key: cord-0861190-8bpa97ls authors: Minocha, Prashant K.; Better, Donna; Singh, Rakesh K.; Hoque, Tasneem title: Recurrence of Acute Myocarditis Temporally Associated With Receipt of the mRNA COVID-19 Vaccine in an Adolescent Male date: 2021-06-22 journal: J Pediatr DOI: 10.1016/j.jpeds.2021.06.035 sha: 186b54e8cbdb2cc8354c78525481db3e4756db59 doc_id: 861190 cord_uid: 8bpa97ls nan The Pfizer-BioNTech coronavirus disease 2019 (COVID-19) messenger ribonucleic acid (mRNA) vaccine has an efficacy of 95% at preventing severe COVID-19 with a low reported incidence of serious adverse events during phase 2/3 global clinical trials. (1) On December 11, 2020, the U.S. Food and Drug Administration (FDA) issued an emergency use authorization (EUA) for the Pfizer-BioNTech vaccine for the prevention of COVID-19 in persons 16 years of age and older. On May 10, 2021, the FDA issued an EUA for the Pfizer-BioNTech vaccine for persons 12-16 years of age. (2) We describe a case of an adolescent male who had recurrence of acute myocarditis temporally associated with receipt of a second dose of the Pfizer-BioNTech mRNA COVID-19 vaccine. A 17-year-old male with no significant past medical history came to medical attention in January 2021 with chest pain consistent with myocarditis. Serum troponin level peaked at 5.06 ng/mL (normal <0.04 ng/mL). Cardiac magnetic resonance imaging (cMRI) showed two small There were four deaths in the placebo group, two from unknown causes, one from myocardial infarction, and one from a hemorrhagic stroke. None of these deaths was thought to be attributable to either vaccine or placebo. (1) The first reported case of myocarditis temporally related to mRNA vaccine occurred in a 39-year-old male who developed chest pain 21 days after administration the BNT162b2 mRNA vaccine. A cMRI confirmed findings of myocarditis and patient had a full and uneventful recovery after this illness. Committee on Immunization Practices COVID-19 Vaccine Safety Technical report issued on May 17, 2021 noted a few reports of myocarditis after the mRNA COVID-19 vaccine to the Vaccine Adverse Event Reporting System (VAERS), a self-reporting database of the CDC. The cases were predominantly in adolescents and young adults, more often in males than females, more often following dose #2 than dose #1, and typically within 4 days after vaccination. These cases appeared mild. CDC officials recommended collaboration between infectious diseases, cardiology, and rheumatology specialists to guide, diagnosis, and management of myocarditis. Safety and Pandemic. FDA News Release Miocarditis aguda tras administración de vacuna BNT162b2 contra la COVID-19 Epub ahead of print Advisory Committee on Immunization Practices (ACIP) Transient Cardiac Injury in Adolescents Receiving the BNT162b2 mRNA COVID-19 Epub ahead of print Symptomatic Acute Myocarditis in Seven Adolescents Following Pfizer-BioNTech Epub ahead of print When Lightning Strikes Twice in Pediatrics : Case Report and Review of Recurrent Myocarditis We thank Dr Puneet Bhatla for his review of the cMRI imaging for this report.