Risk of heart conditions from Covid-19 infection higher than risk from vaccine: S'pore cardiologists

Individuals should avoid strenuous activity for one week after vaccination, especially after the second dose.

Karen Lui | June 14, 2021, 05:55 PM

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Two medical organisations in Singapore have issued a joint statement today (Jun. 14) to address concerns about the occurrence of heart conditions in relation to Covid-19 vaccination.

This comes after recent reports of heart inflammation in four men aged 18 to 30 after the second vaccine dose, prompting the expert committee on the Covid-19 vaccine to advise that young men take additional precautions against the potential risk.

In their Jun. 14 joint statement, the Chapter of Cardiologists, College of Physicians, Singapore, Academy of Medicine, Singapore and Singapore Cardiac Society acknowledged current data that suggests a very small risk of myocarditis and pericarditis following a second dose of mRNA Covid-19 vaccine, particularly in males under 30 years old.

Myocarditis refers to inflammation of heart muscle, while pericarditis refers to inflammation of the pericardium, the lining covering the heart. 

Presently, such data is only available for the mRNA-based vaccines produced by Pfizer-BioNTech and Moderna, both of which are used in Singapore's national vaccination programme.

Israel and the USA have observed increased cases of myocarditis and pericarditis after the second mRNA Covid-19 vaccination dose, said the organisations' statement.

However, the sample size of local data in Singapore is "too small to be conclusive," they added.

As the risk of complications from Covid-19 infection is "significantly" greater than the risk from Covid-19 vaccines, the organisations said that they "continue to recommend" eligible members of the public to go for Covid-19 vaccination.

The vaccination helps prevent the majority of individuals from developing serious illnesses due to Covid-19 infection and facilitates herd immunity in the community, they added.

The medical bodies also said that they will continue to monitor the situation closely and give further advice, should there be updates.

Association of heart conditions to Covid-19 infection and vaccination

Various reports suggest that Covid-19 infection is associated with myocarditis and pericarditis.

In what the organisations called the "largest and most complete" of these studies, the study's subjects were all young competitive athletes who had prior Covid-19 infection, and underwent cardiac MRI scans.

The study showed that the incidence of myocarditis was 2.3% (ranging from 0 to 7.6% at different institutions). i.e. the equivalent of 2,300 per 100,000 patients infected with Covid-19.

On the other hand, preliminary estimates from the U.S. suggest that the overall risk of myocarditis and pericarditis from the second dose of the mRNA vaccines is about 1.6 cases per 100,000 doses, with risk primarily in males under the age of 30.

The organisations advise individuals to avoid strenuous activity for one week after vaccination, especially after the second dose.

They also advise individuals who develop chest discomfort, breathlessness or palpitations after Covid-19 vaccination to seek urgent medical attention.

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Top image by Fullerton Health via Ong Ye Kung's Facebook page.