tzaroukian, L., Levy, Y., Siléo, C., Schnuriger, A., Lorrot, M., Guedj, R., & Pointe, H. D. L. (2020) · Radiology · doi:10.1148/radiol.2020202288 · Cited by 225
Maron, B. J., Udelson, J. E., Bonow, R. O., Nishimura, R. A., Ackerman, M. J., Estes, N. A. M., Cooper, L. T., Link, M. S., & Maron, M. S. (2015) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2015.09.035 · Cited by 223
Cited by
Sorted by citations
Items 301–367 of 367
Coronavirus disease 2019 (COVID-19) mRNA vaccine and the risk of myocarditis: An increasing concern
Shaikh, O. A., Lal, P. M., Mohan, A., Wara, U. U., Costa, A. C. D. S., Ahmad, S., & Essar, M. Y. (2021) · Antimicrobial Stewardship & Healthcare Epidemiology · doi:10.1017/ash.2021.209 · Cited by 1
Clinical features and acute management of COVID-19 in children
Longbottom, K., Whittaker, E., & Penner, J. (2021) · European Respiratory Society eBooks · doi:10.1183/2312508x.10024320 · Cited by 1
Pina, A., Farina, A., & Savonitto, S. (2022) · The American Journal of Medicine · doi:10.1016/j.amjmed.2022.01.047 · Cited by 1
Patel, K., Dalal, S., Tran, D., Patel, A. J., & McMackin, C. (2022) · Cureus · doi:10.7759/cureus.24699 · Cited by 1
Federspiel, J. M., Ramsthaler, F., Kettner, M., & Mall, G. (2022) · Rechtsmedizin · doi:10.1007/s00194-022-00587-9 · Cited by 1
Lira-Álvarez, M. D. L. C., Iribarren-Moreno, R., Salmeán-Piña, Ó. E., Contreras-Bulnes, L., & Vélez-Benítez, E. (2022) · Cirugía Plástica · doi:10.35366/106104 · Cited by 1
Induced Depressive Disorder Following the First Dose of COVID-19 Vaccine
Rammouz, I., Doufik, J., Aalouane, R., & Boujraf, S. (2022) · CNS & Neurological Disorders - Drug Targets · doi:10.2174/1871527321666220829112733 · Cited by 1
Pros and Cons for COVID-19 Vaccination and Boost of Young Adults in Light of Recent Literature
Nemunaitis, J. J., Lehmann, P., & Willey, J. C. (2022) · Medical Research Archives · doi:10.18103/mra.v10i8.2943 · Cited by 1
Wang, L., Kou, K., Tang, K.-S., Lee, Y., Chen, Y., Lo, M., Lee, I., Chuah, S., Lee, C., Kung, C., et al. (2022) · Vaccines · doi:10.3390/vaccines10122114 · Cited by 1
Off-Label Prescription of COVID-19 Vaccines in Children: Clinical, Ethical, and Legal Issues
Persad, G., Lynch, H. F., & Zettler, P. J. (2022) · American Academy of Pediatrics eBooks · doi:10.1542/9781610026697-off_label · Cited by 1
Karaca, S., Özer, P. K., Keskin, G. Y., Gövdeli, E. A., & Ömeroğlu, R. E. (2023) · Cardiology in the Young · doi:10.1017/s104795112200422x · Cited by 1
Myopericarditis Following the Third Dose of COVID-19 mRNA Vaccination: A Case Report
Saeed, A., Yousaf, A., Ahmad, M. I., Ghumman, G. M., & Khan, A. A. (2023) · Cureus · doi:10.7759/cureus.37005 · Cited by 1
Promoting Dialogue by Thinking Differently about Framing and Correcting Misinformation
Gesser‐Edelsburg, A. (2023) · Springer eBooks · doi:10.1007/978-3-031-24490-2_9 · Cited by 1
Izawa, M., Satoh, K., Shiraga, K., Yamaguchi, T., Omori, A., Ogawa, Y., Tanaka, Y., Masuda, H., Kanda, S., Matsui, H., et al. (2022) · Japanese Society of Pediatric Cardiology and Cardiac Surgery · doi:10.9794/jspccs.38.180 · Cited by 1
Cruz, J., Duret, A., Harwood, R., Fraser, L., Jones, C. B., Ward, J., Whittaker, E., Kenny, S. E., & Viner, R. (2021) · medRxiv · doi:10.1101/2021.12.06.21267339 · Cited by 1
Postvaccine Myocarditis: A Risk Worth the Reward?
