COVID Vaccines -- (STILL) Safe & Effective

Summary of yesterday's Advisory Committee on Immunization Practices Meeting

The Advisory Committee on Immunization Practices (ACIP) met yesterday to discuss the link between the COVID-19 vaccine and myocarditis. There was also a short presentation about vaccine boosters. Here’s a quick summary from the meeting (details are below for those of you who want more) —

The COVID vaccine is still recommended for everyone (who is a least 12). The health risks associated with a COVID infection are GREATER than the risks associated with the vaccine.

Cases of myocarditis associated with the COVID vaccines made by Pfizer and Modera are being investigated. The biologic mechanism (the system of causally) has not been determined.

In terms of booster shots, we do not need them right now and whether we will need them in the future is still to be determined.

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What is myocarditis?

Myocarditis is inflammation of the heart muscle (which is called the myocardium). Symptoms of myocarditis include chest pain/pressure, shortness of breath, and heart palpitations. Annually less than one case of myocarditis occurs among every 100,000 children. Myocarditis occurs most often in males (~76% of all cases), gradually decreases with age (meaning - the older you get the less likely you are to be diagnosed), and usually requires hospitalization (~6 days in the hospital). It is caused by viruses, bacterial infections, parasites, fungal infections, exposure to toxic substances, and other health conditions (like diabetes, lupus, or inflammatory bowel disease).

Myocarditis & the COVID-19 Vaccine

Cases of myocarditis (or pericarditis - inflammation of the lining of the heart) have been reported following a COVID-19 vaccine. To date, 484 cases have occurred in individuals who are 29 years old and younger. CDC has been able to investigate 323 of those cases (as of yesterday’s meeting); the remaining cases will be reviewed. A review of these cases found — the onset of symptoms began (on average) four days after the second dose of the vaccine. The majority of cases required hospitalization. There have been NO DEATHS and most of those who have been hospitalized have already been released from the hospital.

The “NO DEATHS” above is really important. In normal times when myocarditis is diagnosed in a young person (caused by something other than a vaccine), the proportion of individuals who die from myocarditis (we call this the case fatality rate in epidemiology) is 4-6%. The fact that zero deaths have occurred means that the type of myocarditis caused by the vaccine is less severe and is not causing death. Please note — individuals who are diagnosed with myocarditis caused by an infection with the SARS-CoV-2 virus have died. Meaning infection with the virus is more harmful than a complication with the vaccine.

Next steps… we need more data and continued monitoring. CDC will be looking for new cases of myocarditis. Additionally, those who have been diagnosed with myocarditis following vaccination will be followed and monitored for any long-term health effects. Following vaccination, one should pay attention to these symptoms —

Read more here.

Should I still get vaccinated? or have my child vaccinated?

Please, GET VACCINATED. The risks associated with the vaccine (even myocarditis) are rare. Harm associated with COVID-19 infection is deadly. If you are not vaccinated, please read my letter to my daughter about the vaccine. According to data presented yesterday, adolescents and young adults have the highest COVID-19 incidence (or the number of new cases) —

Along with the rising number of COVID cases among adolescents and young people, is a rising number of deaths from COVID in this age group —

The Pfizer vaccine — which is available to individuals 12+ — prevents both COVID infections and death. Getting your child vaccinated ensures that they will not be one of these statistics. Speaking of statistics… as of yesterday’s ACIP meeting, a total of 4018 cases of MIS-C (multisystem inflammatory syndrome in children) among kids with COVID-19 have been reported. That is 1 case of MIS-C per 3200 COVID infections in kids (not great odds). Of those kids with MIS-C, 60-70% have been hospitalized and 1-2% have died.

The risk of harm (read: possible DEATH) from COVID infection is much greater than the risk of an adverse health effect from the vaccine.

Additionally, long-term symptoms or “long COVID” is becoming increasingly prevalent in children. Some studies show that more than 50% of kids with a COVID diagnosis are suffering for more than a month with symptoms such as fatigue, insomnia, muscle pain, headaches, inability to concentrate, exercise intolerance, and chest pain, among others. COVID Is no joke. We need to get our kids vaccinated.

Vaccines & variants —

It is expected that the Delta variant will be the most popular/prevalent form of the SARS-CoV-2 virus circulating in the United States by July. This variant is easily transmissible and is causing more serious illness than the other variants. To slow the evolution of the SARS-CoV-2 virus (read: to stop the development of new variants), vaccines are needed. At yesterday’s ACIP meeting, this image was shared —

What we see on the left/green side — is that if a large proportion (83%) of individuals are vaccinated, case counts will remain low throughout 2021 (assuming low transmission of new variants). As you can see from the right/blue side — if vaccination rates remain low (below 70%) and variants continue to arise, we can anticipate a spike in cases beginning in July and lasting throughout the year.

The bottom line — please get vaccinated. Encourage your friends & family to get vaccinated. An infection with the SARS-CoV-2 virus is no joke (it is not “just the flu”) and the number of severe illnesses, deaths, and long-term health complications caused by COVID is increasing, especially among young people.

To slow the spread of COVID and to decrease the number of new variants will require a community effort. We all need to get vaccinated.