The Possibility of Hypersensitivity Myocarditis following COVID-19 Vaccines: Implications for Contrast Echocardiography

Abstract

Response to the comments by Kounis and colleagues on our recent article “Incidence, clinical presentation and management of myocarditis following mRNA-based Covid-19 vaccines: A brief report”, published in Cardiology. We focus on the pharmacological aspects of hypersensitivity myocarditis related to mRNA-based COVID-19 vaccines, which is believed to be caused by the excipient polyethylene glycol (PEG), and show a clinically relevant association between anaphylactic reactions to mRNA-based COVID-19 vaccines and ultrasound contrast agents (UCA). We include hitherto unpublished observations on the frequency of anaphylactic reactions to UCAs.