A case series of acute pericarditis following COVID-19 vaccination in the context of recent reports from Europe and the United States

Vaccine. 2021 Oct 29;39(45):6585-6590. doi: 10.1016/j.vaccine.2021.09.078. Epub 2021 Oct 5.


Background: COVID-19 vaccines were efficacious and safe in clinical trials. We report nine events of acute pericarditis (AP) in eight patients following COVID-19 vaccination with BNT162b2 (6/9), AZD1222 (2/9) and mRNA-1273 (1/9).

Methods: All patients were referred for AP temporally linked with COVID-19 vaccination. Chest pain was the most common clinical manifestation. Alternative etiologies were excluded upon thorough diagnostic work up. AP diagnosis was established according to ESC guidelines.

Findings: Five events occurred after the first vaccine dose and four after the second. The mean age in this cohort was 65.8 ± 10.2 years and the men/women ratio 3/5. All events resolved without sequelae; two events were complicated by cardiac tamponade requiring emergent pericardial decompression. Hospitalization was required in four cases.

Interpretation: Although causality cannot be firmly established, AP has emerged as a possible complication following COVID-19 vaccination. Further investigation is indispensable to fully characterize this new entity.

Keywords: Adenovirus vector-based vaccines; COVID-19 vaccination; Pericarditis; SARS-CoV-2, outcome; mRNA vaccines.

MeSH terms

  • Aged
  • BNT162 Vaccine
  • COVID-19 Vaccines
  • COVID-19*
  • ChAdOx1 nCoV-19
  • Europe
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pericarditis* / etiology
  • SARS-CoV-2
  • United States
  • Vaccination / adverse effects


  • COVID-19 Vaccines
  • ChAdOx1 nCoV-19
  • BNT162 Vaccine