Myopericarditis following smallpox vaccination

Mark K. Arness, Robert E. Eckart, Suzanne S. Love, J. Edwin Atwood, Timothy S. Wells, Renata J.M. Engler, Limone C. Collins, Sharon L. Ludwig, James R. Riddle*, John D. Grabenstein, David N. Tornberg

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

120 Scopus citations

Abstract

Myopericarditis has been a rare or unrecognized event after smallpox vaccinations with the New York City Board of Health strain of vaccinia virus (Dryvax; Wyeth Laboratories, Marietta, Pennsylvania). In this article, the authors report an attributable incidence of at least 140 clinical cases of myopericarditis per million primary smallpox vaccinations with this strain of vaccinia virus. Fifty-eight males and one female aged 21-43 years with confirmed or probable acute myopericarditis were detected following vaccination of 492,730 US Armed Forces personnel from December 15, 2002, through September 30, 2003. The cases were identified through sentinel reporting to military headquarters, active surveillance using the Defense Medical Surveillance System, or reports to the Vaccine Adverse Event Reporting System. The observed incidence (16.11/100,000) of myopericarditis over a 30-day observation window among 347,516 primary vaccinees was nearly 7.5-fold higher than the expected rate of 2.16/100,000 (95% confidence interval: 1.90, 2.34) among nonvaccinated, active-duty military personnel, while the incidence of 2.07/100,000 among 145,155 revaccinees was not statistically different from the expected background rate. The cases were predominantly male (58/59; 98.3%) and White (51/59; 86.4%), both statistically significant associations (p = 0.0147 and p = 0.05, respectively).

Original languageEnglish
Pages (from-to)642-651
Number of pages10
JournalAmerican Journal of Epidemiology
Volume160
Issue number7
DOIs
StatePublished - 1 Oct 2004
Externally publishedYes

Keywords

  • Military personnel
  • Myocarditis
  • Pericarditis
  • Smallpox
  • Vaccination
  • Vaccinia virus

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