The Centers for Disease Control and Prevention is exploring reports that several young people developed a heart condition known as myocarditis after getting the COVID-19 vaccine. But with no causal link between the two established thus far, doctors say the risk of kids developing the heart condition from COVID-19 itself is far higher.
"We know that COVID causes multiple negative outcomes, including myocarditis, the multisystem inflammatory syndrome (MIS-C) in children [and] so-called long COVID," says Dr. Kristen Sexson Tejtel, a pediatric cardiologist at Texas Children’s Hospital. "We know that all of those are risks that are associated with COVID and have seen far more of [those] than we have of any kind of myocarditis since the vaccination started."
So what exactly is myocarditis and what should parents be aware of? Here's what you need to know.
It can be triggered by an infection and occurs in 1 out of every 100,000 kids per year
"Myocarditis is a condition where the muscular walls of the heart become inflamed and it results in poor function of the heart," says Dr. Shelby Kutty, Helen Taussig professor, director of pediatric cardiology and co-director of the Pediatric and Congenital Heart Center at Johns Hopkins hospital and school of medicine. "It can be caused by various infections; viral infection remains a predominant cause of myocarditis."
According to the Mayo Clinic, those viruses include hepatitis B and C, herpes virus, adenovirus (which causes the common cold) and COVID-19. The condition has also been linked to other types of infections, including bacterial and fungal. Experts estimate that it occurs in approximately 1 in every 100,000 kids per year and typically has a mortality rate of under 25 percent in kids.
It has been linked to certain vaccines, in "extremely rare" cases, but not the COVID-19 vaccine
Sexson Tejtel says there is data available that suggests a potential link between myocarditis and certain vaccines like the smallpox vaccine. Kutty says neither he nor any of his colleagues at Johns Hopkins have witnessed that. "With regard to vaccination, it's extremely rare," Kutty says. "I have not personally encountered a vaccine-associated case of myocarditis."
Dr. Robert H. Pass, division chief of pediatric cardiology and director of pediatric electrophysiology at the Mount Sinai Health System, hasn't either. "I am not aware of other vaccines being associated with the development of myocarditis," Pass tells Yahoo Life. "However, it is important to note that any substance can trigger allergic reactions that could theoretically affect inflammation in the heart muscle or other organ systems."
The CDC's May 17 report on the myocarditis cases in kids after the COVID-19 vaccine noted that there had been "relatively few" and that all cases "appear to be mild." The organization says they have occurred more frequently in boys and typically less than four days after the vaccine was given. It also notes that an investigation into the cases isn't meant to suggest it's a major risk. "Within CDC safety monitoring systems, rates of myocarditis reports in the window following COVID-19 vaccination have not differed from expected baseline rates," it reads.
Experts say the risks of not getting the COVID-19 vaccine outweigh the risks of getting myocarditis from it "by a thousand-fold or more"
"We have seen myocarditis and signs of it in children admitted with COVID," says Kutty, adding that "most of them recover... but it's much more common than vaccine-associated occurrences thus far." Sexson Tejtel has seen it too. "We've seen COVID myocarditis, unfortunately not infrequently," she says. "I don't think it can be linked to the COVID vaccine yet, but it's always good to know about concerns."
Both Sexson Tejtel and Kutty believe that vaccination among kids should continue, even as the CDC studies these reactions. Pass agrees. "The risk for getting myocarditis is far larger from COVID than it is from the vaccine. At the present time, though there are reports of some adolescents developing myocarditis in the time period after an mRNA (Pfizer or Moderna) immunization, there is no direct evidence that the vaccine has had anything to do with the actual myocarditis observed and the incidence of this in the immunized population of children is, so far, no different than that in the general adolescent population," Pass says. "The risks to patients for the disease that most vaccines are intended to prevent outweigh this very theoretical risk by a thousand-fold or more."
For parents who are concerned, chest pain and increased heart rate are signs to look for
All three experts acknowledge that seeing a heart condition that affects kids circulating in the headlines may be concerning. For those worried about it happening to their child, there are certain red flags to notice. "Signs to look for are difficulty breathing and an increase in heart rate," says Kutty. "Also if the child suddenly feels tired and their energy level, on the whole, is low."
Pass adds chest pain to the list of symptoms. "Myocarditis is generally treatable and patients generally do very well if they seek medical attention," says Pass. "It is important to understand that from a statistical perspective, the chances of developing this condition are far greater than the risk from the immunization. COVID is serious business — anything we can do to reduce our risks of developing this infection are well worth it."
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