Journal
JOURNAL OF CLINICAL IMMUNOLOGY
Volume 42, Issue 3, Pages 441-447Publisher
SPRINGER/PLENUM PUBLISHERS
DOI: 10.1007/s10875-021-01187-0
Keywords
COVID-19; vaccine; death; autopsy; hypersensitivity; eosinophil; myocarditis; adverse events
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Funding
- German Federal Ministry of Education and Reasearch (BMBF) within the DEFEAT PANDEMIcs project [01KX2021]
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This article describes a case of fatal fulminant necrotising myocarditis triggered by the Pfizer-BioNTech vaccine, highlighting the importance of recognizing this rare hypersensitivity reaction and emphasizing the greater benefits of vaccination compared to the risks of COVID-19 infection.
Rationale Transient myopericarditis has been recognised as an uncommon and usually mild adverse event predominantly linked to mRNA-based COVID-19 vaccines. These have mostly occurred in young males after the second dose of mRNA COVID-19 vaccines. Objectives Fulminant necrotising eosinophilic myocarditis triggered by a variety of drugs or vaccines is an extremely rare hypersensitivity reaction carrying a substantial mortality risk. Early recognition of this medical emergency may facilitate urgent hospital admission for investigation and treatment. Timely intervention can lead to complete cardiac recovery, but the non-specific clinical features and rarity make early diagnosis challenging. Findings The clinical and pathological observations from a case of fatal fulminant necrotising myocarditis in a 57-year-old woman, following the first dose of the Pfizer-BioNTech vaccine, are described. Other causes have been discounted with reasonable certainty. Conclusion These extremely rare vaccine-related adverse events are much less common than the risk of myocarditis and other lethal complications from COVID-19 infection. The benefits of vaccination far exceed the risks of COVID-19 infection.
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