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2022 May – Philadelphia, PA – 39 year old Yashira Cruz (pictured below) developed myositis after one dose of COVID-19 vaccine – “at one point I thought of crashing my car to end with my life.”

2023 June 4 – Julie Jo Koehler developed myositis after 2nd Pfizer COVID-19 mRNA vaccine.

2023 March – Saint Petersburg, FL – Emanuel Sferios got his COVID-19 booster shot in January. 10 days later he was in hospital for severe muscle pain and was diagnosed with myositis.

2021 Dec – 16 year old Caleb had a Pfizer COVID-19 mRNA booster shot and developed myositis and myocarditis.

Medical Literature 

2023 June 30 (Tosunoglu et al) – 21 year old woman had Pfizer COVID-19 mRNA vaccine. Two days later, she complained of pain in her arm and came to neurology 20 days later with difficulty in sitting and getting up, pain in her legs, difficulty climbing stairs. She was diagnosed with myositis, responded only partially to steroids and then fully with IVIG. 

2023 June (Jung Won Han et al) – 49 year old woman developed myositis and arm swelling 1 week after Pfizer COVID-19 mRNA vaccine. She was treated with Celebrex.

2023 March 20 (Nushida et al) – 14 year old girl died unexpectedly 2 days after receiving 3rd dose of Pfizer COVID-19 mRNA vaccine. Autopsy findings showed myositis, among many other findings. 

2023 March 16 (Syrmou et al) – 67 yo Greek woman had 2nd Pfizer mRNA dose. Two days after she noticed a pruritic maculo-papular rash, left arm edema and bilateral symmetric proximal arm and leg muscle weakness. She presented to ER 20 days after Pfizer and was diagnosed with myositis, and put on steroids, methotrexate and hydroxychloroqine.

2022 Dec (Jack Pepys et al) – A rare presentation of rapidly progressing myopathy in an adolescent.

16 year old boy of British and East-Asian descent had 2nd Pfizer COVID-19 vaccine. After 3 hours he developed unusual weakness and deteriorated dramatically over following few weeks. He was unable to dress himself , had shortness of breath on the slightest exertion.

He was extremely difficult to treat, didn’t respond to steroids or IVIG and stayed in the hospital 107 days.

He needed immuno-suppressive drugs used for transplant patients (mycophenolate mofetil) AND chemotherapy (cyclophosphamide) (!!)

2022 July 16 (Eli Magen et al) – 34 year old Israeli woman had 1st dose of Pfizer COVID-19 mRNA vaccines. 4 days later she presented with severe muscle weakness, pain and tenderness.

The authors did some extensive genomic testing of the patient’s blood and muscle tissue biopsy samples. They found mRNA present in the severely inflamed muscle, a full month after COVID-19 vaccine injection! In this case, the mRNA was causing the myositis.

2022 July (Gabriele De Marco et al) – A Large Cluster of New Onset Autoimmune Myositis in the Yorkshire Region Following SARS-CoV-2 Vaccination.

15 cases of myositis after COVID-19 vaccination are reported in this paper, 5 after dose #1, 7 after dose #2 and 3 after dose #3.

6 cases were from Pfizer and 9 were from AstraZeneca, so it’s clearly not just an mRNA vaccine issue.

2022 March 21 (Ji Hyoun Kim et al) – 30 year old man had 2nd dose of Pfizer COVID-19 mRNA vaccine. 6 days later he presented to ER with fever, skin rash and polymyalgia. He was treated with steroids, azathioprine and tacrolimus.

2022 Feb.17 (Al-Rasbi et al) – 37 year old man in Oman, presented to ER 12 days after 1st Pfizer COVID-19 mRNA vaccine with left upper limb swelling, paresthesia and shortness of breath.

He was diagnosed with severe myositis, also had rhabdomyolysis, acute kidney injury, myocarditis with pulmonary edema, pulmonary hemorrhage and thrombocytopenia.

He was treated with steroids and IVIG.

