CDC: Pharmacists Should Watch Out for Myocarditis But Keep Vaccinating
Public health officials have cautioned about a few dozen cases of myocarditis, primarily in young men who received mRNA COVID-19 vaccines, and are advising that they will further investigate. Find out why the largest cardiology specialty group says that very slight risk shouldn’t prevent Americans from continuing to get vaccinated, however.
ATLANTA – The national Centers for Disease Control and Prevention (CDC) is cautioning clinicians to watch out for young adults who develop the rare heart-related complication myocarditis after receiving an mRNA COVID-19 vaccine.
Still, specialty groups are reminding the public – and healthcare professionals providing the vaccines, such as pharmacists – that the benefits still far outweigh the risks.
The CDC’s Advisory Committee on Immunization Practices (ACIP), says it is monitoring the Vaccine Adverse Events Reporting System (VAERS) and the Vaccine Safety Datalink (VSD) for cases of young adults developing myocarditis after receiving a COVID-19 vaccine manufactured by Pfizer-BioNTech or Moderna.
ACIP’s COVID-19 Vaccine Safety Technical Work Group (VaST) announced that it is reviewing several dozen cases of myocarditis that have been reported, most of them mild. Those cases are:
- predominantly in adolescents and young adults,
- more often in males than females,
- more often following dose 2 than dose 1, and
- typically within 4 days after vaccination.
Noting that the benefits of COVID-19 vaccination enormously outweigh the rare, possible risk of heart-related complications, including inflammation of the heart muscle, or myocarditis. The American Heart Association/American Stroke Association, a global force for longer, healthier lives, urges all adults and children ages 12 and older in the U.S. to receive a COVID vaccine as soon as they can.
VaST concludes that there are relatively few reports of myocarditis to date and that these cases seem to occur:
- predominantly in adolescents and young adults,
- more often in males than females,
- more often following dose 2 than dose 1, and
- typically within 4 days after vaccination.
- Most cases appear to be mild, and follow-up of cases is ongoing.
VaST also points out that, within CDC safety monitoring systems, rates of myocarditis reports in the window following COVID-19 vaccination have not differed from expected baseline rates. The group’s members urged that reports of myocarditis be communicated to healthcare providers, however.
Still, VaST recommends the following:
- Collection of more information through medical record review about potential myocarditis cases that were reported into VAERS.
- Providing more Information about this potential adverse event to clinicians in order to enhance early recognition and appropriate management of patients who develop myocarditis symptoms following vaccination.
- Greater collaboration between infectious diseases, cardiology, and rheumatology specialists to provide guidance on diagnosis, treatment, and management of myocarditis.
In response to the alert, the American Heart Association/American Stroke Association issued a statement advising, “We commend the CDC’s continual monitoring for adverse events related to the COVID-19 vaccines through VAERS and VSD, and the consistent meetings of ACIP’s VaST Work Group, demonstrating transparent and robust attention to any and all health events possibly related to a COVID-19 vaccine. The few cases of myocarditis that have been reported after COVID-19 vaccination are being investigated. However, myocarditis is usually the result of a viral infection, and it is yet to be determined if these cases have any correlation to receiving a COVID-19 vaccine, especially since the COVID-19 vaccines authorized in the U.S. do not contain any live virus.
The cardiology specialty group emphasizes its belief that the benefits of vaccination far exceed the very small, rare risks, adding, “The risks of vaccination are also far smaller than the risks of COVID-19 infection itself, including its potentially fatal consequences and the potential long-term health effects that are still revealing themselves, including myocarditis.”
The statement points out that recommendations for vaccination “specifically includes people with cardiovascular risk factors such as high blood pressure, obesity and type 2 diabetes, those with heart disease, and heart attack and stroke survivors, because they are at much greater risk of an adverse outcome from the COVID-19 virus than they are from the vaccine.”
It urges that medical care be sought by those who received the vaccine – and others -- if they have any of the following symptoms:
- chest pain including sudden, sharp, stabbing pains;
- difficulty breathing/shortness of breath;
- abnormal heartbeat;
- severe headache;
- blurry vision;
- fainting or loss of consciousness;
- weakness or sensory changes;
- confusion or trouble speaking;
- seizures;
- unexplained abdominal pain; or
- new leg pain or swelling.
Myocarditis is inflammation of the middle layer of the wall of the heart muscle, which can weaken the heart muscle and the heart’s electrical system, according to the AHA, which adds that severe myocarditis can lead to heart failure, abnormal heartbeat and sudden death. Rates of the condition in the United States annually are 10 to 20 per 100,000, and the cardiology group points out that many cases are fully resolved, either on their own or with treatment.
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