Pediatric cardiologists explain myocarditis and why your teen should still get a Covid-19 vaccine

But pediatric cardiologists have a message for these parents: Covid-19 should scare you more — much more — than the vaccine.

And these doctors should know. They have treated young patients who have contracted this heart condition after vaccination – it’s called myocarditis or inflammation of the heart muscle – and they have also treated young patients who have had Covid-19.

There is simply no comparison between the two, they say.

Myocarditis sounds scary, but there are mild versions of it. In vaccinated young people (aged 16 to 24 years), the symptoms have disappeared quickly in almost all cases. Covid-19, on the other hand, can be a long-term illness, or it can kill a young person – it has already killed thousands of them.

CNN spoke to pediatric cardiologist Dr. Kevin Hall of the Yale School of Medicine and Dr. Stuart Berger of Northwestern University Feinberg School of Medicine, who also chairs the Cardiology and Cardiac Surgery Section of the American Academy of Pediatrics, on cases of myocarditis reported in youth following vaccination with the Moderna or Pfizer Covid-19 vaccine .

Both doctors, as well as the American Heart Association and American Academy of Pediatrics, recommend the Covid-19 vaccine for young people.

What causes myocarditis and how often does it happen in young people?

While myocarditis is relatively uncommon, it does happen in young people (and we mean long before the Covid-19 vaccine ever came out). Usually it is caused by a viral or bacterial infection. Another vaccine, one against smallpox, has previously been linked to myocarditis.

There is a broad spectrum of myocarditis. Some people feel nothing and are fine without treatment. For others, myocarditis can be fatal.

Berger estimates that in the emergency room where he works at Lurie Children’s Hospital in Chicago, they see about one child with the condition during the summer, when coxsackie and other viruses that cause myocarditis are in full bloom. In general, these young people are otherwise healthy.

According to the Myocarditis Foundation, people are at higher risk for myocarditis from puberty to their early 30s. Men are affected twice as often as women.

How many people in the US have developed myocarditis after being vaccinated against Covid-19?

As of May 31, nearly 170 million Americans had at least one dose of the Covid-19 vaccine, according to the U.S. Centers for Disease Control and Prevention. During that time, fewer than 800 cases of myocarditis or pericarditis (inflammation of the tissue around the heart) have been reported after receiving the vaccine, most after the second dose, according to the CDC. And these are preliminary numbers — they may be lower because further research might show that not all of these people actually had myocarditis or pericarditis.

Are these numbers unusual?

As we mentioned, people get myocarditis and pericarditis — inflammation of the lining around the heart — even without the Covid-19 vaccine. The CDC wanted to determine if the rate of myocarditis and pericarditis after vaccination is higher than what you would see without the Covid-19 vaccine.

The answer was “yes” for people aged 16 to 24. The CDC found that as of May 31, among 16- and 17-year-olds, there were 79 reports of the illnesses shortly after vaccination, and you’d normally expect to see about two to 19 cases in this group. Among 18- to 24-year-olds, there were 196 reported cases, and you would expect to see between 8 and 83 cases. There were also reports of myocarditis and pericarditis in older age groups, but the numbers were not higher than what you would normally expect.

Did the myocarditis in these vaccinated youngsters really make them sick?

Sounds like an inflamed heart would always be a big problem by definition, right? But that’s not it.

“A lot of times people have myocarditis and they don’t even know it. It goes away and they’re fine,” Berger said.

In the vast majority of these cases after vaccination, patients recovered completely.

Looking at 270 patients admitted and discharged from the hospital on May 31, the CDC determined that 81% had a full recovery from symptoms. The remaining 19% had persistent symptoms or their recovery status was unknown.

Hall, Yale’s pediatric cardiologist, said many of the myocarditis patients at his hospital didn’t feel very sick after vaccination, but they were admitted so doctors could do more tests and out of an abundance of caution.

“Some of these young men and boys were quite upset that they had to stay in the hospital,” Hall said.

What symptoms did these young people have?

Hall is a co-author of a study published last week that examined seven cases of myocarditis in adolescents after vaccination.

They all had chest pains and some also had a fever or felt weak or tired.

Their symptoms started between two and four days after the second dose of the vaccine. They spent two to six days in the hospital. In all seven patients, their symptoms quickly resolved with medications such as nonsteroidal anti-inflammatories and steroids.

All seven cases were male. In the CDC report, most of the cases were men.

How do young people do when they get Covid-19?

This gets to the heart of the issue. When young people developed myocarditis after vaccination, the numbers were small and they weren’t very sick.

While most young people who develop Covid-19 are fine, some develop complications and even die from the infection.

According to the CDC, 2,637 people under the age of 30 died from Covid-19 on June 9. As of June 5, preliminary data shows 3,110 people under the age of 18 have been hospitalized, a number the CDC says is likely an underestimate.

Berger and Hall have each taken care of dozens of Covid patients.

“Some of them spent weeks in intensive care. They had poor heart function. They had acute infections that were completely preventable by the vaccine,” Berger said.

Even when they recovered, some were ill for a long time.

“We continue to have long-term concerns about these children,” Hall said. “We’ve seen some with persistent changes in their heart tests. This is a very serious disease.”

Justin Lape of CNN contributed to this report.

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