COVID-19Infectious DiseasesPreventive Medicine


Much ado has been made on cable news programs about the adverse effects attributed to COVID-19 vaccines. In particular, there was significant concern about the development of myocarditis in young male adults after both Pfizer-BioNTech and Johnson & Johnson vaccines. Myocarditis is an inflammation of the heart muscle that causes chest pain, fatigue, and weakness, and can result in cardiomyopathy, a long-term weakening of the myocardium.

An American Heart Association study in the journal Circulation, reported 7 cases of myocarditis  in young males aged 19-39 years who lived in Texas and Virginia. Each of these young men developed chest pain and signs of myocarditis 3-7 days after receiving the Pfizer-BioNTech (6) or J & J (1) vaccines. All 7 were hospitalized briefly and were treated and released within 4 days of admission, their symptoms having resolved completely. 

Then, just days later, the CDC’s Advisory Committee on Immunization Practices (ACIP) met to discuss this study plus how to respond to the increasing number (323) of cases of myocarditis and pericarditis occurring in young individuals. These cases, again, occurred within one week of vaccination with COVID-19 vaccine and involved mostly males under age 30. Of the 323 patients, 309 required hospitalization. All but 12 (295) of them were released after treatment. Nine were still hospitalized at the time of the meeting and most cases occurred after the second dose of vaccine.

The CDC and AHA both conclude there is a direct correlation between the vaccines and myocarditis, but still call it a “rare vaccination complication.” The symptoms last a short time and resolve completely so it was decided that “the risk-benefit decision for vaccination remains highly favorable,” ie. they still recommend vaccination.

I would agree. 312 million doses of vaccine have been administered, and far fewer than 1000 cases of myocarditis were reported (323) as of June 1st. That’s one case per 1 million doses of vaccine or an incidence of .0001%. That’s a very small number of cases, and in non-pandemic, politically calmer times would probably be not be reported as vigorously as it has been or even get much attention. If one could put a positive slant on this occurrence, it would be that as of June 1, 2021, 95% of the few patients who developed myocarditis had complete symptom resolution after being hospitalized for an average of only four days.

Dr. G’s Opinion: I think that way too much has been made of the very small incidence of heart muscle inflammation. It’s like saying, out of the entire population of the United States (pop. 328.2 million) only 70% of the people in Jerome, Arizona (pop. 450) became sick. That’s tragic for Jerome, but great for the rest of the country. And all those who were sick recovered and no deaths were reported. I think this information is being used as political leverage to discourage vaccine participation. In this situation, politics should not be involved. Staunch anti-vaxers will seize at anything to justify their position and discourage vaccine participation. I think it’s a shame, and both the CDC and American Heart Association agree. 

I don’t put much stock in this rare occurrence because it has occurred “predominantly in adolescents and young adults, more often in males,” and this cohort of the population is healthy to begin with and recovers from the condition quickly. While this disease is worrisome (only very slightly), it doesn’t have the devastating affect it could potentially have if it affected older people. Thus far it has not. However, if you’re one of the victims of this adverse reaction, you’re not going to think of it as a minor incident, and you’re always going to wonder if this will ever come back to haunt you in old age. Will it lead to arrhythmias, heart failure, physical limitations, or poor quality of life? You certainly hope not. 

I’ll make note of this complication, but will not worry about it when cable TV commentators get overly dramatic and negative. Unless, of course, it starts occurring more frequently and begins to cause real problems. 

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