mRNA COVID-19 Vaccination Associated With Lower Risk of Myocarditis and Death, reassures study
A large study of more than 4 million children and young adults has found that recipients of the Pfizer-BioNTech mRNA COVID-19 vaccine had a lower risk of myocarditis, pericarditis, and death compared with unvaccinated individuals. The findings also showed that COVID-19 infection and being unvaccinated were associated with greater cardiovascular risk and mortality, providing reassurance about the overall cardiovascular safety and benefits of vaccination in younger populations. The study was published in the journal Vaccine by Eman A. and colleagues.
In order to obtain a sound risk assessment analysis, the researchers used the TriNetX research network database that consisted of clinical records from December 2020 to September 2025 globally. In total, the sample consisted of 4,072,375 adolescents and young adults aged 16 to 25 years and divided into four immunologic categories: those that are uninfected/unvaccinated (N= 3,572,000); infected/unvaccinated (N= 248,546); vaccinated/uninfected receiving BNT162b2 (N= 241,152); and hybrid immunity (N= 10,677).
In order to reduce confounders, 1:1 propensity-score matching was done using competing risk analysis and Cox proportional hazards regression. The outcomes included the 6-month follow up period, and incidence rate of acute myocarditis, pericarditis, and all-cause mortality within all cohort subgroups, alongside sex-stratified sensitivity analyses.
Key findings:
- The infected/unvaccinated cohort exhibited the highest cumulative incidence rate of myocarditis at 0.116%.
- Following 1:1 propensity-score matching, SARS-CoV-2 infection was associated with significantly elevated risks compared to no infection: myocarditis (RR = 4.91; 95% CI, 3.11–7.77), pericarditis (RR = 1.93; 95% CI, 1.39–2.67), and all-cause mortality (RR = 1.33; 95% CI, 1.04–1.71).
- In direct comparisons between vaccinated/uninfected and infected/unvaccinated groups, BNT162b2 vaccination was associated with an 85% lower myocarditis risk, a 79% lower pericarditis risk, and a 72% lower all-cause mortality risk.
- The absolute risk difference for myocarditis was 0.0354%, translating directly to one fewer recorded myocarditis event per 2,827 individuals in the vaccinated/uninfected group compared with the infected/unvaccinated group.
- Protective risk reductions associated with vaccination were consistent across both male and female sex-stratified subgroups.
In summary, the risk of developing myocarditis, pericarditis, and mortality in natural infection with SARS-CoV-2 is much higher compared to the BNT162b2 mRNA vaccine. Discovering that there was an 85% lower risk of myocarditis in people who have received the vaccine clearly dismisses fears that there were higher risks associated with the vaccine compared to the risks of getting infected by the disease.
Reference:
Toraih, E. A., Hussein, M. H., Thomas, S. J., & Aiash, H. (2026). Cardiac outcomes following SARS-CoV-2 infection versus BNT162b2 vaccination in adolescents and young adults: a cohort study of 4 million individuals. Vaccine, 91, 129001. https://doi.org/10.1016/j.vaccine.2026.129001
