Introduction
The FDA approved the emergency use of the Pfizer vaccine for 12 to 15 year-olds. Some patients developed myocarditis and pericarditis after receiving the second dose. Myocarditis refers to heart inflammation and pericarditis to inflammation of the area surrounding the heart. Myopericarditis refers to the inflammation of both heart and the surrounding area. About 1 in 100 teenagers between 12 to 15-years old experienced heart swelling after receiving the second vaccine dose. Data suggests that this age group has a risk of 1 in 1000 of experiencing myopericarditis after the second dose.
Method
Dr. Schauer and colleagues used blood tests, electrocardiograms (EKG) and Magnetic Resonance Imaging (MRI) to understand why the teenagers developed myopericarditis. The study included thirteen, 12-17-year-old participants who had experienced myopericarditis two to four days after the second dose. Most cases consisted of 15-year-old males.
Results and Discussion
Blood tests suggested high levels of C-reactive protein (CRP) and troponin proteins in patients. These proteins in the blood suggest heart inflammation and damage. Pictures of the heart and electrical activity from EKG showed that nine patients had abnormal heart rates. Two patients had abnormal activity in the left ventricle, which is the bottom left region of the heart. One patient had stenosis, an issue with the aortic valve that impacts blood flow in the body.
MRI images of the heart and circulatory system showed swelling, scarring and sometimes even abnormal sizes in certain areas of the heart. All patients received anti-inflammatory medication, ibuprofen for two days. Researchers discharged the patients once chest pains disappeared and blood protein levels returned to normal.
The researchers compared the findings to another research study. The latter suggested that once patients received a second vaccine dose, a higher immune response is likely to occur. Children who developed swelling within multiple organs in the body experienced the largest immune responses. This prompted an investigation of whether an increased waiting period is needed between vaccines or patients under 18 should receive a smaller second dose.
Furthermore, other researchers determined that genetics can impact the development of myocarditis. It can also increase the risk of developing myopericarditis after receiving both Pfizer doses.
Conclusion
The cases described above suggest that adolescents can experience heart swelling after receiving the second Pfizer vaccine dose. Nonetheless, limited research is available. Data records used to calculate probability of heart swelling show a higher likelihood than might be the case. Only with further research can conclusive results be drawn.
References
Baggio, C., Gagno, G., Porcari, A., Paldino, A., Artico, J., Castrichini, M., Dal Ferro, M., Bussani, R., & Merlo, M. (2021, May 7). Myocarditis: Which Role for Genetics? Current cardiology reports. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8105238/.
Feldstein LR; Tenforde MW; Friedman KG; Newhams M; Rose EB; Dapul H; Soma VL; Maddux AB; Mourani PM; Bowens C; Maamari M; Hall MW; Riggs BJ; Giuliano JS; Singh AR; Li S; Kong M; Schuster JE; McLaughlin GE; Schwartz SP; Walker TC; Loftis LL; Hobbs CV; Halasa NB; Doymaz S; Babbitt. (2021, Mar 16). Characteristics and Outcomes of US Children and Adolescents With Multisystem Inflammatory Syndrome in Children (MIS-C) Compared With Severe Acute COVID-19. JAMA. https://pubmed.ncbi.nlm.nih.gov/33625505/.
Schauer, J., Buddhe, S., Colyer, J., Sagiv, E., Law, Y., Chikkabyrappa, S. M., & Portman, M. A. (2021, July 3). Myopericarditis after the Pfizer mRNA COVID-19 Vaccine in Adolescents. The Journal of pediatrics. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8253718/.
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