I'm Not Worried About Myocarditis.

Here's why.

Edited 6/24/21

In a fascinating plot twist, I’m putting my Bottom Line at the TOP of this letter. 

Based on what we know, the benefits of the COVID-19 vaccination exceedingly outweigh the risks. Without pause or trepidation, I continue to recommend the vaccine to all my patients over the age of 12 years. Indeed, my own daughter received her second Pfizer dose according to schedule.

What we know about the COVID vaccine and myocarditis. 

• As of mid-May, 2021, over 1.5 million people younger than 18 years of age have received two doses of COVID-19 vaccine. 

• Earlier this year, investigators in Israel began to look into the possible association between the Pfizer/BioNTech vaccine and the development of a rare condition called myocarditis. Since that investigation began, over 200 Israeli cases of myocarditis have been reported after 5 million injected doses.

• Myocarditis is a treatable condition characterized by inflammation of the heart muscle. Symptoms of myocarditis include shortness of breath, chest pain (typically worse lying down) and fever. It’s well-known that a variety of bacterial and viral infections, including COVID-19, can cause heart inflammation. It is also known that myocarditis is a rare side effect following other vaccinations, like the smallpox vaccine. 

• The association between COVID vaccine administration and myocarditis has not been routinely seen in adults, but there have been a few isolated reports of the condition. 

• The AAP has released a sporadic collection of case reports featuring seven teenagers (14-19 years of age) who experienced myocarditis after Pfizer/BioNTech COVID-19 vaccination. These healthy boys developed myocarditis within 4 days of the second dose of the shot. At the time, the teens were confirmed COVID-19 negative and did not have MIS-C. Expectedly, these boys had rapid resolution of their symptoms with minimal intervention. Anti-inflammatory medication was the primary treatment with four of the patients requiring steroids and IVIG. All seven have recovered. 

• On June 10th, the CDC reported a total of 226 case of myocarditis post-vaccination. Seventy-nine cases have been reported in 16/17 yo patients. This is above the expected rate. The condition is most commonly seen in males after dose 2, with an average age of 24. The majority of these cases have fully recovered.

• Medical experts are recommending that doctors report any additional cases of myocarditis after vaccination to the FDA as this investigation is ongoing.

• On June 23rd, the FDA/CDC/ACIP conducted a joint meeting to evaluate all relevant data regarding cases of myocarditis after vaccination. It was determined that myocarditis after vaccination is a possible side effect. The risk of myocarditis after natural infection with COVID-19 is still higher and more severe. A collaborative statement from leading health experts determined that the 0.0005% risk of identifiable and treatable myocarditis after COVID vaccination should NOT deter teens from getting vaccinated as soon as they are able.

• The rapid delivery of COVID-19 vaccines are saving lives and getting us to the other side of this global emergency. Our kids deserve safe and effective protection from this disease.

Why I’m not worried. 

• The system is working. Just think--Millions and millions of doses have been given. A relative handful of patients with an interesting finding has triggered interest from scientists around the world.  The system is working for you and it’s working for me. This is science in action. 

  

• COVID-19 disease itself has been shown to cause heart inflammation in young children (even after mild illness) and long-term heart damage in adults. I do not want my children to get this disease.

• We need our kids to have direct protection COVID-19. Vaccination remains the safest and most effective way to do it. 

• I would never recommend anything for my patients that I would not do for my own children. That being said, my daughter will get her second vaccine. I’ll do my part to watch for any side effects she may experience, but anticipate only life-protecting antibodies in her future.

As you complete your child’s vaccine series, be aware of the signs of myocarditis and contact your doctor any time your are worried. We are here to help.

Onward,