Vaccines and Heart Failure: Analysis of Vaccine Adverse Events Reporting System between 1990-2021

Introduction: the role of vaccines in preventing diseases is well-established. However, the evolving techniques and types of vaccine necessitate the search for its safety more than ever. While cases of takotsubo cardiomyopathy and COVID-19 vaccine have been described, a comprehensive study to investigate the role of vaccination with cardiomyopathy and heart failure is lacking. The aim of this study is to investigate the link between the current vaccines and heart failure. Method: we utilized vaccine adverse event reporting system (VAERS) to search for cardiomyopathy, cardiac failure or ventricular dysfunction. Disproportionality signal analysis was conducted by measuring reporting odds ratio (ROR) with 95% confidence interval (CI). Results: VAERS reported over 1,300,000 adverse events between 1990-2021. Heart failure was reported over 2000 times in association with multiple vaccines. 56% of vaccine-related heart failure reported in males; 88% were serious; 19% mortality rate. The majority of reported heart failure was related to COVID-19 vaccines with ROR of 21.6 (CI: 18.3 to 25.4, P<0.0001). Smallpox was also significant with ROR 7.2 (CI 5.5-9.6, P<0.0001) On the other hand, heart failure was minimally described to be associated with other vaccines (influenza, zoster, tetanus, human papillomavirus (PPV)). Conclusions: Our study showed for the first time that vaccines maybe associated with heart failure. In particular, we show that covid-19 and smallpox vaccines are associated with increased risk of heart failure. Vaccines against Influenza, zoster, tetanus and (PPV) are associated with reduced heart failure. These data warrant longitudinal studies to delineate the association between heart failure and vaccines.