Raman, B., & Neubauer, S. (2022) · Radiology · doi:10.1148/radiol.220252 · Cited by 1
Hoffmann, S. S., Nielsen, S., Thysen, S. M., Duriseti, R. S., & Benn, C. S. (2023) · medRxiv · doi:10.1101/2023.12.07.23298573 · Cited by 1
Acute cardiac events following ChAdOx1 nCoV-19 corona virus vaccine (recombinant)Preprint
Singh, R. M., Chakrabarti, S. S., Gambhir, I. S., Tiwari, A., Chandan, G., Chakrabarti, S., & Kaur, U. (2021) · Research Square · doi:10.21203/rs.3.rs-891077/v1
Midterm Follow-Up of Multisystem Inflammatory Syndrome in Children From PakistanPreprint
Aziz, O. A., Sadiq, M., Qureshi, A. U., Hyder, S. N., Kazmi, U., Batool, A., Naz, S., Mushtaq, A., Bari, A., & Rasheed, J. (2021) · SSRN Electronic Journal · doi:10.2139/ssrn.3954089
Gabrić, P. (2021) · OSF Preprints (OSF Preprints) · doi:10.31219/osf.io/sjhra
Analysis of adverse effects caused by mRNA vaccines used in the fight against COVID-19
Pitoscia, G. O., & Faria, T. V. (2021) · MedNEXT Journal of Medical and Health Sciences · doi:10.54448/mdnt21602
Narrative Review: Addressing Covid-19 Vaccine Concerns in Special and Vulnerable Populations
Owusu, K. A., Effendi, M. K., Bastin, M. L. T., Tirmizi, S., Lat, I., & Ammar, M. A. (2022) · Hospital Pharmacy · doi:10.1177/00185787211066463
Qasim, G. A., Arulselvam, V., Amer, S. R. A., Alghanem, S., & Kalis, N. N. (2021) · Journal of the Bahrain Medical Society · doi:10.26715/jbms.33_2021_4_7
Effectiveness and Safety of COVID-19 Vaccine
Nishi, J. (2021) · TRENDS IN THE SCIENCES · doi:10.5363/tits.26.10_18
A Systematic Review of Myocarditis Associated with Covid-19 Mrna Vaccination among Adolescents
Ariye, E. O. (2022) · International Journal of Medical Science and Clinical Research Studies · doi:10.47191/ijmscrs/v2-i2-13
Al-Qudimat, A. R., Al‐Zoubi, R. M., Elaarag, M., Nashwan, A. J., Hamze, A. K., Bawadi, H. A., Yassin, A. A., Assim, A., Aboumarzouk, O. M., Zarour, A. M., et al. (2022) · doi:10.22541/au.165217342.21121509/v1
Screening per rilevare il maltrattamento in un ambiente ospedaliero pediatrico
Valletta, E. A. (2022) · QUADERNI ACP · doi:10.53141/peqacp.2022.2.am1
Myopericarditis and COVID-19 Vaccination
Rao, M. (2022) · Journal of Virology and Viral Diseases · doi:10.54289/jvvd2200110
Tsao, S. S. L., Chua, G. T., Kwan, M. Y. W., Wong, I. C. K., To, K. K., Kwok, J., Chan, B. H. B., Wong, J. S. C., Ip, P., & Lau, Y. (2022) · Journal of the Hong Kong College of Cardiology · doi:10.55503/2790-6744.1208
(2022) · Reactions Weekly · doi:10.1007/s40278-022-23758-7
Alp, H., & Doğan, M. T. (2022) · Journal of Contemporary Medicine · doi:10.16899/jcm.1150607
Incidence Rates and Risk Factors for Covid-19 Booster Adverse Reactions in General Medicine
Turabián, J. L. (2022) · MedPress Public Health and Epidemiolog · doi:10.33582/mpphe.2022.202210007
López-Martínez, S. I., Monroy-Sánchez, E. N., Solis‐Reyna, R. A., Pasos-Caamal, M. V., & Onofre-Castillo, J. J. (2022) · Cardiovascular and Metabolic Science · doi:10.35366/107625
A COVID-19 gyermekgyógyászati és sport vonatkozásai
Pelle, J. (2021) · Testnevelés Sport Tudomány · doi:10.21846/tst.2021.1-2.1
Association between mRNA COVID-19 vaccination and myocarditis
Tomkins, A. M., & Stiles, M. K. (2022) · New Zealand Medical Student Journal · doi:10.57129/uzxq3935
Adverse cardiac events following mRNA COVID-19 vaccination: A systematic review and meta-analysis
Putri, E. A. C., Munir, M., Setiawan, H. K., Herawati, L., Sari, G. M., Wungu, C. D. K., Susilo, H., & Sutanto, H. (2022) · Journal of Pharmacy & Pharmacognosy Research · doi:10.56499/jppres22.1524_11.1.76
