Recent reports have surfaced on the observation of myocarditis and pericarditis after the COVID-19 vaccination. As a primary care physician, I have been hearing concerns about myocarditis and pericarditis following a COVID-19 vaccination that has caused many to delay or cancel their COVID vaccination bookings.
At the time of writing, six patients in Singapore, have been reported to suffer these conditions out of nearly 2.7 million people who have had their mRNA COVID-19 vaccinations, with a higher number coming from America at 475 cases among young adults aged 30 years or younger following their injection. This article covers what you need to know and if you should be concerned.
What is myocarditis?
Myocarditis is an inflammation of the heart muscle (myocardium) which can affect your heart’s electrical system and lead to rapid or abnormal heart rhythms (arrhythmias). A viral infection usually causes myocarditis, but it can also result from a reaction to a drug and be part of more general inflammatory condition.
Symptoms of myocarditis
Symptoms include:
- Chest pain
- Shortness of breath
- Rapid or abnormal heart rhythms (arrhythmias)
- Fatigue
What is pericarditis?
Pericarditis is a condition that can be caused by inflammation of the saclike tissues surrounding your heart (pericardium). The pericardium becomes inflamed when both layers of the pericardium rub against each other during movement or normal activity. This causes irritation and presents itself as sharp pain in the chest.
Symptoms of pericarditis
Symptoms include:
- Pain behind the breastbone or on the left side of your chest. The pain commonly worsens when the patient coughs, lie down or take a deep breath, while sitting up and leaning forward makes the pain lesser
- Abdominal or leg swelling
- Cough
- Fatigue
- Feeling of heart beating faster
Vaccine related myocarditis
The majority of those diagnosed with myocarditis after receiving the COVID-19 vaccine were under 30 years old (over 80% being males), reporting symptoms 2 to 4 days later following the second dose from their vaccines. While most cases reported relate to the mRNA vaccines, there have also been reports from other vaccines.
While there is evidence for a potential correlation between the vaccine and myocarditis, the exact mechanism of this reaction has yet to be fully understood, and can possibly be due to reactogenic side effects just like other symptoms such as lethargy, fever or muscle aches that can occur after receiving the vaccines.
Doctors can diagnose myocarditis by evaluating the patient's medical history, ECG results and blood biomarker changes. Most patients usually recover in a week after symptoms develop with medications for pain relief and anti-inflammatories to help reduce any swelling around their hearts.
Should I still get Vaccinated?
The Centers for Disease Control and Prevention (CDC) in US recommends COVID-19 vaccination for everyone 12 years of age and older to protect against the risk of COVID-19 illness and related issues that could cause complications. The known benefits of the COVID-19 vaccination outweigh the known risks, which include myocarditis or pericarditis symptoms.
In Singapore, the Pfizer-BioNTech/ Comirnaty vaccine is also offered to children between 12 to 17 years of age, while Moderna is only available for those 18 years and above.
It is important to note that COVID-19 is a virus which can lead to myocarditis and the risk is higher in young adults. However the benefits of getting one vaccinated against COVID-19 virus outweighs the potential risk of side-effects associated with it and hence children above the age of 12 is advised to be vaccinated against COVID-19.
If you have any reservations about getting your COVID-19 vaccine, do speak to your doctor for a personalised discussion and advice before making your decision.
What symptoms to look out for after mRNA COVID-19 Vaccination
After your mRNA COVID-19 vaccination, do keep a lookout of any symptoms such as chest pain, shortness of breath or heart palpitations and seek medical attention if you identify any of these symptoms within a week after you received your vaccination.
Precautionary measures
Please avoid strenuous exercises within one week of vaccination, have adequate rest and keep well-hydrated. If any symptoms occur such as chest pain or abnormal heartbeats seek medical help immediately.
Updates on the COVID-19 vaccination can be found on the Ministry of Health’s website here.
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