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Background Acute pericarditis is a diffuse inflammation of the pericardial sac with many well-defined etiologies. Acute pericarditis as a vaccine-related adverse event is a rare entity and the association between pericarditis and the immunogenic response to COVID-19 vaccines is still being fully characterized. Case Report A previously healthy 18-year-old male presented with fever, pleuritic chest pain, and shortness of breath shortly after receiving the first dose of a COVID-19 mRNA-based vaccine. The patient was found to have a large pericardial effusion with early tamponade physiology requiring pericardiocentesis. Why Should an Emergency Physician Be Aware of This : As COVID-19 vaccination becomes more prevalent globally, physicians should be aware of pericarditis as a rare but potentially serious adverse reaction.

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