• Ann Falco

Heart Inflammation Following COVID-19 Vaccination


Researchers have identified a correlation between COVID-19 and persistent health issues including irregular heartbeat, chest pain, dizziness, and shortness of breath. Additionally, a rare complication of COVID-19 has surfaced and involves inflammation in multiple systems including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. This syndrome is more common in children and adolescents and has been termed Multisystem Inflammatory Syndrome in Children (MIS-C). These health issues have all been linked to infection with coronavirus However, doctors and health care providers are now reporting new cases of heart inflammation in many individuals following COVID-19 vaccination.


The United States Food and Drug Administration (US FDA) recently confirmed a rare risk of heart inflammation following the Pfizer and Moderna COVID-19 vaccines. A warning to patients and a provider fact sheet have been added to both vaccines. For each of these vaccines, the fact sheets were revised to include a specific warning about cases of myocarditis and pericarditis which were observed following the second vaccine dose and the onset of symptoms within a few days after receiving the shot. Myocarditis is characterized by inflammation of the heart muscle (myocardium) and is usually caused by a viral infection. This condition can affect the heart muscle and the heart's electrical system, reducing the ability to effectively pump causing rapid or abnormal heart rhythms (arrhythmias). Pericarditis involves swelling and irritation of the thin, sac-like tissue (pericardium) that surrounds the heart. This inflammation can lead to chest pain and pressure in the chest. At this point, according to Yale Medicine, it is too early to tell what may be causing the recently reported myocarditis and pericarditis cases. The FDA and CDC are continually monitoring the use and side effects of the available vaccines, which is why the recent cases are being thoroughly examined.


A CDC safety group reported a likely association between a rare heart inflammatory condition in adolescents and young adults mostly after they have received the second COVID-19 vaccine shot. In June 2021, the CDC reported more than 1,200 cases of myocarditis or pericarditis especially in people thirty and under who received mRNA (messenger RNA) vaccinations manufactured by Pfizer or Moderna. Furthermore, there have been 267 cases of myocarditis or pericarditis reported after receiving one dose of the mRNA vaccines and 827 reported cases after two doses through June 11, 2021. However, there are 132 additional cases where the number of doses received is unknown. There is speculation that these heart issues are being reported more often after the Pfizer mRNA vaccine since only Pfizer is approved for emergency use in the United States for teens ages 12 to 18. For this age group, adenovirus-based vaccines, such as Johnson & Johnson, are not currently available.


The CDC considers this a rare event and mentions the risk appears to be very low. For both vaccines combined, there were 12.6 heart inflammation cases per million doses. The cases were more frequent among Moderna’s vaccine recipients at 19.8 cases per million compared to eight cases per million for Pfizer’s vaccine recipients. In recent data, it appears that most of the cases are in men under thirty years old. The CDC also reports that most occurrences are considered mild cases of inflammation. Out of the 295 individuals who have developed the condition and have been discharged, 79% have fully recovered. Nine people were hospitalized, with two in intensive care as of June 11, 2021.


The clinical presentation of myocarditis cases following vaccination has been distinct, occurring most often within one week after the second dose. In these cases, chest pain has been the most common indication of an issue. CDC officials are gathering more data to fully understand the potential risks, how to manage them, and whether there are any long-term issues.


Symptoms of myocarditis and pericarditis include chest pain, shortness of breath, and a fast-beating (tachycardia), fluttering, or pounding heart. Typically, these symptoms develop within a week of receiving the vaccine, with most developing within four days. Confirmed cases have occurred mostly in male adolescents and young adults aged 16 years or older. Additionally, these symptoms have appeared more often after receiving the second dose rather than after the first dose of the vaccine from Pfizer or Moderna.


Since April 2021, there have been more than a thousand reports to the Vaccine Adverse Event Reporting System (VAERS) of cases of myocarditis and pericarditis following COVID-19 vaccination in the United States (refer to Figure below). The CDC is actively monitoring these reports to fully understand the relationship to COVID-19 vaccination.

The CDC continues to recommend COVID-19 vaccination for everyone 12 years of age and older, given the risk of COVID-19 illness and the associated complications. The known and potential benefits of vaccination outweigh the known and potential risks, including the possible risk of myocarditis or pericarditis. Receiving the vaccination is the best way for the general public to help protect themselves and their families from COVID-19. The CDC reports only an exceedingly small number of people will experience myocarditis or pericarditis after vaccination and most cases are mild. The affected individuals recover often on their own or with minimal treatment. Patients can usually return to normal daily activities after symptoms improve, but they should speak with their doctor or health care provider about returning to exercise or sports following infection.


Based on the information from the CDC, it is highly recommended to still get vaccinated against COVID-19. Especially now with the increase in cases of the Delta variant, and it more readily impacting younger individuals, the risks of being unvaccinated are far greater than any of the rare side effects from the vaccines. As scientists continue to research and collect data, it is hopeful they will find a more definitive link between vaccinations and the associated side effects.

 

Speaking Plainly:

  • The US FDA recently confirmed a rare risk of heart inflammation following the Pfizer and Moderna COVID-19 vaccines.

  • The CDC reported more than 1,200 cases of myocarditis or pericarditis mostly in people thirty and under who received mRNA vaccinations manufactured by Pfizer or Moderna.

  • Confirmed cases of myocarditis and pericarditis have occurred mostly in male adolescents and young adults aged 16 years or older.

  • Symptoms of myocarditis and pericarditis include chest pain, shortness of breath, and a fast-beating, fluttering, or pounding heart.

  • The CDC recommends COVID-19 vaccination for everyone 12 years of age and older, given the risk of COVID-19 illness and the associated complications. The known and potential benefits of vaccination outweigh the known and potential risks, including the possible risk of myocarditis or pericarditis.