Concerns about the potential impact of COVID-19 vaccines on heart health have emerged. This article provides an overview of the scientific understanding regarding heart-related events linked to COVID-19 vaccines, comparing these risks to those posed by the virus itself.
Specific Heart Conditions and Vaccines
The heart conditions observed following COVID-19 vaccination are myocarditis and pericarditis. Myocarditis is inflammation of the heart’s muscular wall, which can affect its ability to pump blood effectively and lead to irregular heartbeats.
Pericarditis is inflammation of the thin membrane surrounding the heart. This inflammation can cause fluid to accumulate, restricting normal heart function. Both conditions can occur together, sometimes called myopericarditis. These rare events are predominantly associated with messenger RNA (mRNA) COVID-19 vaccines, such as those from Pfizer-BioNTech and Moderna.
Incidence and Demographics
Myocarditis and pericarditis following mRNA COVID-19 vaccination are considered rare occurrences. Across various studies, the incidence of myopericarditis in adolescents aged 12–17 years has been reported at approximately 43.5 cases per million vaccine doses. This rate is higher in males (about 66.0 cases per million doses) compared to females (10.1 cases per million doses) in this age group.
The risk is higher after the second dose of an mRNA vaccine. For males aged 12–17 years, data indicate a rate of around 75.9 cases per million second doses administered. In men aged 18–24 years, the incidence of vaccine-related myocarditis was approximately 0.95 per 100,000 individuals, with the highest rates after two doses. While more common in young males and typically after the second dose, most reported cases are mild and transient, with individuals generally recovering well.
Heart Health Risks from COVID-19 Infection
COVID-19 infection poses a significantly higher range of heart health risks compared to vaccination. The risk of cardiac complications, including myocarditis and pericarditis, is substantially greater after SARS-CoV-2 infection than after mRNA COVID-19 vaccination for all age groups and sexes. Individuals infected with COVID-19 before vaccination were 11 times more at risk for developing myocarditis within 28 days of a positive test. Even among males aged 12–17 years, who have the highest incidence of vaccine-related cardiac events, the risk of heart complications was 1.8 to 5.6 times higher after COVID-19 infection than after a second vaccine dose.
Beyond myocarditis and pericarditis, COVID-19 infection can lead to other serious cardiovascular issues such as arrhythmias, blood clots, heart attacks, and strokes. Long-term cardiovascular complications can also arise from the virus. Vaccination significantly reduces these cardiovascular complications associated with COVID-19 infection, with protective effects lasting up to a year.
Recognizing Symptoms and Seeking Care
Recognize the symptoms of myocarditis or pericarditis, regardless of vaccination status or recent infection. Common symptoms include chest pain or discomfort, shortness of breath, and heart palpitations. Chest pain associated with pericarditis may worsen when lying down and improve when sitting up and leaning forward. Fatigue, lightheadedness, and swelling in the hands, legs, ankles, or feet can also occur.
If you experience any of these symptoms, particularly chest pain or shortness of breath, seek prompt medical evaluation. A healthcare provider can assess your condition with a physical examination, blood tests, and imaging studies like an electrocardiogram or echocardiogram. Early diagnosis and appropriate care are important for managing these conditions. Public health recommendations support COVID-19 vaccination for eligible individuals due to the benefits in preventing severe disease and associated complications.