On 13th September the UK government announced that the Pfizer COVID vaccine would be made available on an optional basis to all young adults and children aged 12-15 years. The vaccine comes with a very small risk of myocarditis or pericarditis. It is understandable that parents of children with cardiac conditions may be more anxious about the vaccine. We thought it may be helpful as your local Children’s heart team if we provided you with some information to help you make this decision.
What is the risk?
In rare cases the Pfizer vaccine has been associated with a condition called myocarditis (inflammation of the heart) or pericarditis (inflammation of the heart covering). The risk after a single dose of vaccine is less than 1 in 100,000 cases. The risk is slightly higher after two doses. You will find different estimates of the risk online, this is because it is difficult to be certain whether the myocarditis is actually caused directly by the vaccine. In the majority of cases the inflammation is self-resolving without treatment. In the United States the Pfizer vaccine has been approved for use in children since 10th May. They have seen a small number of hospital admissions but not a single death in any patient under the age of 30. In summary there is a risk but it is very small and rarely serious.
What is the benefit?
In children the risk of hospitalisation from COVID is also small. This is why the decision to offer the vaccine has been difficult. Hospitalisation, however, doesn’t capture the full impact of COVID on our children. As parents you will be aware of the impact on schooling that the pandemic is having. This is directly associated with their mental well-being and future prospects. Minimising this over the coming year will have life-long benefits for all of our children. This is why the Royal College of Paediatrics has taken the decision to recommend the vaccine. In addition we continue to see children with acute complications from COVID. These complications include long COVID which is an unpleasant and often chronic problem. Finally we continue to see a small number of patients with a condition known as PIMS. This is an inflammatory condition caused by COVID and can result in intensive care admission. We hope the vaccine will reduce the risk of this.
What should you do?
We fully support the optional basis for parents to make their own decisions with regard to this vaccine. As a network we feel it is a positive step and we would encourage the uptake. For your child individually there is probably a small benefit but the risk is even smaller. Taken together the increased protection should enable children to return to school without ongoing sustained absence.
Further information:
If you have concerns not covered here then you are welcome to discuss this with your local cardiologist or the cardiac nurse specialist team on 0116 256 3338. More detailed information about the vaccines in general can be found on the British Heart Foundation's website.
Yours sincerely,
On behalf of the Cardiologists, Paediatricians and Cardiac Nurse Specialists of the East Midlands Congenital Heart Network
