Study at a glance

Title: Vascular and inflammatory diseases after COVID-19 infection and vaccination in children and young people in England: a retrospective, population-based cohort study using linked electronic health records (Lancet Child & Adolescent Health, 2025). You can read the full text of the study by clicking here: (The Girards Law Firm)

Objective

To estimate short-term and long-term risks of rare vascular and inflammatory conditions (arterial thromboembolism, venous thromboembolism, thrombocytopenia, myocarditis/pericarditis, and other inflammatory conditions) after a firstSARS-CoV-2 diagnosis and after a first BNT162b2 (Pfizer) vaccination in people aged <18 in England. (The Girards Law Firm)

Population & period

Whole-population linked electronic health records for all individuals in England aged <18 registered with a GP and with known demographics between 1 Jan 2020 and 31 Dec 2022.
Total cohort: 13,896,125 children/young people; 3,903,410 (28.1%) had a recorded COVID-19 diagnosis; 3,407,560received a first vaccine (in the 5–<18 subset eligible for vaccination). (The Girards Law Firm)

Methods

Retrospective cohort analysis using linked primary- and secondary-care data. Adjusted hazard ratios (aHRs) estimated by time since first COVID diagnosis and time since first vaccination, controlling for age, sex, ethnicity, region, deprivation, GP contact frequency, and medication use. Predominant vaccine in study period: BNT162b2. (The Girards Law Firm)

Main findings

  • In the first week after COVID-19 diagnosis (vs no/before diagnosis) risks were substantially elevated for multiple outcomes:
  • Persistence of elevated risk: incidence declined in weeks 2–4 but remained elevated beyond 12 months for:
    • VTE: aHR 1.39 (1.14–1.69).
    • Thrombocytopenia: aHR 1.42 (1.01–2.00).
    • Myocarditis/pericarditis: aHR 1.42 (1.05–1.91). (The Girards Law Firm)
  • After first BNT162b2 vaccination: there was an increased short-term risk of myocarditis or pericarditis in the first 4 weeks: aHR 1.84 (1.25–2.72). (The Girards Law Firm)
  • Absolute-risk perspective (6-month excess risks):
    • After COVID-19 diagnosis: myocarditis/pericarditis excess risk = 2.24 per 100,000 (95% CI 1.11–3.80).
    • After vaccination: myocarditis/pericarditis excess risk = 0.85 per 100,000 (95% CI 0.07–1.91).
      So the absolute excess risk after infection was larger than after vaccination. (The Girards Law Firm)

Authors’ interpretation

Although rare, children and young people face higher risks of several vascular and inflammatory diseases after SARS-CoV-2 infection — both acutely and with some persistence up to ≈12 months — while vaccination carries a smaller, short-term increased risk of myocarditis/pericarditis. Overall, the findings support vaccination of children and young people because vaccination reduces the more frequent and longer-lasting risks associated with infection. (The Girards Law Firm)

Strengths and limitations

Strengths

  • Whole-population, large sample size (national linked records) → good power to detect rare events.
  • Adjustment for multiple confounders and long follow-up (up to 12+ months). (The Girards Law Firm)

Limitations

  • Observational design — possibility of residual confounding.
  • Case ascertainment depends on testing and coding practices (some infections undiagnosed or unrecorded).
  • Predominant vaccine was BNT162b2; findings may not generalize to other vaccines or later variants/boosters/changes in population immunity.
  • Absolute risks remain small (rare events), which is important context for policy decisions. (The Girards Law Firm)

Bottom line

In children and adolescents in England (2020–22) SARS-CoV-2 infection was associated with substantially higher and sometimes persistent risks of rare vascular and inflammatory conditions than the small, short-term increased risk of myocarditis/pericarditis following BNT162b2 vaccination — supporting vaccination as a strategy to reduce overall risk. (The Girards Law Firm)

 

The Girards Law Firm specializes in severe injury and wrongful death cases, especially those that involve birth injuries, brain damage, heart damage, spinal cord injuries, severe burns, commercial plane crashes and commercial trucking crashes nationwide, and especially in Texas, Arkansas and Oklahoma. James E. Girards is a private pilot licensed to fly single- and multi-engine aircraft in both visual and instrument conditions. Contact us at www.girardslaw.com by using the chat feature for more information.

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