Thread by @drjootz

Today in the @AmerAcadPeds journal, my colleagues & I share a summary of 7 male adolescents who developed #myocarditisAfterPfizer vaccination #scicomm 🧵
pediatrics.aappublications.org/content/early/…

Our report describes 7 teens across the US who developed inflammation of the protective sac around the heart (pericarditis) and inflammation of the heart muscle (myocarditis) within 2-4 days of Pfizer vaccine. 2/

We currently do not know if the #COVID19 vaccine caused myopericarditis in these 7 pts, but each story is EXTREMELY similar. We reported all cases to #VAERS and quickly notified our public health colleagues. 3/

All 7 patients recovered rapidly to treatment; 3 rec’d NSAIDs alone. They DID NOT have hx of prior COVID (6 had neg nucleocapsid Abs), none met MIS-C criteria, and all had negative COVID PCRs. Their ID diagnostics work-ups are summarized in Table 2 (too large to screenshot). 4/

Many children are diagnosed with myocarditis/pericarditis every year. We do not know if there is a currently a higher-than-expected number of these cases, as compared to past years. #VAERS and @CDCgov are investigating and following closely. 5/

Truth and transparency are my guiding principles, which is why I quickly worked w co-authors to get this published. We needed to alert pub health & clinicians of a poss ass'n. Do I think that #MyocarditisAfterPfizer is a vaccine side effect? Not confirmed. But if so, it's rare 6/

Over 2.2 mill 16-17yo teens have already rec'd 2 doses of Pfizer. Over 3 mill kids 12-15yo have dose #1. These are huge, very reassuring denominators, increasing daily! If there is a high risk of #myocarditisAfterPfizer, we would have likely seen a signal by now via #VAERS 7/

Meanwhile, we know that COVID itself causes myocarditis, severe disease, and MIS-C in kids. I strongly disagree with those who say that “COVID doesn’t affect children.” I'm a pediatric ID doc, and I’ve cared for critically ill kids with COVID. The vaccine prevents all of this. 8/

Close monitoring of myocarditis is critical as we continue to roll out mRNA vaccines across the country. Truth & transparency must be the guiding principles for all physicians and public health. I know that #VAERS works! I remember the swift removal of RotaShield back in 1999! 9/

FOR ADULT CLINICIANS: If a young adult presents with chest pain & ST changes, be sure to ask about recent COVID vaccine before activating STEMI protocol. Consider myocarditis or pericarditis in your DDX. One pt in our case series had unnecessary cardiac cath. 10/

FOR PEDIATRICIANS: If a teen or young adult presents with chest pain, ask about recent COVID vaccine. Consider myocarditis or pericarditis in your DDX, check an ECG and a troponin. 11/

FOR ALL CLINICIANS: If you diagnose myocarditis in someone after COVID vaccine, work with rheumatology & ID to do a full, comprehensive diagnostic eval, and report promptly to #VAERS 12/

The challenge: We are entering summer, and masks are coming off too early. We cannot assume that every teen case of #myocarditisAfterPfizer is due to vaccine -- this will be hard to tease out, so please work with your ID & rheum experts for a detailed diagnostic evaluation! 13/13