Skip Navigation

American Journal of Epidemiology 2004 160(7):642-651; doi:10.1093/aje/kwh269
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (32)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Arness, M. K.
Right arrow Articles by Tornberg, D. N.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Arness, M. K.
Right arrow Articles by Tornberg, D. N.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Copyright © 2004 by the Johns Hopkins Bloomberg School of Public Health

ORIGINAL CONTRIBUTIONS

Myopericarditis following Smallpox Vaccination

Mark K. Arness1, Robert E. Eckart2, Suzanne S. Love3, J. Edwin Atwood4, Timothy S. Wells5, Renata J. M. Engler6, Limone C. Collins6, Sharon L. Ludwig7, James R. Riddle8 , John D. Grabenstein9 and David N. Tornberg10 for the Department of Defense Smallpox Vaccination Clinical Evaluation Team

1 Army Medical Surveillance Activity, Washington, DC.
2 Brooke Army Medical Center, Fort Sam Houston, TX.
3 Regional Vaccine Healthcare Center, Naval Medical Center, Portsmouth, VA.
4 Walter Reed Army Medical Center, Washington, DC.
5 Naval Health Research Center, San Diego, CA.
6 Vaccine Healthcare Center Network, Walter Reed Army Medical Center, Washington, DC.
7 US Coast Guard Health and Safety Directorate, Washington, DC.
8 Air Force Research Laboratories, Wright-Patterson Air Force Base, OH.
9 Military Vaccine Agency, US Army Medical Command, Falls Church, VA.
10 Office of the Assistant Secretary of Defense for Health Affairs, Falls Church, VA.

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).

military personnel; myocarditis; pericarditis; smallpox; vaccination; vaccinia virus

Abbreviations: Abbreviations: CDC, Centers for Disease Control and Prevention; DMSS, Defense Medical Surveillance System; DoD, US Department of Defense.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 HeartHome page
M Imazio, E Cecchi, B Demichelis, A Chinaglia, S Ierna, D Demarie, A Ghisio, F Pomari, R Belli, and R Trinchero
Myopericarditis versus viral or idiopathic acute pericarditis
Heart, April 1, 2008; 94(4): 498 - 501.
[Abstract] [Full Text] [PDF]

Home page
 J. Immunol.Home page
L. Jing, T. M. Chong, B. Byrd, C. L. McClurkan, J. Huang, B. T. Story, K. M. Dunkley, L. Aldaz-Carroll, R. J. Eisenberg, G. H. Cohen, et al.
Dominance and Diversity in the Primary Human CD4 T Cell Response to Replication-Competent Vaccinia Virus
J. Immunol., May 15, 2007; 178(10): 6374 - 6386.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
M. Madjid, R. V. Luepker, K. J. Greenlund, K. A. Taubert, M. J. Roy, and R. M. Robertson
Task Force IV: Cardiovascular Effects of Emerging Infectious Diseases and Biological Terrorism Threats: Basic, Clinical, and Population Science Research and Training Needs
J. Am. Coll. Cardiol., March 27, 2007; 49(12): 1407 - 1412.
[Full Text] [PDF]

Home page
 Epidemiol RevHome page
J. D. Grabenstein, P. R. Pittman, J. T. Greenwood, and R. J.M. Engler
Immunization to Protect the US Armed Forces: Heritage, Current Practice, and Prospects
Epidemiol. Rev., August 1, 2006; 28(1): 3 - 26.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
C. G. Casey, J. K. Iskander, M. H. Roper, E. E. Mast, X.-J. Wen, T. J. Torok, L. E. Chapman, D. L. Swerdlow, J. Morgan, J. D. Heffelfinger, et al.
Adverse Events Associated With Smallpox Vaccination in the United States, January-October 2003
JAMA, December 7, 2005; 294(21): 2734 - 2743.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
R. E. Eckart, J. E. Atwood, and J. D. Grabenstein
Reply
J. Am. Coll. Cardiol., April 19, 2005; 45(8): 1309 - 1310.
[Full Text] [PDF]

Home page
 JWatch Infect. DiseasesHome page
Monitoring Postvaccinial Myocarditis
Journal Watch Infectious Diseases, December 10, 2004; 2004(1210): 8 - 8.
[Full Text]

Home page
 BMJHome page
P. E M Fine
Non-specific "non-effects" of vaccination
BMJ, December 4, 2004; 329(7478): 1297 - 1298.
[Full Text] [PDF]


Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.