Myocarditis in Adolescents (12-17 years) Associated with the Pfizer-BioNTech (BNT162b2) Vaccine: A Systematic Review and Meta-analysis

Purpose: Data on the incidence rate of myocarditis associated with mRNA COVID-19 vaccines in adolescents is limited. The research estimated the incidence of myocarditis associated with the Pfizer- BioNTech COVID-19 vaccine (BNT162b2) in adolescents (12-17 years).    Methodology: This study was conducted as per the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Incidence rates were estimated after generating a random effects model. Findings: The Incidence rate in males after the first dose was 2.4 per 100,000 persons (0.8- 6.8 per 100,000; I2: 17.17%). The IR in females after the first dose was 1.9 per 100,000 persons (0.5-6.5 per 100,000; I2: 0.00). After the second dose, the IR in males was 15.7 per 100,000 persons (3.2-78.1 per 100,000; I2: 96.45%), while in females the IR after the second dose was 6.1 per 100,000 persons (2.9-12.1 per 100,000; I2: 0.00). The Incidence Rate Ratio (IRR) after the first dose between males and females was 1.86 (0.40-8.5; I2: 0.00) and 6.35 (2.98-13.49; I2: 0.00) after the second dose. Among individuals between 12- 17 years of age, myocarditis is a rare side effect associated with Pfizer- BioNTech COVID-19 vaccine (BNT162b2) vaccination. The incidence in males were about two times greater than females following the first dose and six times greater following the second dose. Recommendation: Vaccination strategy in adolescent males needs to be revisited to mitigate risk of myocarditis.