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Myocarditis: Heart inflammation looked like heart attack in children, pediatrician says

They complained of chest pain and general discomfort, and tests initially looked like they were suffering from an acute myocardial infarction or heart attack.

But they weren’t. Instead, the seven young people between the ages of 14 and 19 suffered from a very rare type of heart inflammation. It is the one that public health officials are starting to associate with Covid-19 vaccines.

“Fortunately, none of our patients were seriously ill and all responded very quickly to treatment,” Dr. Judith Guzman-Cottrill of Oregon Health & Science University said Thursday at a meeting of the National Vaccine Advisory Committee.

While all of the young patients were hospitalized for heart monitoring due to their symptoms, they recovered quickly.

Guzman-Cottrill said she believed the inflammation of the heart, called myocarditis, could be the result of a very rare reaction to the coronavirus vaccine. All seven patients had been recently vaccinated and none had evidence of recent coronavirus infection.

Children and adolescents appear to have stronger immediate reactions to the vaccine than adults, she noted. These reactions, widely reported, include fever, malaise, and headache. Inflammation of the heart may be a more extreme manifestation of this response, Guzman-Cottrill said.

“I wonder if myocarditis is actually an additional rare adverse event related to systemic reactogenicity and / or immunogenicity and these younger patients just tend to have more reactogenicity compared to older populations – and reactogenicity more severe, ”she told the NVAC meeting.

NVAC is advising the US Department of Health and Human Services and asked Guzman-Cottrill to describe the results she reported on June 1 in the journal Pediatrics.

The seven youngsters had chest pain, fever and other symptoms and the test results were similar to those seen in people with acute myocardial infarctions – the technical term for a heart attack. But none of the teenagers had a heart attack.

The patients were all getting better within a few days. Different treatments have been tried including aspirin, ibuprofen and steroids.

“We still don’t know to this day what the optimal therapy is,” said Guzman-Cottrill.

Myocarditis: Heart inflammation looked like heart attack in children, pediatrician says
Doctors in Virginia and Texas on Wednesday reported similar results in a series of cases of seven men aged 19 to 39. They also had alarming symptoms, including chest pain. They were diagnosed with myocarditis, were treated and released, the doctors reported in the journal Circulation.

Another group of vaccine advisers, the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices, was scheduled to meet on Friday to discuss the possibility that myocarditis is clearly linked to vaccines. This meeting has been postponed until next week due to the federal holiday of June 17th.

The United States Food and Drug Administration is considering the possible risk of myocarditis as it decides how to advise companies that want to seek permission to use vaccines in children under 12. The FDA has noted that people will want additional safety data for children, especially since the virus is less likely to cause serious illness and death in children than in adults.

Guzman-Cottrill says it’s important for pediatricians and parents to be aware of symptoms, but said she is monitoring CDC data showing millions of young people have been vaccinated and very few cases of myocarditis have been reported. reported. “It’s very reassuring for me,” she said.

CDC director Dr Rochelle Walensky said her agency was looking for cases but found them to be unusual.

Myocarditis: Heart inflammation looked like heart attack in children, pediatrician says

“These cases are rare, and the vast majority are fully resolved with rest and supportive care,” she said at the White House briefing on Covid-19 on Thursday. The agency is preparing a report for the ACIP meeting next week.

“The CDC will present details of more than 300 confirmed cases of myocarditis and pericarditis reported to the CDC and the FDA among the more than 20 million adolescents and young adults vaccinated in the United States,” she said. .

The big question is whether the risk of myocarditis may be linked to vaccines and, if so, whether the risk to children and young people is greater than the risk of catching the virus.

The CDC has urged doctors to consider the risk of myocarditis and a similar condition called pericarditis if children or adolescents have heart symptoms.

“Consider myocarditis and pericarditis in adolescents or young adults with severe chest pain, shortness of breath, or palpitations. In this younger population, coronary events are less likely to cause these symptoms.” , he advises. And doctors should ask about recent vaccinations.

Myocarditis: Heart inflammation looked like heart attack in children, pediatrician says

But Walensky noted that she had no hesitation in having her own children vaccinated.

“My own children received the Covid-19 vaccine because vaccination is the best way to protect our adolescents, adolescents and young adults from Covid-19 and its complications,” Walensky said during the briefing.

“The Covid-19 vaccine saves lives. Covid-19 has resulted in more than 320 deaths of children under 18 in the United States during this pandemic. And hospitalization rates among teens who contracted Covid-19 were two and a half to three times. higher than they are during a typical flu season, ”she added.

“In addition to preventing hospitalizations, the vaccine also reduces the risk of Covid-19 and therefore reduces the risk of MIS-C, a serious multisystemic inflammatory disease in children, which has affected more than 4,000 children in the United States. United during the pandemic, including 36 children whose deaths have been linked to MIS-C. “

While officials worry about the complication, organizations representing doctors have supported vaccination of children.

“The American Heart Association continues to urge all adults and children aged 12 and over in the United States to receive a COVID-19 vaccine as soon as they can, as recommended by the CDC,” the group said. .

He said 81% of the first 270 patients under the age of 30 discharged from care after suspected myocarditis linked to the Covid-19 vaccination have made a full recovery.

Members of the FDA’s Vaccines and Related Biologics Advisory Committee have also noted the dangers of Covid-19 to children.

“I think we need these vaccines as early as possible in children,” said Dr. Mark Sawyer, professor of pediatrics at the University of California San Diego School of Medicine, at a meeting of the group last week.


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