Researchers at the U.S. Centers for Disease Control and Prevention (CDC) are investigating a link between COVID-19 vaccines from Pfizer-BioNTech and Moderna and heart inflammation in young men and boys.
Kristin Oliver, MD, MHS, a pediatrician and preventive medicine physician at the Mount Sinai Health System and an Assistant Professor of Pediatrics, and Environmental Medicine and Public Health, at the Icahn School of Medicine at Mount Sinai, explains what parents, guardians, and young adults need to know about this rare side effect.
What is the situation as you see it?
The COVID-19 mRNA vaccines from Pfizer-BioNTech and Moderna have been linked to cases of myocarditis, which is an inflammation of the heart, and pericarditis, which is inflammation of the sac-like covering around the heart. Myocarditis and pericarditis can happen after an infection from different viruses, including SARS-CoV-2—the virus that causes COVID-19. They are more commonly seen in males.
How common is this side effect?
Myocarditis and pericarditis can be serious but, fortunately, these side effects to vaccination are very rare. While we don’t know the precise rate of these side effects in relation to COVID-19 vaccines, we do know that it is more commonly seen in men and boys and after the second dose of the vaccine. Signs of myocarditis and pericarditis tend to become visible within four days of the vaccine dose.
Keep in mind that as of July 2021, more than 52 million doses of the COVID-19 vaccines have been administered in the United States to people ages 30 or younger, and the CDC has only confirmed about 600 reports of myocarditis or pericarditis in connection with vaccination in this age group. The cases connected to receiving the COVID-19 vaccine have also been mild. So, the benefits of COVID-19 vaccination in this group still outweigh the risks of getting myocarditis from the vaccine.
What are the signs of myocarditis/pericarditis?
People with heart inflammation experience chest pains, difficulty breathing, heart palpitations, and excessive sweating. These symptoms may also be accompanied by stomach pain, dizziness, coughing, unexplained swelling, and even fainting. If a recently vaccinated person shows symptoms of myocarditis or pericarditis, they should seek medical attention.
The most common side effects from COVID-19 vaccination are pain at the injection site, fatigue, headache, fever, chills, muscle pain, or joint pain. These vaccination side effects can be managed with over-the-counter medication and rest.
What do you say to families who are concerned about this serious, but rare, side effect?
I’m honest with families when I talk about it, and I understand that it’s disappointing to learn about this connection. But because it happens so rarely and because COVID-19 infection can have serious consequences in adolescents and young adults, the benefits of vaccination still outweigh the risks.
In making any medical decision we are weighing the potential risks and benefits. Remember, the risks of COVID-19 infection in this age group are real and so are benefits of COVID-19 vaccination. Data from the CDC estimate that if we vaccinate one million males between the ages of 12 and 17, we will prevent: 5,700 cases of COVID-19, 215 hospitalizations, 71 ICU stays, and 2 deaths in this group.
But I always recommend that parents talk with their pediatrician about any concerns. Pediatricians know what’s important to you and your family and have lots of experience giving vaccines and answering these questions.