The global prevalence and association between the risk of myocarditis and mRNA-based COVID-19 vaccination: A network meta-analysis version 1; peer review: awaiting peer review

Background: Cases of myocarditis development have been reported after administration of messenger ribonucleic acid (mRNA)-based coronavirus disease (COVID-19) vaccines. However, the reports vary among the studies, and the types of mRNA vaccines with potential to cause myocarditis remain unidentified. The objective was to assess the cumulative prevalence of myocarditis and determine the association between myocarditis and mRNA-based COVID-19 vaccination. Methods: We performed a network meta-analysis by searching articles in PubMed, Scopus, and Web of Science. Information on the prevalence of myocarditis after the mRNA-based COVID-19 vaccination was collected from each study. Analysis was performed by calculating the pooled prevalence rate, and the association was determined using the Z-test. Data networking was performed using the Bayesian method. Results: A total of 18 papers was included in our analysis. We found that the cumulative prevalence of myocarditis was 1.7, 1.9, 1.2, and 1.1 per 100,000 population after vaccination with different types of mRNA-based COVID-19 vaccines, namely all mRNA COVID-19 vaccines, BNT162b1, mRNA-1273, and the combination of BNT162b1 and mRNA-1273, respectively. Moreover, the results revealed that BNT162b1 vaccination increased the risk of myocarditis by 1.64- and 1.71-folds compared to mRNA-1273 and the combination of BNT162b2 and mRNA-1273, respectively. Similar risks of developing myocarditis were observed after mRNA-1273 and the combination of BNT162b1 and mRNA-1273 vaccination. Conclusions: Our findings suggest the cumulative prevalence of myocarditis after mRNA-based COVID-19 vaccination with maximum prevalence was observed after BNT162b2 administration. BNT162b2 was associated with a higher risk of developing myocarditis than the other mRNA-based COVID-19 vaccines

SPINE20 recommendations 2022: spine care-working together to recover stronger

Purpose Globally, spine disorders are the leading cause of disability, affecting more than half a billion individuals. However, less than 50% of G20 countries specifically identify spine health within their public policy priorities. Therefore, it is crucial to raise awareness among policy makers of the disabling effect of spine disorders and their impact on the economic welfare of G20 nations. In 2019, SPINE20 was established as the leading advocacy group to bring global attention to spine disorders. Methods Recommendations were developed through two Delphi methods with international and multi-professional panels. Results In 2022, seven recommendations were delivered to the leaders of G20 countries, urging them to: Develop action plans to provide universal access to evidence-based spine care that incorporates the needs of minorities and vulnerable populations. Invest in the development of sustainable human resource capacity, through multisectoral and inter-professional competency-based education and training to promote evidence-based approaches to spine care, and to build an appropriate healthcare working environment that optimizes the delivery of safe health services. Develop policies using the best available evidence to properly manage spine disorders and to prolong functional healthy life expectancy in the era of an aging population. Create a competent workforce and improve the healthcare infrastructure/facilities including equipment to provide evidence-based inter-professional rehabilitation services to patients with spinal cord injury throughout their continuum of care. Build collaborative and innovative translational research capacity within national, regional, and global healthcare systems for state-of-the-art and cost-effective spine care across the healthcare continuum ensuring equality, diversity, and inclusion of all stakeholders. Develop international consensus statements on patient outcomes and how they can be used to define and develop pathways for value-based care. Recognize that intervening on determinants of health including physical activity, nutrition, physical and psychosocial workplace environment, and smoking-free lifestyle can reduce the burden of spine disabilities and improve the health status and wellness of the population. At the third SPINE20 summit 2022 which took place in Bali, Indonesia, in August 2022, 17 associations endorsed its recommendations. Conclusion SPINE20 advocacy efforts focus on developing public policy recommendations to improve the health, welfare, and wellness of all who suffer from spinal pain and disability. We propose that focusing on facilitating access to systems that prioritize value-based care delivered by a competent healthcare workforce will reduce disability and improve the productivity of the G20 nations