2022 Feb.7 (Wesam Gouda et al) – 43 year old Asian Indian woman had 2nd dose of Pfizer COVID-19 mRNA vaccine. About 10 days later, she presented to ER with an itchy, erythematous rash all over her face, trunk and hands, inability to walk, difficulty rising from a chair and climbing stairs

She was treated with steroids, hydroxychloroquine, mycophenolate and physiotherapy.

2022 Jan. 30 (Vutipongsatorn et al) – Inflammatory myopathy occurring shortly after severe acute respiratory syndrome coronavirus 2 vaccination: two case reports.

55 year old South East Asian woman had 1st dose of Pfizer COVID-19 mRNA. Two days later she developed a facial and torso rash and presented to ER with worsening proximal myopathy.

72 year old Caucasian woman had 2nd dose of Pfizer COVID-19 mRNA. She developed a proximal myopathy the next day and presented to ER 2 weeks later.

Both patients didn’t respond to steroids but did respond to IVIG therapy.

2021 Dec (Ramalingam et al) – Cleveland Clinic Journal of Medicine – 81 year old man had 2nd dose of mRNA vaccine. The next day he noticed swelling, pain and redness in left arm. He was diagnosed with myositis and cellulitis. He was treated with steroids.

My Take…

Myositis refers to a group of conditions that share common features of muscle inflammation, resulting in muscle weakness and damage.

WHO VigiAccess reports 1729 cases of myositis after COVID-19 vaccination, however this is probably a significant under-reporting, as many cases are mis-diagnosed and very few cases are biopsied.

Clinical picture is as follows:

• Myositis begins usually within a few days of COVID-19 vaccination but could appear weeks after
• more common in women (3:2 ratio), average age is 56
• starts as an itchy maculopapular rash, usually on extremities, face, or trunk
• accompanied by swelling and pain in the extremities
• often involves proximal muscle weakness to the point where the patient has trouble getting up from sitting position, or going up the stairs.
• Diagnosis: MRI will show muscle edema but muscle biopsy is definitive, although findings will vary widely.
• Treatment usually starts with steroids and is then followed by IV immunoglobulin (IVIG) if needed
• Some cases are very difficult to treat and require very strong immuno-suppressants like those used for transplant patients

When COVID-19 mRNA vaccines cause myositis, it is an abnormal auto-immune reaction, indicative that something has gone haywire with the immune system.

This abnormal auto-immune response can occur anywhere in the body and is further evidence of immune system damage caused by COVID-19 mRNA vaccines.

Possible mechanisms of immune system damage:

“Immunological cross-reactivity and molecular mimicry, involving spike dominant epitopes and myositis-related auto-antigenic targets, have been considered a likely mechanism for myositis induced by COVID-19 and its relevant vaccines. Kanduc and Shoenfeld (2020) described a striking oligopeptide homology between SARSCoV-2 spike glycoprotein and human and murine peptides, providing strong evidence towards immunogenicity of the virus and its spike in humans and mice”

“mRNA vaccines can trigger immune reactions not only by coding specifc antigenic epitopes (proteins) but also themselves as nucleic acids. This mRNA is surrounded by nanoparticles or liposomes that keep it intact and help it escape cleavage by RNases. These particles transfer the mRNA in the cytosol by fusion to cellular membrane and endocytosis. However, while in the cytosol, mRNA can bind to several pattern recognition receptors (PRRs), including Toll-like receptors (TLRs), retinoic acid-inducible gene 1(RIG-1), and melanoma differentiation-associated protein 5 (MDA5) stimulating pro-infammatory cascades via type 1 interferon and transcription factor nuclear factor (NF)-kB”

COVID-19 mRNA vaccine induced myositis can be severe and potentially life-threatening. Fortunately, most cases seem to respond to steroids and IVIG. 

P. S. Special thanks to Twitter user Nashville Angela for keeping track of some of these post COVID-19 vaccine myositis cases and warning others about this severe auto-immune reaction.

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Dr. William Makis is a Canadian physician with expertise in Radiology, Oncology and Immunology. Governor General’s Medal, University of Toronto Scholar. Author of 100+ peer-reviewed medical publications.

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