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Myocarditis, pericarditis and the COVID-19 vaccine

In B.C. and elsewhere in Canada, there have been a small number of reports of heart inflammation in youth following vaccination with a COVID-19 mRNA vaccine. An expert at BC Children’s Hospital weighs in on the new developments.
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​Now that B.C. has opened registration and appointment bookings for the Pfizer-BioNTech COVID-19 vaccine to all youth and adolescents age 12 and older, a new worry is emerging.

In rare cases, some youth have experienced inflammation of the heart following immunization with a COVID-19 mRNA vaccine. But Dr. Kevin Harris, a pediatric cardiologist at BC Children’s Hospital, says few children have been hospitalized for this in Canada, so far.

“Typically, the severity of this condition has been mild. People respond well to treatment and make a full recovery.”

The National Advisory Committee on Immunization (NACI) is recommending informed consent for people receiving an mRNA vaccine should include a discussion about the very rare risk of myocarditis and/or pericarditis following immunization. As a precaution, NACI recommends that individuals who experienced myocarditis and/or pericarditis after a first dose of an mRNA vaccine should wait to get their second dose until more information is available.

In the U.S., cases have mostly been among male adolescents and young adults under 30. The symptoms started within several days of vaccination. Most patients who received care responded well to treatment and rest and made a full recovery.

Myocarditis or pericarditis can be caused by viruses, other types of infections or medications. 

“Given that there are many causes of myocarditis and there have been very few cases in adolescents who have been vaccinated, more investigation is needed to confirm the association to the mRNA vaccines,” says Harris. 

Experts still recommend vaccination

In the U.S. and B.C., it is recommended that young people get vaccinated. 

“The pluses of vaccination continue to outweigh the minuses,” says Harris. “There are clear benefits of mRNA vaccines in reducing hospitalizations and deaths due to COVID-19 infections.”

While younger people are less likely to experience serious outcomes of COVID-19, having access to a safe and effective vaccine will help protect them against severe COVID-19 disease. It will also protect those around them, including vulnerable populations who may not be adequately protected by vaccine. 

If a young person is vaccinated, they are much less likely to spread COVID-19. 

“At BC Children’s, we have immunocompromised children who depend on others to be vaccinated,” says Harris. “It’s not just about getting your own child vaccinated for their own protection. It’s also about helping to protect others, including immunocompromised children who may not be adequately protected by vaccine or younger children for whom vaccines are not approved for use at this time.”

Understanding the risk 

Canada is watching the U.S. data because that country has fully vaccinated more children, including with two doses of the Pfizer vaccine. As of July 14, more than nine million 12 to 17 year olds in the U.S. have received at least one dose of a COVID-19 vaccine and more than seven million are fully vaccinated. In comparison, as of July 3, approximately 1.6 million children aged 12 to 17 in Canada have had at least one dose of a COVID-19 vaccine and about 233,000 are fully vaccinated. 

The U.S. CDC estimates one case of myocarditis or pericarditis per 100,000 second doses of mRNA vaccine.

What parents can watch out for

Symptoms of heart inflammation can include:

  • Chest pain
  • Shortness of breath
  • Feeling of a rapid or abnormal heart rhythm

If your child experience these symptoms, seek medical attention right away. Inform the health care provider that your child received a COVID-19 vaccine recently.

Got questions about vaccination?

Learn more about COVID-19 vaccination information for young people age 12 to 17. You can also call 8-1-1 or talk to a health care provider if you have questions. Not all COVID-19 vaccine information is reliable. Learn how to find trusted information about vaccines. 

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