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Largest Pediatric Study Finds Infection Carries Higher, Longer-Lasting Heart and Inflammatory Risks Than First COVID Vaccine Dose

Researchers used records from nearly 14 million children in England to provide absolute risk estimates that can guide vaccination decisions.

Overview

  • The Lancet Child & Adolescent Health analysis linked electronic health records for about 98% of England’s under-18s from January 2020 to December 2022, led by teams at Cambridge, Edinburgh and UCL with data accessed in the NHS England Secure Data Environment.
  • Over six months, the study estimated 2.24 additional myocarditis or pericarditis cases per 100,000 after a first COVID-19 infection versus 0.85 additional cases per 100,000 after a first PfizerBioNTech dose.
  • Risks after a first infection peaked in the first four weeks and for several outcomes stayed elevated for up to 12 months, whereas the vaccine-associated myocarditis or pericarditis risk was short-lived, largely confined to the first 4–6 weeks.
  • Researchers assessed rare outcomes including myocarditis, pericarditis, arterial and venous thrombosis, thrombocytopenia, and inflammatory syndromes such as PIMS and Kawasaki disease.
  • The analysis covered 3.9 million first COVID-19 diagnoses and 3.4 million first vaccinations and evaluated only first events, with authors cautioning that repeated infections, boosters and newer variants could alter future risk profiles and warrant ongoing monitoring.