AHA Reassures Myocarditis Rare After COVID Vaccination, Benefits Overwhelm Risks

Megan Brooks

May 24, 2021

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

The benefits of COVID-19 vaccination "enormously outweigh" the rare possible risk for heart-related complications, including myocarditis, the American Heart Association (AHA)/American Stroke Association (ASA) says in new statement.

The message follows a Centers for Disease Control and Prevention (CDC) report that the agency is monitoring the Vaccine Adverse Events Reporting System (VAERS) and the Vaccine Safety Datalink (VSD) for cases of myocarditis that have been associated with the mRNA vaccines against SARS-CoV-2 from Pfizer and Moderna.

The "relatively few" reported cases myocarditis in adolescents or young adults have more often involved males than females, more often followed the second dose rather than the first, and were usually seen in the 4 days after vaccination, the CDC's COVID-19 Vaccine Safety Technical Work Group (VaST) found.

"Most cases appear to be mild, and follow-up of cases is ongoing," the CDC says. "Within CDC safety monitoring systems, rates of myocarditis reports in the window following COVID-19 vaccination have not differed from expected baseline rates."

In their statement, the AHA/ASA "strongly urge" all adults and children 12 years and older to receive a COVID-19 vaccine as soon as possible.

"The evidence continues to indicate that the COVID-19 vaccines are nearly 100% effective at preventing death and hospitalization due to COVID-19 infection," the groups say.

Although the investigation of cases of myocarditis related to COVID-19 vaccination is ongoing, the AHA/ASA notes that myocarditis is typically the result of an actual viral infection, "and it is yet to be determined if these cases have any correlation to receiving a COVID-19 vaccine."

"We've lost hundreds of children and there have been thousands who have been hospitalized, thousands who developed an inflammatory syndrome, and one of the pieces of that can be myocarditis," Richard Besser, MD, president and CEO of the Robert Wood Johnson Foundation (RWJF), said today on ABC's Good Morning America .

Still, "from my perspective, the risk of COVID is so much greater than any theoretical risk from the vaccine," said Besser, former acting director of the CDC.

The symptoms that can occur after COVID-19 vaccination include tiredness, headache, muscle pain, chills, fever, and nausea, reminds the AHA/ASA statement. Such symptoms would "typically appear within 24 to 48 hours and usually pass within 36-48 hours after receiving the vaccine."

All healthcare providers should be aware of the "very rare" adverse events that could be related to a COVID-19 vaccine, including myocarditis, blood clots, low platelets, and symptoms of severe inflammation, it says.

"Healthcare professionals should strongly consider inquiring about the timing of any recent COVID vaccination among patients presenting with these conditions, as needed, in order to provide appropriate treatment quickly," the statement advises.



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