Issue link: https://viewer.e-digitaledition.com/i/1453839
Israel-Based Research Defines Myocarditis Risk Following Pfizer‑BioNTech Vaccination BY DANIEL K. BRANTLEY A RETROSPECTIVE RE VIE W of clinical and laboratory data taken out of Israel indicates a connection bet ween the BNT162b2 messenger R NA (mR NA) vaccine from Pfizer-BioNTech and cases of myocarditis. The study was timely, as there has been some intimation that such a connection exists. Israel presents an ideal environment for this study for two reasons. First, the nation almost exclusively used the Pfizer-BioNTech vaccine. Second, as it is legally required to report all cases to the Israeli Ministry of Health, individuals who experience myocarditis symptoms while in Israel are hospitalized as matter of course. As a result of these factors, it's possible to achieve accurate accounting of myocarditis incidents. One piece of research, published in The New England Journal of Medicine, was led by Dror Mevorach, MD, who heads Hadassah Hospital Ein Kerem's Internal Medicine Department. To date, this is the largest study ever performed regarding side effects and complications of vaccination using cardiac MRI to examine vaccine-related damage to heart muscle tissue. A second study, published in the same issue of The New England Journal of Medicine, was led by Guy Witberg, MD, member of the Cardiology Department at Beilinson Hospital in Petah Tikva, Israel. This study uncovered similar results based on data from Israel's largest healthcare organization, Clalit Health Services, of which Beilinson Hospital is a part. Speaking to Science, Dr. Mevorach said his research findings are "very suggestive of a causal nature," continuing that he is "convinced there is a relationship." STATISTICALLY SIGNIFICANT Dr. Mevorach's team studied all cases of myocarditis reported to the Israeli Ministry of Health from Dec. 20, 2020, through May 31, 2021. Of 5.1 million fully immunized Israelis (having received both Pfizer-BioNTech injections, with 21 days between vaccinations), 304 presented with myocarditis symptoms. The main symptom was chest pain. "We dissected every case," Dr. Mevorach told Nature. Twenty-one individuals experienced conditions other than myocarditis, and 142 experienced their initial symptoms post-vaccination. From this group of 142, 136 received a definitive or probable diagnosis of myocarditis. One of these individuals had fatal complications, and 129 experienced mild symptoms of the disease. During the same time period, Dr. Mevorach's team also uncovered 101 myocarditis diagnoses in unvaccinated people. Of these, 29 were confirmed to have COVID-19. The group at highest risk for post-vacci- nation myocarditis was 16- to 19-year-old males (13.73 per 100,000). The rate ratio among this population a month after the second dose was 8.96, whereas the rate ratio among their unvaccinated peers was 2.35. Dr. Witberg's study, though smaller in scale, had equally significant results. It reviewed the data of 2.5 million vaccinated patients who used Clalit Health Services. Within this smaller study group, 2.13 cases of myocarditis were confirmed per 100,000 individuals. As with the other research, young males were at greatest risk (10.69 per 100,000 vaccinated males ages 16 to 29), and the majority of cases were mild or moderate. E VIDENCE INDICATES THE STRONGEST CONNECTION BE T WEEN THE VACCINATION AND MYOCARDITIS IS AMONG MALES AGES 16 TO 29. 1 4