Journal of Pediatric Cardiology and Cardiac Surgery

Since the COVID-19 outbreak in Wuhan, China in early 2020, the pandemic has become a major global health concern. While vaccines are believed to be crucial for preventing COVID-19, there have been reports of vaccine-related cardiac events, particularly peri-myocarditis. In collaboration with the Taipei City Government, we conducted electrocardiogram (ECG) screenings to investigate the potential cardiovascular adverse effects of the BNT162b2 COVID-19 vaccine in school-aged students. Among the 7934 eligible students, 4928 (62.1%) completed both pre- and post-vaccine ECGs. The incidence of cardiac-related symptoms after the second dose was 17.1%, with palpitations and chest pain being the most common symptoms. ECG parameters showed a significant increase in heart rate and a decrease in QRS duration, QT, QTc, and QTcf intervals after vaccination. After comparing pre- and post-vaccine ECGs, 51 (1.03%) students were identified with significant ECG changes, with ST-T changes being the most common. Further evaluation revealed that most adverse events were mild and did not require hospital admission. Sensitivity and specificity analysis indicated that the serial comparison method was the most appropriate screening approach for post-vaccine cardiac adverse events. However, a cost-benefit analysis would be essential for further consideration. The study highlights the importance of paired ECG screening as a potential tool to serve as a reference for future medical events that may require screening.