In my email...
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Dear LSBME Licensees,
05/28/2021 02:35:06 PM
Message Urgency: HIGHThis message is being sent via the Louisiana Department of Health Emergency Operations Center (LDH EOC) for all Louisiana Health Alert Network (LA HAN) recipients and Primary Care Healthcare Professionals. This message is from LDH regarding Clinical Considerations of Myocarditis and Pericarditis after Receipt of mRNA COVID-19 Vaccines Among Adolescents and Young Adults. Please read the message below and share with relevant stakeholders and partners through your own distribution channels.
Clinical Considerations: Myocarditis and Pericarditis after Receipt of mRNA COVID-19 Vaccines Among Adolescents and Young Adults
Please report any clinically significant myocarditis or pericarditis in an individual who received either the Pfizer or the Moderna vaccine to the Louisiana Department of Health, Infectious Disease Epidemiology Clinician Hotline: 800-256-2748
Summary
Since April 2021, increased cases of myocarditis and pericarditis have been reported in the United States after mRNA COVID-19 vaccination (Pfizer-BioNTech and Moderna), particularly in adolescents and young adults. There has not been a similar reporting pattern observed after receipt of the Johnson & Johnson COVID-19 vaccine.In most cases, patients who presented for medical care have responded well to medications and rest and had prompt improvement of symptoms. Reported cases have occurred predominantly in male adolescents and young adults 16 years of age and older. Onset was typically within several days after mRNA COVID-19 vaccination, and cases have occurred more often after the second dose than the first dose. CDC and its partners are investigating these reports of myocarditis and pericarditis following COVID-19 mRNA vaccination.
CDC continues to recommend COVID-19 vaccination for everyone 12 years and older given the risk of COVID-19 illness and related, possibly severe complications, such as long-term health problems, hospitalization, and even death.
Background
Myocarditis is inflammation of the heart muscle, and pericarditis is inflammation of the lining outside the heart. In both cases, the body’s immune system is causing inflammation in response to an infection or some other trigger. Symptoms can include chest pain, shortness of breath, or palpitations.The severity of cases of myocarditis and pericarditis can vary. For the cases reported after mRNA COVID-19 vaccination, most who presented to medical care have responded well to medications and rest.
Recommendations for Clinicians
CDC continues to recommend COVID-19 vaccination for everyone 12 years and older given the greater risk of other serious complications related to COVID-19, such as hospitalization, multisystem inflammatory syndrome in children (MIS-C), or death.
Report all cases of myocarditis and pericarditis post COVID-19 vaccination to VAERS, and to Louisiana Department of Health, Infectious Disease Epidemiology Clinician Hotline: 800-256-2748.
Consider myocarditis and pericarditis in adolescents or young adults with acute chest pain, shortness of breath, or palpitations. In this younger population, coronary events are less likely to be a source of these symptoms.
Ask about prior COVID-19 vaccination if you identify these symptoms, as well as relevant other medical, travel, and social history.
For initial evaluation, consider an ECG, troponin level, and inflammatory markers such as C-reactive protein and erythrocyte sedimentation rate. In the setting of normal ECG, troponin, and inflammatory markers, myocarditis or pericarditis are unlikely.
For suspected cases, consider consultation with cardiology for assistance with cardiac evaluation and management. Evaluation and management may vary depending on the patient age, clinical presentation, potential causes, or practice preference of the provider.
For follow-up of patients with myocarditis, consult the recommendations from the American Heart Association and the American College of Cardiology .
It is important to rule out other potential causes of myocarditis and pericarditis. Consider consultation with infectious disease and/or rheumatology to assist in this evaluation.
Where available, evaluate for potential etiologies of myocarditis and pericarditis, particularly acute COVID-19 infection (e.g., PCR testing), prior SARS-CoV-2 infection (e.g., detection of SARS-CoV-2 nucleocapsid antibodies), and other viral etiologies (e.g., enterovirus PCR and comprehensive respiratory viral pathogen testing).