COVID-19 and pediatrics—phylogeny, pathology, and pathogenesis of SARS-CoV-2
Matkovic, E., & Gulliver, J. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-95059-6.00001-2
COVID-19 vaccine-associated myocarditis (Russian translation)
Morgan, M. C., Atri, L., Harrell, S., AlJaroudi, W., & Berman, A. E. (2022) · Juvenis scientia · doi:10.32415/jscientia_2022_8_6_41-55
Viêm cơ tim sau tiêm vaccine COVID-19
Ái, T. T. K., & Nguyen, H. T. (2022) · Tạp chí Tim Mạch Học Việt Nam · doi:10.58354/jvc.100.2022.85
Acute Myocarditis after Pfizer-BioNTech COVID-19 m-RNA Vaccination
Nastevska, E. G., Andova, V., Zafirovska, P., Kandic, E., Chelikikj, A., Vrajnko, E., Jovchevska, S., Bushljetikj, O., ZİMBAKOV, Z., Spiroski, I. M., et al. (2022) · South East European Journal of Cardiology · doi:10.3889/seejca.2022.6032
Lock the Doors: The Myocarditis Disaster and a call for the broad examination of the CDC and FDA
Jablonowski, K. D., & Hooker, B. S. (2023) · Medical Research Archives · doi:10.18103/mra.v11i5.3907
Echocardiographic assessment of left ventricular function after COVID-19 vaccination in adults
Wahdan, H., Biomy, R., & Haseeb, W. A. (2023) · Journal of the Pakistan Medical Association · doi:10.47391/jpma.egy-s4-47
Perlman, S. M., & Denison, M. R. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-79058-1.00017-7 · Cited by 2
Myocarditis after vaccination for COVID-19
Hamatani, Y., & Akao, M. (2023) · Japanese Journal of Thrombosis and Hemostasis · doi:10.2491/jjsth.34.452
Hwang, J. W., Chien, S. J., Wang, C., Kuo, K.-C., Tang, K.-S., Lee, Y., Chen, Y., Lo, M., Lee, I., Chuah, S., et al. (2023) · Adolescent Health Medicine and Therapeutics · doi:10.2147/ahmt.s429238
Formanek, A., Wagner, T., Newrkla, S., & Kurz, H. (2023) · Pädiatrie & Pädologie · doi:10.1007/s00608-023-01148-3
Haq, M., & Deshpande, S. V. (2023) · Cureus · doi:10.7759/cureus.47984 · Cited by 1
Análise da miocardite como desfecho da vacinação para COVID-19
Santos, D. M., Marotta, C. D. S., & Lima, R. F. D. S. (2024) · Revista Eletrônica Acervo Médico · doi:10.25248/reamed.e14543.2024
Case of Myocarditis, Pericarditis, and Fatal Aortic Dissection following Covid-19 mRNA VaccinationPreprint
Balbona, E. J., Hudson, H., Lindsay, J., & Mörz, M. (2024) · doi:10.31219/osf.io/xnr5t
Shoaibi, A., Matuska, K., Lloyd, P. C., Wong, H., Gruber, J. F., Clarke, T. C., Cho, S., Lassman, E., Lyu, H., McEvoy, R., et al. (2024) · medRxiv · doi:10.1101/2024.02.20.24303089
Slater, K. M., Buttery, J. P., Crawford, N. W., & Cheng, D. R. (2024) · Communicable Diseases Intelligence · doi:10.33321/cdi.2024.48.18
COVID-19 VE KARDİYOVASKÜLER SİSTEME ETKİLERİ
URKMEZ, F. Y., & Polat, E. (2024) · Kocatepe tıp dergisi. · doi:10.18229/kocatepetip.1100443
She, C.-H., Tsang, H.-W., Yang, X.-T., Tsao, S., Tang, C. S., Chan, S. H. S., Kwan, M. Y., Chua, G. T., Yang, W., & Ip, P. (2024) · BMC Genomic Data · doi:10.1186/s12863-024-01238-6
Vieira, L. A. V., Almeida, G. N., Scheis, G., Munhoz, L. R., & Dantas, R. A. E. (2024) · Revista Eletrônica Acervo Médico · doi:10.25248/reamed.e15417.2024
Birtolo, L. I., Pietro, G. D., D’Ascenzio, F., Cuccuru, G., Fabris, E., Merlo, M., Andreis, A., Cameli, M., Improta, R., Campo, G. C., et al. (2024) · SSRN Electronic Journal · doi:10.2139/ssrn.4859906
Cardiothoracic imaging in patients affected by COVID-19
D’Angelo, T., Lanzafame, L. R. M., Carerj, M. L., Micari, A., Mazziotti, S., & Booz, C. (2024) · Elsevier eBooks · doi:10.1016/b978-0-443-18703-2.00020-7
