{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T10:53:59Z","timestamp":1779360839211,"version":"3.51.4"},"reference-count":26,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T00:00:00Z","timestamp":1650844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceuticals"],"abstract":"<jats:p>Considering the clinical significance for myocarditis and pericarditis after immunization with mRNA COVID-19 vaccines, the present pharmacovigilance study aimed to describe these events reported with mRNA COVID-19 vaccines in the Vaccine Adverse Events Reporting System (VAERS). From 1990 to July 2021, the mRNA vaccines were the most common suspected vaccines related to suspected cases of myocarditis and\/or pericarditis (myocarditis: N = 1,165; 64.0%; pericarditis: N = 743; 55.1%), followed by smallpox vaccines (myocarditis: N = 222; 12.2%; pericarditis: N = 200; 14.8%). We assessed all suspected cases through the case definition and classification of the Brighton Collaboration Group, and only definitive, probable, and possible cases were included in the analysis. Our findings suggested that myocarditis and pericarditis mostly involve young male, especially after the second dose with a brief time to onset. Nevertheless, this risk is lower (0.38\/100,000 vaccinated people; 95% CI 0.36\u20130.40) than the risk of developing myocarditis after SARS-CoV-2 infection (1000\u20134000 per 100,000 people) and the risk of developing \u201ccommon\u201d viral myocarditis (1\u201310 per 100,000 people\/year). Comparing with the smallpox vaccine, for which is already well known the association with myocarditis and pericarditis, our analysis showed a lower probability of reporting myocarditis (ROR 0.12, 95% CI 0.10\u20130.14) and pericarditis (ROR 0.06, 95% CI 0.05\u20130.08) following immunization with mRNA COVID-19 vaccines.<\/jats:p>","DOI":"10.3390\/ph15050525","type":"journal-article","created":{"date-parts":[[2022,4,26]],"date-time":"2022-04-26T02:14:39Z","timestamp":1650939279000},"page":"525","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Disentangling a Thorny Issue: Myocarditis and Pericarditis Post COVID-19 and Following mRNA COVID-19 Vaccines"],"prefix":"10.3390","volume":"15","author":[{"given":"Concetta","family":"Rafaniello","sequence":"first","affiliation":[{"name":"Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, 80138 Naples, Italy"},{"name":"Section of Pharmacology \u201cL. Donatelli\u201d, Department of Experimental Medicine, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4287-5510","authenticated-orcid":false,"given":"Mario","family":"Gaio","sequence":"additional","affiliation":[{"name":"Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, 80138 Naples, Italy"},{"name":"Section of Pharmacology \u201cL. Donatelli\u201d, Department of Experimental Medicine, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessia","family":"Zinzi","sequence":"additional","affiliation":[{"name":"Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, 80138 Naples, Italy"},{"name":"Section of Pharmacology \u201cL. Donatelli\u201d, Department of Experimental Medicine, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Giuseppa","family":"Sullo","sequence":"additional","affiliation":[{"name":"Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, 80138 Naples, Italy"},{"name":"Section of Pharmacology \u201cL. Donatelli\u201d, Department of Experimental Medicine, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valerio","family":"Liguori","sequence":"additional","affiliation":[{"name":"Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, 80138 Naples, Italy"},{"name":"Section of Pharmacology \u201cL. Donatelli\u201d, Department of Experimental Medicine, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marialuisa","family":"Ferraro","sequence":"additional","affiliation":[{"name":"Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, 80138 Naples, Italy"},{"name":"Section of Pharmacology \u201cL. Donatelli\u201d, Department of Experimental Medicine, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fiorella","family":"Petronzelli","sequence":"additional","affiliation":[{"name":"Pharmacovigilance Unit, Post-Marketing Surveillance Area, Italian Medicine Agency, 00187 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrizia","family":"Felicetti","sequence":"additional","affiliation":[{"name":"Post-Marketing Surveillance Area, Italian Medicine Agency, 00187 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pasquale","family":"Marchione","sequence":"additional","affiliation":[{"name":"Signal Management Unit, Post-Marketing Surveillance Area, Italian Medicine Agency, 00187 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna Rosa","family":"Marra","sequence":"additional","affiliation":[{"name":"Post-Marketing Surveillance Area, Italian Medicine Agency, 00187 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Rossi","sequence":"additional","affiliation":[{"name":"Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, 80138 Naples, Italy"},{"name":"Section of Pharmacology \u201cL. Donatelli\u201d, Department of Experimental Medicine, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonella","family":"De Angelis","sequence":"additional","affiliation":[{"name":"Section of Pharmacology \u201cL. Donatelli\u201d, Department of Experimental Medicine, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annalisa","family":"Capuano","sequence":"additional","affiliation":[{"name":"Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, 80138 Naples, Italy"},{"name":"Section of Pharmacology \u201cL. Donatelli\u201d, Department of Experimental Medicine, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2140","DOI":"10.1056\/NEJMoa2109730","article-title":"Myocarditis after BNT162b2 mRNA Vaccine against Covid-19 in Israel","volume":"385","author":"Mevorach","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_2","unstructured":"(2021, November 01). European Medicines Agency\u2014COVID-19 Vaccines: Update on Ongoing Evaluation of Myocarditis and Pericarditis. Available online: https:\/\/www.ema.europa.eu\/en\/news\/covid-19-vaccines-update-ongoing-evaluation-myocarditis-pericarditis."},{"key":"ref_3","unstructured":"(2021, November 01). 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