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Myocarditis, COVID and Covid Vaccines (Pfizer & Moderna Vaccines) 

By  Dr. Mike Hansen

Myocarditis, COVID, and Covid Vaccines: Myocarditis is heart inflammation, but to be more specific, it’s inflammation of the heart muscle. Pericarditis is inflammation of the pericardium (outer lining of the heart). Myocarditis and pericarditis often occur together, hence the term myopericarditis.

How often is it caused by COVID?
How often is it caused by the mRNA vaccines, Pfizer and Moderna?
What are the symptoms of heart inflammation?
How is it diagnosed?
I’m going to unpack all of it in this video.

Myocarditis, COVID and Covid Vaccines

Myocarditis is an interesting diagnosis because it can present in a variety of ways. Not just in terms of various signs and symptoms, but a variety of non-specific labs in the bloodwork. Non-specific EKG findings. Non-specific echocardiogram findings, meaning ultrasound of the heart. Also, most people with this diagnosis have zero or mild symptoms. On the flip side, it can RARELY present with sudden cardiac arrest. And even if you can make the diagnosis, it’s usually even TRICKIER to determine the cause.

Disease severity can range from unnoticeable to mild symptoms, severe illness requiring the ICU to death. More often than not, it’s a mild, temporary issue. In more serious cases, when there is more heart inflammation, the heart has a harder time pumping blood, leading to heart failure.

What are the Symptoms?
The highest risk population for myocarditis is from puberty to the early 30s. It affects males more often than females.
There are no specific symptoms associated with myocarditis, but common symptoms include:
• Chest pain or pressure
• Shortness of breath
• Fatigue
• Swelling in the hands and feet
• Heart palpitations
• Lightheadedness
• A sudden loss of consciousness

How does COVID affect the heart?
Even though COVID is a respiratory virus, it can affect the heart in several ways. First, when COVID causes pneumonia, it can damage the lungs, decreasing the amount of oxygen that gets to the heart and making it harder for it to pump blood to the body. This is known as demand ischemia.

Second, the inflammatory response from the immune system to fight the virus is sometimes excessive. The cytokine storm that you hear about, it’s a cascade of cytokines and chemokines of the immune system that can ultimately damage organs in the body. Basically, it’s collateral damage. The damage from this inflammatory response is known to especially affect the kidneys, brain, and heart. And that’s when you have myocarditis.

What is the risk of COVID in Children?
As of June 10th, 4,008,572 children have contracted COVID. This number represents 14% of all cases and is about 5,300 cases per 100,000 children. About 17,000 children have been hospitalized, and 330 have died. COVID has been in the top 10 causes of pediatric death since the pandemic began. As a comparison, 188 children died of influenza in the 2019-2020 season. The CDC reported that as of June 9th, 2,637 people under age 30 have died of COVID.

What is the risk of myocarditis from the COVID vaccine?
The COVID vaccines that are mRNA (Pfizer and Moderna) have caused some cases of myocarditis (heart inflammation). There have been cases and minimal studies looking at patients who developed myocarditis after getting the covid vaccine. The CDC has received 1,226 preliminary reports of myocarditis and pericarditis following about 300 million total doses of Pfizer and Moderna vaccines.

These preliminary reports came through the Vaccine Adverse Event Reporting System maintained by the CDC and the FDA. Among people 12 and older, there were 267 reports of heart inflammation after one dose of vaccine, 827 after the second dose, and 132 after an unknown dose. The CDC continues to recommend COVID vaccination for everyone 12 years of age and older. Why? For every million second-dose vaccinations with either Moderna or Pfizer, there may be tens of myocarditis cases, but thousands of Covid cases are prevented.

In males aged 12 to 17, it’s estimated that for every 1 million second-dose vaccinations, 5,700 Covid cases, 215 hospitalizations, 71 intensive care unit admissions, and two deaths would be prevented, with an estimated 56 to 69 myocarditis cases. For females aged 12 to 17, it’s estimated that for every 1 million doses to complete a two-dose series of vaccines, 8,500 Covid cases, 183 hospitalizations, 38 intensive care unit admissions, and one death would be prevented estimated 8 to 10 cases of myocarditis.

And In those aged 18 to 24 years, the numbers look even better. Since Wednesday, there’s been a joint statement from the leaders of more than a dozen health agencies and organizations — including the CDC, the American Academy of Pediatrics, the American Heart Association, and more – all saying that the Covid vaccines are safe and effective and that they “strongly encourage” everyone 12 and older to be vaccinated against Covid.

Doctor Mike Hansen, MD
Internal Medicine | Pulmonary Disease | Critical Care Medicine

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