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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 developments.
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​Now that B.C. has opened registration and appointment bookings for the Pfizer-BioNTech COVID-19 vaccine to children, youth and adolescents age five 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 most cases have been mild.


“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.

The highest rate of myocarditis reported in Canada in association with the Pfizer mRNA vaccine has been for males aged 12 to 30 years following the second dose, with about 1.5 cases per 100,000 doses in B.C. Most receive conservative or no treatment and have no serious outcomes.

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

Experts still recommend vaccination

In 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 December 5, more than 20 million five to 17 year olds in the U.S. have received at least one dose of a COVID-19 vaccine and more than 14 million are fully vaccinated. In comparison, as of November 27, approximately 2.3 million children aged five to 17 in Canada have had at least one dose of a COVID-19 vaccine and about 2.1 million are fully vaccinated. 

The U.S. CDC estimates two cases 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 five to 11 and 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. 

BC Children's Hospital; COVID-19; COVID-19 vaccine; COVID vaccine; Covid vaccine children; myocarditis; pericarditis; adverse effects; vaccine
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