The most reliable way to inflame the heart is to bother it with a virus. Many types of viruses can manage it—coxsackieviruses, flu viruses, herpesvi

Doctors Are Puzzled by Heart Inflammation in the Young and Vaccinated

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2021-07-02 13:00:05

The most reliable way to inflame the heart is to bother it with a virus. Many types of viruses can manage it—coxsackieviruses, flu viruses, herpesviruses, adenoviruses, even the new coronavirus, SARS-CoV-2. Some of these pathogens bust their way straight into cardiac tissue, damaging cells directly; others rile up the immune system so overzealously that the heart gets caught in the crossfire. Whatever the cause, the condition is typically mild, but can occasionally be severe enough to permanently compromise the heart, requiring lifesaving interventions including ventilators or organ transplants; in very rare cases, it’s fatal.

That is decidedly not what we’re seeing in the CDC’s recent reports. The agency has confirmed more than 500 cases of myocarditis or pericarditis—inflammation of the heart itself or of the lining that shrouds it—in people younger than 30 who recently received Pfizer-BioNTech’s or Moderna’s two-shot COVID-19 vaccines. These events are, so far, not matching the most terrifying versions of the condition, which have been observed with coronavirus infections. Rather, compared with more typical cases of myocarditis, the ones linked to the vaccines, on average, involve briefer symptoms and speedier recoveries, even with less invasive treatments. Still, the incidents are showing up in the few days that follow each vaccine’s second dose at higher-than-expected rates, especially in boys and young men, and no one is yet sure why.

The CDC’s Advisory Committee on Immunization Practices, or ACIP, met last week to weigh the risks and benefits of keeping the vaccines in circulation among the nation’s eligible youngest. It rapidly reached a familiar verdict: The perks of immunization far outweigh the potential drawbacks of these side effects and others. Days later, the FDA appended a warning about the rare events onto its fact sheets for the vaccines. Most of the experts I spoke with enthusiastically backed both agencies’ decisions without reservation. Vaccines, they said, remain our most powerful defensive tool against the coronavirus; if anything, staying unimmunized is the bigger gamble when it comes to severe organ inflammation. But several of them also noted that this particular side effect, and the country’s response to it, represents a new type of stumbling block for our inoculations.

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