Advances in mRNA vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have helped curb the coronavirus disease 2019 (COVID-19) pandemic and prevent disease onset and severity. Growing cases of vaccine-associated myocarditis (VAM) following SARS-CoV-2 immunization have been reported. Although COVID-19 VAM commonly occurs in young males after the second dose of vaccination, most cases are mild.Severe cases can be fatal if left untreated. Early diagnosis remains challenging because of the broad clinical spectrum of phenotypes and pathophysiologies, including minor focal myocarditis, multisystemic inflammatory syndrome and fulminant myocarditis. Furthermore, histological evaluation remains to be fully understood..