Archive 28: Summary of NACI advice on vaccination with COVID-19 vaccines following myocarditis (with or without pericarditis) [2022-01-14]

Publication date: January 14, 2022

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NACI continues to recommend that:

In most circumstances, and as a precautionary measure until more information is available, further doses of mRNA COVID-19 vaccines should be deferred among people who experienced myocarditis (with or without pericarditis) within 6 weeks of receiving a previous dose of an mRNA COVID-19 vaccine. This includes any person who had an abnormal cardiac investigation including electrocardiogram (ECG), elevated troponins, echocardiogram or cardiac MRI after a dose of an mRNA vaccine.

NACI now recommends that:

Those with a history compatible with pericarditis and who either had no cardiac workup or had normal cardiac investigations, can receive the next dose once they are symptom free and at least 90 days has passed since vaccination.

Some people with confirmed myocarditis (with or without pericarditis) after a dose of an mRNA COVID-19 vaccine may choose to receive another dose of vaccine after discussing the risks and benefits with their healthcare provider. If another dose of vaccine is offered, they should be offered the Pfizer-BioNTech 30 mcg vaccine due to the lower reported rate of myocarditis and/or pericarditis following the Pfizer-BioNTech 30 mcg vaccine compared to the Moderna 100 mcg vaccine. Informed consent should include discussion about the unknown risk of recurrence of myocarditis and/or pericarditis following receipt of additional doses of Pfizer-BioNTech COVID-19 vaccine in individuals with a history of confirmed myocarditis and/or pericarditis after a previous dose of mRNA COVID-19 vaccine, as well as the need to seek immediate medical assessment and care should symptoms develop.

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