Benefits of COVID-19 vaccines outweigh risk of rare reactions in adolescents, doctors say

This story appeared in MLive. Read more here.

Benefits of COVID-19 vaccines continue to outweigh risks, including rare cases of heart inflammation in younger individuals, according to federal regulators and more than a dozen health care associations.

Earlier this week, the CDC’s advisory group of independent vaccine experts said there’s a “likely association” between the vaccines and recent reported cases of myocarditis, or inflammation of the heart muscles.

But the risks presented by COVID-19 remain greater, according to a statement co-signed by the U.S. Department of Health and Human Services, the American Academy of Family Physicians, the American Academy of Pediatrics, and another 12 national groups.

“The facts are clear: this is an extremely rare side effect, and only an exceedingly small number of people will experience it after vaccination,” reads the statement. “Importantly, for the young people who do, most cases are mild, and individuals recover often on their own or with minimal treatment. In addition, we know that myocarditis and pericarditis are much more common if you get COVID-19, and the risks to the heart from COVID-19 infection can be more severe.”

Newer variants have proven more serious to younger individuals than the initial strains. During the first year of the pandemic, six Michiganders age 10 to 19 died of COVID-19, and another 60 deaths were reported in the 20-29 age group.

Since April, there have been nine more reported deaths in the younger age bracket, and 39 in the 20-something group.

Hospitalizations have also increased for adolescents and young adults. Since April, there have been about 550 Michiganders younger than 20 admitted to hospitals with COVID-19 and another 1,500 among 20-to-29-year-olds.

“The way I explain it to my patients is there isn’t a zero-risk option,” said Dr. Heather Sowinski, a pediatric cardiologist for Spectrum Health in West Michigan.

As of May 31, the U.S. had reported 216 cases of either myocarditis or pericarditis (inflammation of the outside of the heart) after a first dose of mRNA vaccine, and 573 cases after a second dose. In both conditions, the adverse reactions were more common in males than females, with a median age of 30 after the first dose, and 24 after the second dose.

For context, nearly 300 million doses had been administered in the U.S. as of June 11.

The CDC estimates that the rate of heart inflammation for individuals 16 to 39 years old is about three cases per million people after one dose, and about 16 cases per million people after a second dose. That’s higher than typical occurrence, but remains rare in reality.

Reported cases of myocarditis have predominately been in males 16 and older. Onset of symptoms, which include prolonged chest pain, typically occurs within the first several days of vaccination and is more common after the second dose than the first.

In most cases, patients who presented for medical care “have responded well to medications and rest and had prompt improvement of symptoms,” according to the CDC. Of those who had been discharged from care as of May 31, 81% had full recovery of symptoms and 19% had ongoing signs or symptoms or their status was unknown.

Health officials recommend monitoring for symptoms like acute chest pain, shortness of breath or heart palpitations for about a week after vaccination, and seeking medical care if they occur. Physicians should ask about vaccination status while treating patients with these symptoms, and cases should be reported to the nation’s Vaccine Adverse Event Reporting System (VAERS).

“We recommend getting vaccinated right away if you haven’t yet,” reads the joint statement. “It is the best way to protect yourself, your loved ones, your community, and to return to a more normal lifestyle safely and quickly.”

Other groups backing the statement include the American College of Obstetricians and Gynecologists (ACOG), American College of Physicians (ACP), American Heart Association, American Hospital Association (AHA), American Medical Association (AMA), American Nurses Association (ANA), American Public Health Association (APHA), Association of Public Health Laboratories, Association of State and Territorial Health Officials (ASTHO), Big Cities Health Coalition, Council of State and Territorial Epidemiologists, Infectious Diseases Society of America, and the National Association of County and City Health Officials (NACCHO).

Michigan has administered a first-dose vaccine to 330,499 residents age 12-to-19. Shots are available throughout the state for individuals 12 years and older. For more information, visit the state’s COVID-19 vaccine website.

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