<b>PUBLIC SPECULATION REGARDING COVID-19 VACCINATION AND SUDDEN CARDIAC ARREST IN YOUNG ADULTS: EVIDENCE FROM LITERATURE</b>

Background: Sudden cardiac arrest (SCA) in young adults, though rare, has gained increased attention following the introduction of COVID-19 mRNA vaccines. Reports of vaccine-associated myocarditis, particularly in young males, have raised public concerns about a potential link between vaccination and SCA. This review critically examines the epidemiological evidence regarding the association between COVID-19 vaccination and sudden cardiac arrest in young adults. Methods: A comprehensive literature search was conducted across PubMed, Google Scholar, Scopus, and Embase databases for studies published between December 2022 and June 2024. Search terms included "COVID-19 vaccine," "sudden cardiac arrest," "myocarditis," and "young adults." Registry-based cohort studies, case series, and observational studies involving individuals aged 12-40 years were included. Case reports lacking diagnostic details, animal studies, and non-primary source articles were excluded. Results: Current evidence confirms a small but statistically significant increased risk of myocarditis following mRNA COVID-19 vaccination, particularly in males aged 16-29 years after the second dose, with incidence rates of 10-20 cases per 100,000 vaccinees. Most cases are mild and self-limiting. However, large-scale registry studies from Israel, Denmark, and the UK found no statistically significant increase in sudden cardiac arrest temporally associated with COVID-19 vaccination. Comparative studies demonstrate that SARS-CoV-2 infection poses a substantially higher risk of myocarditis (16-fold) compared to vaccination (2-3-fold). Conclusion: Available epidemiological evidence does not support a causal relationship between COVID-19 vaccination and sudden cardiac arrest in young adults. While vaccine-associated myocarditis is a documented rare adverse event, it is typically benign and rarely progresses to life-threatening arrhythmias or SCA. The cardiovascular risks associated with COVID-19 infection significantly outweigh the risks of vaccination. Healthcare providers should maintain transparent communication regarding vaccine risks and benefits to address vaccine hesitancy, while future research should focus on long-term cardiac outcomes and genetic predisposition factors.