Pimentel, M. A. F., Shaikh, M., Safi, M. A., Naqvi, Y., & Khan, S. (2024) · Nature Communications · doi:10.1038/s41467-024-49744-6 · Cited by 1
Eventos adversos da vacina contra COVID-19 em crianças e adolescentes: uma revisão integrativa
Klemann, D., Freire, M. H. D. S., Peres, A. L., Lourenço, R. G., & Khalaf, D. K. (2024) · Revista de Enfermagem UFPE on line · doi:10.5205/1981-8963.2024.259217
COVID-19 vaccines: A comprehensive review of safety and efficacy
Yan, Z., Yang, M., & Lai, C. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-19170-1.00028-0
Infectious Myocarditis: I Cannot Breath and My Heart Is Racing
Jouhar, L., & Egan, M. J. (2025) · Springer eBooks · doi:10.1007/978-3-031-84089-0_18
Acquired Heart Disease in Children
Ishimine, P. T. (2025) · Emergency Medicine Clinics of North America · doi:10.1016/j.emc.2025.06.007
Simpson, K. E., Jone, P., Orr, W. B., & Canter, C. E. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-13279-7.00032-8
Corrao, G., Franchi, M., Cereda, D., Bortolan, F., Leoni, O., Vignati, E., Pavesi, G., & Gori, A. (2022) · Figshare · doi:10.6084/m9.figshare.21547340
Multiorgan Outcomes Following COVID-19 Vaccine vs Infection: 30M AnalysisPreprint
Toraih, E. A., Bruce, D. N., Hussein, M. H., Aiash, H., & Thomas, S. J. (2026) · medRxiv · doi:10.64898/2026.01.30.25343064
Inflammation and Heart Failure
Kim, K., Kim, D., & Eisen, H. J. (2026) · Springer eBooks · doi:10.1007/978-3-032-12629-0_20
COVID-19 Vaccination in Children: A Global Perspective
Joshi, H. S., Dixit, A. M., Koparkar, A. R., Kharya, P., Mohanty, A., Mittal, M., & Rath, R. S. (2026) · Journal of Health Management · doi:10.1177/09720634261466390
Phimsawat, O.-U. (2026) · LEARN Journal : Language Education and Acquisition Research Network · doi:10.70730/kgzo5241
Metadata
- Authors
- Marshall, M., Ferguson, I. D., Lewis, P., Jaggi, P., Gagliardo, C., Collins, J. S., Shaughnessy, R., Caron, R., Fuss, C., Corbin, K. J. E., Emuren, L., Faherty, E., Hall, E. K., Di Pentima, C., Oster, M. E., Paintsil, E., Siddiqui, S., Timchak, D. M., & Guzman-Cottrill, J. A.
- Affiliations
- Oregon Health & Science University (US)
- Yale University (US)
- Emory University (US)
- Thomas Jefferson University (US)
- Spectrum Health (US)
- dGoryeb Children’s Hospital, Atlantic Health System, Morristown, New Jersey
- Goryeb Children's Hospital (US)
- Columbia University Irving Medical Center (US)
- aDepartment of Pediatrics, Oregon Health and Science University, Portland, Oregon
- ORCID
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2021-09-01
- Volume
- 148
- Issue
- 3
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W3165142255
- Cited by
- 367
- References
- 18
- Citations by year
- 2026: 6 · 2025: 17 · 2024: 22 · 2023: 52 · 2022: 163 · 2021: 107
- FWCI
- 57.61
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Viral Infections and Immunology Research
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Kawasaki Disease and Coronary Complications
- Keywords
- acute myocarditis, myopericarditis, COVID-19 vaccination, BNT162b2, adolescents, vaccine adverse events, late gadolinium enhancement, cardiac MRI, troponin elevation, intravenous immunoglobulin, corticosteroids, nonsteroidal anti-inflammatory drugs, vaccine safety
- MeSH terms
- COVID-19, Coronavirus Nucleocapsid Proteins, COVID-19 Vaccines, COVID-19 Nucleic Acid Testing, BNT162 Vaccine, Acute Disease, Adolescent, Gadolinium, Humans, Magnetic Resonance Imaging, Male, Myocarditis, Phosphoproteins, Time Factors, Troponin, Systemic Inflammatory Response Syndrome, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review