Does The COVID-19 Vaccine Trigger Myocarditis? Here’s What We Know

By Amie Knowles

May 29, 2021

Some adolescents and young adults developed an inflammatory heart condition following a COVID-19 vaccination. 

CHARLOTTESVILLE – A warning label is going up on Pfizer and Moderna’s versions of the COVID-19 vaccine. This has nothing to do with adults. It’s about a very rare side effect federal health officials are seeing in teens. A Centers for Disease Control advisory panel said that data suggests a “likely association” between the vaccines and cases of heart inflammation. 

No, it’s not time to panic, but it is time to raise awareness. 

Remember just over a month ago, when rare cases of blood clots formed in women who received the Johnson & Johnson vaccine? Well, some teens and young adults developed a rare heart condition, potentially as a result of the COVID-19 vaccine.

The CDC monitored 1,200 cases of heart inflammation. They found more than 800 cases happened after teens took the second doses of the vaccine. The majority of cases happened to boys and young men under 24.

To be clear, the CDC report says teens should still get the vaccine, as the inflammation cases are mostly mild. Also, the benefits “still clearly outweigh the risks,” the report says.

What Do We Know About Myocarditis?.

The symptoms typically occurred within four days of vaccination. They also started more often following the second dose, rather than the first. 

Current information also points to a younger, biologically-based patient profile. The heart condition occurred predominantly in adolescents and young adults and more often in males than females.

Dr. Jeff Vergales, a pediatric cardiology specialist at UVA Health, expressed that one of those findings, specifically, did not surprise him. That’s because myocarditis typically impacts more males than females. 

However, another aspect differed – the age of onset for those vaccinated. Myocarditis is not solely a childhood condition.

“Adults can get myocarditis. Newborn babies,” Vergales said. “In fact, pre-natal, like, fetuses can get myocarditis as well. So it’s seen across all ages.”

The CDC noted that most known cases discovered after the COVID vaccine appeared mild. 

Not a New Condition

Myocarditis did not originate with the COVID-19 vaccine. In fact, Carl Ludwig Alfred Fiedler first discovered the condition in 1900, while performing an autopsy using a microscope. 

“It’s not a new condition,” Vergales said. “It’s a condition we see and evaluate people for all the time in pediatric cardiology. So that, in and of itself, is not new.” 

So what causes myocarditis? Well, a number of things, actually. The condition sometimes arises in response to a viral, bacterial, parasitic or fungal infection.

“It can sometimes be infectious ideology,” Vergales said. “It can sometimes be drugs. [And] it can sometimes be other disease processes.”

In the younger population, the cardiologist noted the condition typically starts because of a virus. 

While many cases remain mild, others progress to tragic circumstances.

“It all depends on how sick they are. Thankfully the majority of myocarditis that we see recovers and those kids do not have longstanding disfunction. That is true,” Vergales said. “Unfortunately, there’s definitely a subset of kids and young adults that can get very sick from it and they can have ongoing disfunction to the point that some of those kids will potentially die from it. And some of those kids will end up having to undergo a heart transplant for it. That can happen with this disease.”

Onset After Vaccination 

The reason adolescents and young adults sometimes develop myocarditis following a vaccine relates to an onset caused by an infection. 

“Viruses in this age population are the most common reasons to cause that. It goes without saying, though, and the reason that it probably happens is because the entity – i.e. the virus – causes a reaction that develops inflammation around the heart,” Vergales said. “You could also say that you could see logically why someone that receives a vaccine that develops the same immune reaction that can develop inflammation, so the same reason that some people will get sore arms with the vaccine or feel under the weather for a day or so with the vaccine is because they are generating inflammation in their body. That’s the point of vaccines.”

The possibility of myocarditis developing following the COVID vaccine did not shock the doctor.

“It’s not surprising that just like a small group of people when they get infected with the virus develop inflammation around their heart, there’s going to be a small group of people that when they get vaccinated are going to develop inflammation around their heart,” Vergales said.

Vergales noted that the concept of developing myocarditis following a vaccination is not new to the COVID-19 vaccine. 

“We’ve seen it with other vaccines,” Vergales said. “It’s been demonstrated with influenza vaccine before, it’s been demonstrated with smallpox vaccination before [and] it’s been demonstrated with tetanus and pertussis vaccination before.”

Could Myocarditis Happen to My Kids?

Everyone’s body reacts differently to infections and vaccinations. 

“I guess the question is, ‘Why do certain kids’ [bodies] set up the inflammation that way in their heart?’ We don’t really know that. There’s a lot of, kind of, theories out there and research that we try to do to try to figure out why certain kids and adults react to viruses and inflation the way that they otherwise do,” Vergales said. “But thankfully myocarditis is rare, but not super rare that we don’t see it every year.”

While Vergales noted that youth cases of myocarditis occur in Virginia, he stressed that the chances of developing the condition remain slim.

“The first thing I would tell parents is [that] this is exceedingly rare,” Vergales said. 

For those with concerns, the doctor listed symptoms to monitor.

“Oftentimes kids that have myocarditis will have profound shortness of breath, will oftentimes have some significant chest pain and chest discomfort. Myocarditis is not a sudden, gentle diagnosis. Pediatricians know this, like, you know. You know someone’s got it because it’s not like, ‘Oh, a kid feels a little bad’ or anything,” Vergales said. “I just kind of tell parents [that] if something doesn’t seem right with your kid, you should have them evaluated by their regular doctor because there are some signs and symptoms that a regular doctor can kind of piece out to diagnose myocarditis. It’s not the simplest of diagnoses and it’s not something that there’s a certain sign that someone would know.”

Taking the proper precautions, the CDC plans to follow-up on the myocarditis cases that developed after the COVID-19 vaccine.

“Everything’s under a microscope,” Vergales said. “We’re looking at things so, so closely to make sure.” 

Amie Knowles reports for Dogwood. You can reach her at [email protected] 

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  • Amie Knowles

    Amie is Dogwood's community editor. She has been in journalism for several years, winning multiple awards from the Virginia Press Association for news and features content. A lifelong Virginia resident, her work has appeared in the Martinsville Bulletin, Danville Register & Bee and NWNC Magazine.

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