As Nordic countries restrict the use of Moderna’s COVID-19 vaccine, should U.S. reevaluate risk of myocarditis?

by mcardinal

Lauren Dempsey, MS in Biomedicine and Law, RN, FISM News 


This week Finland, Sweden, and Denmark restricted the use of Moderna’s COVID-19 vaccine due to the risk of myocarditis in certain age groups, specifically for men under the age of 30. Nordic countries will offer the Pfizer BioNTech vaccine instead. However, reports of myocarditis have occurred following both Moderna and Pfizer’s mRNA vaccines.

As of July, there were thousands of cases reported to VARES of myocarditis post-vaccination in adolescent boys and men under 30. Previous research has shown that only approximately 1% of vaccine injuries or adverse reactions are reported, which could indicate that this side-effect could have a much wider reach.

Myocarditis, which is inflammation of the heart, can cause lifelong damage to the heart muscle leading to heart failure and death. 

The FDA and Moderna have both said they are aware of myocarditis as a side effect. However, they believe “the known and potential benefits of vaccination outweigh the known and potential risks for the Moderna COVID-19 vaccine,” according to an FDA statement. 

Some experts have made the argument that vaccination of all is essential, no matter the potential side effects, but what is the actual risk verses benefit? In August, the CDC’s Advisory Committee on Immunization Practices conducted a meeting that focused on recommendations for vaccinating children. In this meeting, data was released showing 765 reports of abnormal cases of myocarditis following vaccination based on specific age groups.

For boys aged 12-15 years old there was a twenty fold increase in myocarditis after vaccination with 117 total cases being reported. For boys aged 16-17 years old there were forty times more cases totaling 121 reported cases. In men aged 18-24  years old there were a total of 213 cases, which is 20 times more than expected. In another study, JAMA Cardiology revealed that 23 military members reported “acute-onset chest pain following mRNA COVID-19 vaccination.” All of the patients were diagnosed with “myocarditis without infectious, ischemic, or autoimmune etiologies identified.”

Current research shows that in reported cases, patients with myocarditis had complaints of chest pain, elevated cardiac troponin levels, abnormal ECG results and cardiac MRI’s indicated myocarditis. Important to note is that these patients did not have COVID-19 or other viral infections, which is often the cause of myocarditis. 

While myocarditis is rare, having impacted 0.0004% of the millions that have been vaccinated, it is important to weigh this against the risk of contracting COVID-19 for this age group. According to the CDC, the current fatality rate for children under age 18 in the United States is 0.0007%. The risk of dying from COVID-19 has remained low throughout the course of the pandemic and out of the 74.1 million children in the U.S., 513 have died. We also know that for individuals without serious medical conditions or comorbidities, the risk of severe COVID symptoms or death from COVID is extremely low. 

With this in mind, should the FDA reconsider the use of mRNA vaccines in specific age groups where individuals are considered low risk or do we continue to mass vaccinate without considering potential side effects? Is this really for the greater good of society or are we putting healthy individuals at risk for life long complications?