Thread by @drjhuang

Post-COVID vaccine myocarditis: a #tweetorial from a pediatric cardiologist

First off this complication is reasonably scary for parents deciding whether or not to vaccinate their kids. I do hope that this 🧵 helps clarify the data and dispel some myths.

Myocarditis is inflammation or swelling of the heart muscle and can lead to dysfunction. Many ways to diagnose it, but gold standard is visualizing the inflammation on cardiac MRI.

In some data sets, it can be over-represented if the definition is an ⬆️troponin (🫀protein) alone

Post-vaccine myocarditis is rare but most common in males age 12-17 years (0.0067% in this group and 0.001% overall) & occurs a median of 3.5 days after the 2nd vax

Big BUT…

Almost 7x less common than myocarditis after an infection with COVID in this same group (0.045%)

While not all data has been published,

The experience across US centers, including in this soon-to-be published study in @AmerAcadPeds journal Pediatrics and my own experience, is that kids recover quickly and completely.

pediatrics.aappublications.org/content/pediat…

While we still don’t know the long term outcomes of post-vaccine myocarditis, we do know that other myocarditis caused by viruses (#1 cause) like Covid can sometimes lead to death or need for heart transplant…

And we haven’t seen that from post-vaccine myocarditis in the US.

One potentially big problem for kids is that we do restrict competitive sports for at least 3 months for kids after myocarditis.

Of course, they are also restricted for MIS-C, functionally restricted with long-Covid syndrome, & will definitely miss field time even if just Covid+

So overall, given what we do know now, from a myocarditis perspective alone and not taking into account MIS-C and long-Covid syndrome (both of which look much worse),

The vaccine is safer for kids and their hearts 🫀 than getting a Covid infection.

-signed #PedsCards

Thanks @DrJenChen4kids for suggesting a #pedscards perspective.

I defer to my colleagues @larsgrowo @SupriyaJainMD @preetir85 @Kfarooqi @ShelbyKuttyMD for more in-depth perspectives.