Why we should vaccinate healthy teens

Despite Pfizer’s FDA approval for COVID vaccines, many parents are still opting to hold off on having their teenagers vaccinated. Is this a good idea?

We have been hearing concerns about myocarditis, or heart inflammation, seen after administering the Pfizer and Moderna vaccines, which are mRNA. These vaccines do not contain the live virus that causes COVID-19 but rather give instructions to cells to make the COVID spike protein, which triggers an immune response in our bodies, protecting us from illness.

To date, in the United States, about 52 million doses of mRNA vaccines have been administered to people ages 12-29; 30 million were first and 22 million were second doses. From December 2020 through June 2021, of the overall 1,226 cases of myocarditis reported, 687 were among persons under age 30.

The highest reporting rates of myocarditis related to vaccination were noted among males ages 12−17 years, and then in males ages 18−24 years. In general, they experienced mild illness; and among all hospitalized patients with known clinical outcomes, 95% had been discharged at the time of the CDC review, and none had died.

The big picture: There is little to worry about.

Myocarditis reporting rates were 40.6 cases per million second doses of mRNA COVID-19 vaccines administered to males ages 12−29 years. This translates to about 5 cases per 100,000 doses administered to this age group compared with a background of unrelated myocarditis rate of 0.9 per 100,000 similar-age population.

The symptoms for myocarditis are often shortness of breath and chest pain. It is diagnosed with an electrocardiogram and via blood tests, and often treated with anti-inflammatory medications such as Aleve or Motrin and occasionally also immune globulin.

How many COVID-19 infections and severe disease illnesses could be prevented from giving vaccines to this age group, as compared with the risks?

Per million second doses of mRNA COVID-19 vaccine administered to males ages 12-29 years: 11,000 COVID-19 cases, 560 hospitalizations, 138 ICU admissions, and six deaths due to COVID-19 could be prevented, compared with possibly 39-47 treatable myocarditis cases, after COVID-19 vaccination.

Additionally, giving the vaccine to females of the same age group, with their much lower rates of vaccine-related myocarditis, prevented even more COVID infections and hospitalizations.

What about the argument that student athletes are in excellent health and would do just fine with a COVID infection?

In the Big Ten University study published in May, approximately 2 out of every 100 athletes diagnosed with COVID, regardless of how mild the disease was, had evidence of cardiac inflammation by MRI.

While very few were ill, seeing any cardiac inflammation stopped them from competing in athletic events. Similar to this data is information on hospitalized kids with COVID; more than 10% had cardiac inflammation, were symptomatic, and had long-term sequela.

What do all these numbers mean?

In the end, your teenager is 1,000 times more likely to have cardiac inflammation from their COVID infection, however mild, than from any vaccine used to prevent this infection.

With no natural protection from COVID, and at a time when 90% of all infections are being caused by the highly infectious delta strain, do we really want to put these young adults at risk from getting seriously sick from a preventable disease, which could result in short-term or possibly long-term illnesses?

This guest essay reflects the views of Dr. Sharon Nachman, chief of Pediatric Infectious Diseases at Stony Brook Children’s Hospital.