Myocarditis and COVID-19 vaccine: Patient case studies demonstrate easily treated symptoms

Research
Vaccine
Vaccine
A gloved doctor's hands holding a syringe, about to vaccinate a patient in the clinic to prevent the spread of the COVID-19 virus.
An OHSU-led review of seven patient cases of myocarditis following COVID-19 mRNA vaccination demonstrates easily treated symptoms. Clinical-researchers urge prompt reporting of instances to VAERS. (Getty Images)

According to the Centers for Disease Control and Prevention, approximately 41% of all Americans are fully vaccinated against the novel coronavirus. More than 2 million of these individuals are young adults younger than 18.  

The CDC also recently reported cases of myocarditis and myopericarditis, or inflammation of the heart muscle, following mRNA vaccination. While extremely rare, the majority of symptoms were mild and were reported predominantly in adolescent males.

A new case review, published online as a preprint in the journal Pediatrics, outlines seven nationwide instances of myocarditis or myopericarditis that developed in healthy 14- to 19-year-old males within four days of receiving the second dose of the Pfizer-BioNTech COVID-19 mRNA vaccine. All cases presented to their local hospitals with chest pain following vaccination; five of the seven also had fever. None tested positive for COVID-19 infection nor did they meet the clinical criterial for multi-system inflammatory syndrome, or MIS-C.

head shot of Mayme Marshall, M.D., a smiling adult woman with long, curly, red hair
Mayme Marshall, M.D.

“Overall, the seven individuals experienced symptoms of myocarditis or myopericarditis, such as chest pain or shortness of breath, and were easily treated by a range of common anti-inflammatory drugs, such as ibuprofen or corticosteroids,” says Mayme Marshall, M.D., a pediatric cardiology fellow at Oregon Health & Science University Doernbecher Children’s Hospital and co-author of the case review. “The average hospital stay was approximately four days, with symptoms diminishing as early as one week following hospital discharge.”

While it is possible that myocarditis or myopericarditis may be an additional, yet rare, side effect related to mRNA vaccines, Marshall says that despite ongoing CDC investigation, there is not yet a confirmed connection between inflammation of the heart muscle and COVID-19 vaccination.

Head shot of Judith Guzman-Cottrill, D.O., a smiling Asian woman with long, black hair
Judith Guzman-Cottrill, D.O.

“Data from these seven cases, as well as other patient cases reported to the CDC, suggest the risk of developing myocarditis or myopericarditis following COVID-19 mRNA vaccine appears to be extremely low. Based on the current data, the benefits of receiving the COVID-19 vaccine overwhelmingly outweigh the risks, and those able to get the vaccine should continue to do so at this time,” says the review’s corresponding author Judith Guzman-Cottrill, D.O., a professor of pediatrics (infectious disease) in the OHSU School of Medicine and OHSU Doernbecher Children’s Hospital.

Guzman-Cottrill also urges clinicians to consider myocarditis in the evaluation of adolescents and young adults who develop chest pain after COVID-19 vaccination and promptly report any associated instances to the Vaccine Adverse Event Reporting System, or VAERS.

“Recognizing the timeliness of COVID-19 vaccine and myocarditis is critical and may spare healthy adolescents and young adults presenting with chest pain from undergoing unnecessary invasive cardiac procedures,” she says.

The full review, including the seven patient case studies, is available here.

This review does not represent all instances of myocarditis or myopericarditis following vaccination reported to VAERS. In addition to OHSU, the following institutions contributed to this case review: Yale University School of Medicine; Emory University School of Medicine and Children’s Healthcare of Atlanta; Goryeb Children's Hospital; Thomas Jefferson University; Spectrum Health, Grand Rapids; and, Columbia University Irving Medical Center.


Tracy Brawley
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