Myocarditis, pericarditis, and dilated cardiomyopathy after smallpox vaccination among civilians in the United States, January-October 2003.
Myocarditis was reported after smallpox vaccination in Europe and Australia, but no association had been reported with the US vaccine. We conducted surveillance to describe and determine the frequency of myocarditis and/or pericarditis (myo/pericarditis) among civilians vaccinated during the US smallpox vaccination program between January and October 2003. We developed surveillance case definitions for myocarditis, pericarditis, and dilated cardiomyopathy after smallpox vaccination. We identified 21 myo/pericarditis cases among 37,901 vaccinees (5.5 per 10,000); 18 (86%) were revacinees, 14 (67%) were women, and the median age was 48 years (range, 25-70 years). The median time from vaccination to onset of symptoms was 11 days (range, 2-42 days). Myo/pericarditis severity was mild, with no fatalities, although 9 patients (43%) were hospitalized. Three additional vaccinees were found to have dilated cardiomyopathy, recognized within 3 months after vaccination. We describe an association between smallpox vaccination, using the US vaccinia strain, and myo/pericarditis among civilians.
Morgan
Juliette
J
Centers for Disease Control and Prevention and 2Department of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
Roper
Martha H
MH
Sperling
Laurence
L
Schieber
Richard A
RA
Heffelfinger
James D
JD
Casey
Christine G
CG
Miller
Jacqueline W
JW
Santibanez
Scott
S
Herwaldt
Barbara
B
Hightower
Paige
P
Moro
Pedro L
PL
Hibbs
Beth F
BF
Levine
Nancy H
NH
Chapman
Louisa E
LE
Iskander
John
J
Lane
J Michael
JM
Wharton
Melinda
M
Mootrey
Gina T
GT
Swerdlow
David L
DL
D000293:Adolescent; D000328:Adult; D016907:Adverse Drug Reaction Reporting Systems / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D002311:Cardiomyopathy, Dilated / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006282:Health Personnel; D006801:Humans; D007117:Immunization, Secondary / Q000009:adverse effects*; D015994:Incidence; D008297:Male; D032541:Mass Vaccination / Q000009:adverse effects; D008875:Middle Aged; D009205:Myocarditis / Q000453:epidemiology* / Q000209:etiology; D010493:Pericarditis / Q000453:epidemiology* / Q000209:etiology; D018571:Sentinel Surveillance; D012900:Smallpox Vaccine / Q000009:adverse effects*; D014481:United States / Q000453:epidemiology
C078786:DryVax vaccine; D012900:Smallpox Vaccine