Patient education materials can be found at: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/myocarditis.htmlFor more information
NIH materials on myocarditis and pericarditis
Frequently asked questions about VAERS reporting for COVID-19 vaccines VAERS – FAQs (hhs.gov)
How to report to VAERSThank you,
EOC HAN
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This is a little scary, I'd heard stories about this before - it's also not going to do much to help the drive to vaccinate everybody.
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How do I become a young adult again?
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How does this problem square against 611,000 deaths and the millions additional without a vaccine?
How often do people get myocarditis from other causes? How serious is it long term?
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How does this problem square against 611,000 deaths and the millions additional without a vaccine?
How often do people get myocarditis from other causes? How serious is it long term?
@loki said in In my email...:
How does this problem square against 611,000 deaths and the millions additional without a vaccine?
Hey, all those people that have been saying that the virus is totally overblown will undoubtedly say this is like having a head-cold, amirite?
I was only joking
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How does this problem square against 611,000 deaths and the millions additional without a vaccine?
How often do people get myocarditis from other causes? How serious is it long term?
@loki said in In my email...:
How often do people get myocarditis from other causes?
It has been linked to Covid.
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@loki said in In my email...:
How does this problem square against 611,000 deaths and the millions additional without a vaccine?
Hey, all those people that have been saying that the virus is totally overblown will undoubtedly say this is like having a head-cold, amirite?
@doctor-phibes said in In my email...:
@loki said in In my email...:
How does this problem square against 611,000 deaths and the millions additional without a vaccine?
Hey, all those people that have been saying that the virus is totally overblown will undoubtedly say this is like having a head-cold, amirite?
Dunno, I've had worse head colds.
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CDC says this stuff is rare, often subclinical and the Mayo Clinic says minor instances heal on their own.
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/myocarditis.html
200,000 cases a year prior to Covid so we have a baseline and we will see where this goes.
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@loki said in In my email...:
How often do people get myocarditis from other causes?
Myocarditis is rare in younger people, to be sure. When looking at the 600K-plus deaths, the fraction of younger people should be considered when looking at the incidence of myocarditis.
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@loki said in In my email...:
How often do people get myocarditis from other causes?
Myocarditis is rare in younger people, to be sure. When looking at the 600K-plus deaths, the fraction of younger people should be considered when looking at the incidence of myocarditis.
@george-k said in In my email...:
@loki said in In my email...:
How often do people get myocarditis from other causes?
Myocarditis is rare in younger people, to be sure. When looking at the 600K-plus deaths, the fraction of younger people should be considered when looking at the incidence of myocarditis.
This
️. We’re talking 16-19 year old boys. Over 600 cases in Israel. I doubt there were many cases of COVID in16-19 year old boys in Israel? I would love to see the comparison. -
@george-k said in In my email...:
@loki said in In my email...:
How often do people get myocarditis from other causes?
Myocarditis is rare in younger people, to be sure. When looking at the 600K-plus deaths, the fraction of younger people should be considered when looking at the incidence of myocarditis.
This
️. We’re talking 16-19 year old boys. Over 600 cases in Israel. I doubt there were many cases of COVID in16-19 year old boys in Israel? I would love to see the comparison.@lufins-dad said in In my email...:
@george-k said in In my email...:
@loki said in In my email...:
How often do people get myocarditis from other causes?
Myocarditis is rare in younger people, to be sure. When looking at the 600K-plus deaths, the fraction of younger people should be considered when looking at the incidence of myocarditis.
This
️. We’re talking 16-19 year old boys. Over 600 cases in Israel. I doubt there were many cases of COVID in16-19 year old boys in Israel? I would love to see the comparison.I have kids and nephews/nieces slightly older (actually Israel says their risk is greater). Personally I have not heard one story of a side effect from the vaccine. I have read the studies.
Honestly I wouldn’t spend a nanosecond worrying. You did the right thing and hopefully he is feeling better.
If the advice is take one shot where there is no evidence of myocarditis that would be fine. 85% effective after that.
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This entire exercise is one of risk management. For some of us, the numbers are 1% vs .00005%. That's a huge difference. For others, the numbers might be .0003% vs .00005%. For teenagers, the numbers might be even lower.
