COVID-19 Vaccine Benefits Still Outweigh Risks

COVID-19 vaccination record. Credit: Copyright American Heart Association 2021

American Heart Association / American Stroke Association Statement: The benefits of the COVID-19 vaccine still outweigh the risks, despite possible rare heart complications.

Late last week, the U.S. Centers for Disease Control and Prevention (CDC) alerted health care providers to follow the Vaccine Adverse Events Reporting System (VAERS) and the Vaccine Safety Datalink (VSD) for cases of young adults developing the rare heart. related complication of myocarditis, after receiving a COVID-19 vaccine manufactured by Pfizer-BioNTech or Moderna. The COVID-19 Vaccine Safety Technical Work Group (VaST) of the CDC’s Advisory Committee on Immunization Practices (ACIP) is reviewing several dozen cases of myocarditis reported in adolescents and young adults: more often in men than in women; more often after the second dose than after the first dose of the Pfizer-BioNTech or Moderna vaccine; and usually appear within 4 days of vaccination.

The benefits of vaccination with COVID-19 greatly outweigh the rare potential risk of heart-related complications, including inflammation of the heart muscle or myocarditis. The American Heart Association / American Stroke Association, a global force for a longer, healthier life, is urging all adults and children 12 and older in the US to get a COVID vaccine as soon as possible.

The following statement echoes the views of the American Heart Association / American Stroke Association and its scientific leaders:

President Mitchell SV Elkind, MD, MS, FAHA, FAAN, Immediately Former President Robert A. Harrington, MD, FAHA, President-Elect Donald M. Lloyd-Jones, MD, Sc.M., FAHA, Chief Science and Medical Officer Mariell Jessup , MD, FAHA and Chief Medical Officer for Prevention Eduardo Sanchez, MD, MPH, FAAFP.

“We strongly urge all adults and children 12 and older in the US to get a COVID vaccine as soon as they can get it, as recently approved by the US Food and Drug Administration and the CDC. The evidence continues to indicate that the COVID-19 vaccines are nearly 100% effective in preventing death and hospitalization from COVID-19 infection. According to the CDC, more than 283 million doses of COVID-19 vaccines have been administered in the US since May 22, 2021, since December 14, 2020, and more than 129 million Americans have been fully vaccinated (i.e., they have either received two doses). of the Pfizer-BioNTech or Moderna COVID-19 vaccine, or the Johnson & Johnson / Janssen single dose COVID-19 vaccine).

“We commend the CDC’s ongoing monitoring of adverse events related to the COVID-19 vaccines through VAERS and VSD, and the consistent meetings of ACIP’s VaST working group, which shows transparent and robust attention to all health events that may be related keep with a COVID-19. vaccine. The few cases of myocarditis reported after vaccination with COVID-19 are under investigation. However, myocarditis usually results from a viral infection and it remains to be determined whether these cases are related to receiving a COVID-19 vaccine, especially since the US-approved COVID-19 vaccines do not contain live virus. .

“We remain convinced that the benefits of vaccination far outweigh the very small, rare risks. The risks of vaccination are also much smaller than the risks of COVID-19 infection itself, including the potentially fatal consequences and the potential long-term health effects that are still emerging, including myocarditis. The vaccination recommendation specifically includes people with cardiovascular risk factors such as high blood pressure, obesity, and type 2 diabetes, people with heart disease, and heart attack and stroke survivors, because they are at a much greater risk of an adverse outcome from the COVID-19 virus than they do. are of the vaccine.

“We also encourage everyone to stay in touch with their doctor and seek immediate help if they have any of these symptoms in the weeks after receiving the COVID-19 vaccine:

chest pain including sudden, sharp, stabbing pains; breathing difficulties / shortness of breath; abnormal heartbeat; severe headache; blurry sight; fainting or loss of consciousness; weakness or sensory changes; confusion or difficulty speaking; to attack; unexplained stomach pain; or new leg pain or swelling.

“We will stay on top of the CDC’s recommendations regarding all potential complications associated with COVID-19 vaccines, including myocarditis, pericarditis, central venous sinus thrombosis (CVST) and other blood clotting events, thrombosis, thrombocytopenia syndrome (TTS ) and vaccine-induced immune thrombosis thrombocytopenia (VITT).

“The American Heart Association recommends that all health care professionals be aware of these very rare side effects that may be associated with a COVID-19 vaccine, including myocarditis, blood clots, low platelets, or symptoms of severe inflammation. Healthcare professionals should strongly consider inquiring about the timing of a recent COVID vaccination in patients with these conditions, if necessary, in order to provide appropriate treatment promptly. As detailed in last month’s AHA / ASA statement, any suspected CVST or blood clots associated with the COVID-19 vaccine should initially be treated with non-heparin anticoagulants. Heparin products should not be administered at any dose if TTS / VITT is suspected until appropriate tests can be performed to rule out heparin-induced antibodies. In addition, healthcare professionals are required to report suspected vaccine-related adverse events to the Vaccine Adverse Event Reporting System, in accordance with federal regulations.

“We also support last week’s CDC recommendations that ease restrictions on mask wearing and social distance for people who are fully vaccinated. For those who cannot be vaccinated, we reiterate the importance of hand washing, social distancing, and wearing masks, especially for those at high risk of infection and / or severe COVID-19. These simple precautions remain crucial to protect people who have not been vaccinated against the virus that causes COVID-19.

“Individuals should contact their local and state health departments for specific information on where and when to get vaccinated. We implore everyone 12 and older to get vaccinated so that we can be together again in person and enjoy life with little to no risk of serious COVID-19 infection, hospitalization, or death. “

Myocarditis and pericarditis

Both myocarditis and pericarditis usually result from an infection and / or inflammation caused by a virus.

Myocarditis is inflammation of the middle layer of the wall of the heart muscle and can weaken the heart muscle and the heart’s electrical system, keeping the heart pumping regularly. Severe myocarditis can lead to heart failure, abnormal heart rate and sudden death. Signs and symptoms of myocarditis include chest pain, abnormal heart rate (arrhythmia), and unexpected shortness of breath. About 10 to 20 per 100,000 people in the US are diagnosed with myocarditis each year, and many cases resolve on their own or with treatment, leading to a full recovery.

Pericarditis is a condition often related to myocarditis, and involves swelling and inflammation of the pericardium, a sac-like structure with two thin layers of tissue that surround the heart to keep it in place and keep it functioning properly. Pericarditis can progress and lead to serious complications, including cardiac tamponade, which results from too much fluid in the pericardium, which can cause a sharp drop in blood pressure and be fatal; and chronic constrictive pericarditis, where scar-like tissue develops in the pericardium causing it to stiffen, impairing the heart’s ability to contract. Symptoms of pericarditis are sharp, stabbing chest pain that comes on suddenly; fever; weakness; and trouble breathing or shortness of breath. About 45,000 people in the US are hospitalized with pericarditis every year.

Typical vaccine-related symptoms

According to the CDC, typical symptoms of the COVID-19 vaccine are fatigue, headache, muscle pain, chills, fever, and nausea. Symptoms usually appear within 24-48 hours and usually disappear within 36-48 hours of vaccine administration. If symptoms are severe and include difficulty in breathing, seek immediate medical attention – call 911 or go to the hospital nearest emergency room.