Cardiac arrhythmias following COVID-19 vaccination: insights from the U.S. vaccine adverse event reporting system (VAERS), December 2020-January 2025, United States.

Publication date: Jun 24, 2026

Although COVID-19 vaccines are highly effective in preventing infection and severe disease, their cardiovascular safety, particularly regarding arrhythmic risk, continues to raise concerns. A disproportionality analysis was conducted using the U. S. Vaccine Adverse Event Reporting System (VAERS) to evaluate arrhythmia-related AEs reported between December 2020 and January 2025. Adverse events (AEs) were identified using MedDRA Preferred Terms, and signal strength was assessed by Reporting Odds Ratio (ROR) and Proportional Reporting Ratio (PRR). A total of 52,518 reports were identified, with a median onset interval of 1 day after vaccination. The most frequent AEs were tachycardia (40. 5%) and atrial fibrillation (16. 9%). Atrial flutter, extrasystoles, and atrioventricular block exhibited the strongest signals. Severe events primarily involved ventricular and conduction abnormalities, particularly among older adults and male individuals. Reports involving mRNA vaccines were predominantly characterized by tachyarrhythmia-related events, whereas findings for bradyarrhythmia- and conduction-related events after adenoviral vector vaccination should be interpreted cautiously. Cardiac arrhythmias following COVID-19 vaccination typically occurred within the early post-vaccination period and demonstrated clear platform- and population-specific differences. Although the overall risk is low, enhanced early monitoring and stratified pharmacovigilance are warranted to optimize vaccine safety.

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Concepts Keywords
Cardiac adenoviral vector vaccine
December arrhythmia
Disease COVID-19 vaccine
Pharmacovigilance mRNA vaccine
VAERS

Semantics

Type Source Name
disease MESH Cardiac arrhythmias
disease MESH COVID-19
disease MESH infection
disease MESH tachycardia
disease MESH atrial fibrillation
disease MESH Atrial flutter
disease MESH extrasystoles
disease MESH atrioventricular block
disease MESH bradyarrhythmia
drug DRUGBANK Coenzyme M
pathway REACTOME Reproduction
disease MESH severe acute respiratory syndrome
disease MESH fatigue
disease MESH headache
disease MESH chills
disease MESH myalgia
disease MESH fever
disease MESH arthralgia
disease MESH nausea
disease MESH anaphylaxis
disease MESH thrombocytopenia
disease MESH immune thrombocytopenia
disease MESH Guillain Barre syndrome
disease MESH Bell’s palsy
disease MESH autoimmune hepatitis
disease MESH myocarditis
disease MESH cardiac events
disease MESH hypertension
disease MESH heart failure
disease MESH supraventricular tachycardia
disease MESH ventricular tachycardia
disease MESH ventricular fibrillation
disease MESH stroke
disease MESH sudden cardiac death
disease MESH included
disease MESH cardiac arrest

Original Article

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