Dear Editor

We would like to share ideas on the publication “Acute myocarditis after administration of BNT162b2 vaccine against COVID-19¹”. Cueva-Recalde et al. present the case of a 28-year-old male patient with no prior medical history who has been experiencing chest pain for the past 3 days¹. The patient was hospitalized but remained asymptomatic and did not require treatment¹. Cueva-Recalde et al. stated that, while rare, physicians should be aware of this adverse event of COVID-19 vaccination, while bearing in mind its unquestionably positive benefit-risk profile¹.

We both agree that protecting the COVID-19 is essential and that more study is required to address the major clinical problem. The development of clinical diseases and immunization may be causally related. It might occasionally be difficult to identify the specific path-immunopharmacological link due to ignorance. If a clinical condition is thought to be related to the COVID-19 immunization, there are a few important factors that need to be taken into account. There is a chance of comorbidity. For instance, a concurrent dengue infection and vaccination could result in a clinical illness that was misdiagnosed². Comorbidity is a likely ailment that might be misdiagnosed as a negative vaccination reaction. It may be difficult to understand how therapy methods are impacted by chronic medical conditions. It could be difficult to understand how persistent medical issues affect therapeutic strategies. The COVID-19, which is currently unidentified, must also be considered³.

It is conceivable that a previous COVID-19 pandemic had an impact on the vaccine's efficiency and results. Infection with COVID-19 may also have an impact on clinical outcomes. It is often challenging to completely rule out the effects of earlier asymptomatic illnesses without the required laboratory investigations. An important auxiliary factor is genetics⁴. The immune system's response to certain genetic components may affect how it handles negative vaccine side effects. Understanding how the underlying genetic component impacts the clinical scenario regarding vaccine success would be very beneficial. This problem needs to be resolved if more research is to be done. Summative large-scale data may help researchers better comprehend the COVID-19 vaccine's effects.