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Does the COVID-19 vaccine cause myocarditis?

Yvonne A. Maldonado, MD, FAAP

Answer

​​​​​Compared to the potential risks of COVID-19 infection in kids ages 5 to 11 and kids 12 to 17, myocarditis appears to be quite rare. In fact, children are more at risk of myocarditis after multisystem inflammatory syndrome, a serious illness from COVID-19 infection.

That is why the American Academy of Pediatrics recommends COVID-19 vaccination for all children and adolescents 5 years and older who do not have contraindications. Your child should get the COVID-19 vaccine that is authorized for their age.

What causes myocarditis?

Myocarditis is an inflammation of the heart muscle. It happens when the body's immune system reacts to an infection or some other trigger. In more than half of cases, no cause is identified. Symptoms can include feelings of abnormal heart rhythms, shortness of breath, or chest pain.

Very rarely, myocarditis also has occurred in some people who have received the vaccine. In most of these people, symptoms began within a few days following receipt of the second dose of vaccine. The chance of having this occur is very low.

In the clinical trials studying the vaccine in kids 12 to 17 years, a small number of adolescents and young adults experienced mild cases of myocarditis after getting the COVID-19 vaccine. Most got better on their own or with minimal treatment and rest. And in the clinical trials of more than 3,000 children age 5 to 11, there were no reports of myocarditis from the vaccine.

The reports of myocarditis after COVID-19 vaccination were seen:

  • mostly in adolescents and young-adult males, especially those 16 years of age and older,

  • more often in males than females,

  • more often following dose 2 than dose 1, and

  • typically within 4 days after vaccination.

What we do know: COVID-19 vaccines save lives

The Centers for Disease Control and Prevention (CDC) will continue to study the vaccine for these younger children to see if any potential link appears. This kind of ongoing monitoring is standard with all new vaccines to make sure they are safe.

Especially with the more contagious delta and delta plus variants of COVID-19 now circulating, the risks of being unvaccinated and becoming ill with COVID-19 are far greater than any rare side effects from the vaccines. Thousands of children have been hospitalized, and hundreds have died after being infected with COVID-19. Some children who have recovered still experience lingering symptoms. In fact, becoming infected with COVID-19 itself is much more likely to cause myocarditis than the vaccine.

Remember

COVID-19 vaccines are proven to be very effective at preventing severe illness and are truly lifesaving. As soon as your children are eligible, plan to get the vaccine. Right now, the only COVID-19 vaccine available for children in the U.S. is the Pfizer BioNTech mRNA vaccine. Two separate doses are given 21 days apart. The COVID shot for children 5 years to 11 years of age is a lower dose than the dose recommended for people 12 years and older. If you have any questions or concerns, don't hesitate to talk with your pediatrician.

More information

Yvonne A. Maldonado, MD, FAAP

​Yvonne A. Maldonado, MD, FAAP, is Professor and Chief of the Division of Infectious Diseases, Department of Pediatrics at Stanford University School of Medicine, Stanford, California. She is also the Senior Associate Dean for Faculty Development and Diversity at the Stanford School of Medicine. With the onset of the COVID-19 pandemic she has over 10 clinical, epidemiology and laboratory-based studies in this area and is involved in epidemiologic modeling at the university, state and national level. She is the Chair of the American Academy of Pediatrics Committee on Infectious Diseases. Dr. Maldonado has published over 200 peer-reviewed articles in scientific journals and is co-editor of the textbooks "Remington and Klein Infectious Diseases of the Fetus and Newborn Infant" and "Report of the American Academy of Pediatrics Committee on Infectious Diseases (Red Book)."

Last Updated
11/5/2021
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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