Covid-19 and children: How often do vaccines cause heart problems?

Federal regulators Data confirmation The company announced on Sunday the link between Modana’s coronavirus vaccine and rare heart problems in adolescence. Its side effects, myocarditis and myocardial inflammation, are also worrisome to federal agency advisors in deliberations on the use of the Pfizer-BioNTech vaccine in infants and teenagers.

Scientists advising the Centers for Disease Control and Prevention will review the latest data on the condition at a meeting on Tuesday before deciding whether to recommend the Pfizer-BioNTech vaccine to infants.

So how common is myocarditis? And do parents need to worry about vaccination of their children?

Absolutely not, said some experts familiar with recent research. Vaccines produced by Pfizer-BioNTech and Moderna appear to be associated with an increased risk of myocarditis, but the absolute risk remains very small. In most cases it is mild and resolves quickly.

Dr. Brian Feingold, a pediatric cardiac inflammation expert at the UPMC Children’s Hospital in Pittsburgh, said:

However, Covid-19 itself is much more likely to cause permanent damage to the heart, he said. “Statistically, it’s much more likely.”

Myocarditis is commonly caused by a viral or bacterial infection that causes symptoms such as rapid or irregular heartbeat, chest pain, and shortness of breath.Globally, about 10 to 20 out of 100,000 Develop myocarditis Every year, many other symptoms are mild and may not be diagnosed.

Tens of thousands of children have been hospitalized in Covid since the coronavirus pandemic began. And 657 died, According to the data collected by the CDC

Some children infected with the coronavirus may develop a long Covid that remains ill for several months after the initial infection disappears, or an affected multisystem inflammatory syndrome. At least 5,200 children In the United States.

The risk of myocarditis after vaccination is realistic, but “these are greater than the actual numbers,” said Dr. Finegold.

The incidence of myocarditis after vaccination depends on age, gender, dose, and study. However, the trends so far suggest that male patients aged 16 to 29 years are most likely after two doses of the mRNA vaccine.

Roughly 11 cases of myocarditis One study estimated for every 100,000 vaccinated male patients in this age group. The probability of myocarditis decreases with age.

Data on adolescents aged 12 to 15 years are limited due to the recent availability of the Pfizer-BioNTech vaccine. But so far, post-vaccination heart problems appear to be less common in boys of that age than in older men, says Paul A. Ofitt, director of the Vaccine Education Center at the Philadelphia Children’s Hospital. The doctor said.

This age distribution is similar to that seen in patients with myocarditis caused by a viral infection, Dr. Ofit said.

The FDA’s Scientific Advisory Board, to which he belongs, met last week to review the safety of the Pfizer-BioNTech vaccine in children aged 5 to 11 and recommend that children be finally vaccinated. I resolved that.

“Myocarditis is usually a post-pubertal phenomenon,” said Dr. Ofit, and the surge in myocarditis in young children after immunization “made me feel better about the fact that we are not uncomfortable. I added.

That sense of security may not be enough for some parents. Jeff Gastin, a plant geneticist at the Ministry of Agriculture, said he and his two sons increased their heart rate after receiving the Pfizer-BioNTech vaccine.

His teenage son recovered quickly, but 42-year-old Dr. Gustin says he can feel his heart beating violently, especially when lying down. He is currently considering boost immunization with the Johnson & Johnson vaccine rather than the Pfizer-BioNTech or Moderna vaccine.

And given his family history, he hesitates to immunize the youngest 11-year-old unless the school district requires it.

However, Dr. James Delemos, a cardiologist at the University of Texas Southwestern Medical Center in Dallas, said some cases of post-immunization myocarditis could be detected due to a thorough scrutiny of the vaccine. Said there is.report One of the first cases In January.

Vaccine-related myocarditis is far less frequent, severe, and unlikely to cause permanent harm compared to that observed in patients with Covid, Dr. Delemos said.

Coronavirus infects the inner walls of the heart muscle and blood vessels, risking long-term damage to the heart and other organs. The virus also weakens the heart enough to require a transplant and can even cause fatal damage.

In contrast, myocarditis observed after vaccination is mild and transient. “It’s anxious, but it’s rarely life-threatening,” said Dr. Delemos.

Still, in some Scandinavian countries where the Moderna vaccine has already been approved for adolescents, Stopped offering to people under 30, At least for now. The decision was based on evidence suggesting that the risk of myocarditis is higher with the Moderna vaccine than with the Pfizer-BioNTech vaccine.

For example, researchers in Kaiser Permanente Northern California compared the two vaccines directly and found that men between the ages of 18 and 39 had an increased incidence of myocarditis after both vaccines, but after Moderna. Was found to have risen further.

“The post-modana rate is objectively higher than the post-Pfizer rate,” said Dr. Nicola P. Klein, director of the Kaiser Permanente Vaccine Research Center. “It’s consistent regardless of which case you use, or whether you’re a man or both men and women.”

Risks after administration of both Moderna vaccines in people aged 18-39 years 37 times higher Like the average person, the rate after two doses of the Pfizer-BioNTech vaccine between the ages of 12 and 39 was 19 times higher.

That may sound alarming, but the absolute numbers are still small, Dr. De Lemos said. “30 times the number is still small,” he said. “Mathematics still supports vaccination of adolescents and children.”

It is unclear why myocarditis seems to affect boys more often than girls and whether it is specific to the coronavirus vaccine or a side effect of all mRNA vaccines. Focusing on post-vaccination myocarditis may also help to understand the general condition, according to experts.

“If you understand exactly what the etiology is and what’s going on, you’ll feel much better about this,” said Dr. Ofit. “It may be possible to treat it to some extent,” he added, if the doctor could identify the cause.