British Congenital Cardiac Association – Advice on COVID-19 Vaccinations

– Single ventricle patients or those palliated with a Fontan (Total Cavo-Pulmonary Connection) circulation

– Those with chronic cyanosis (oxygen saturations <85% persistently)

– Patients with cardiomyopathy requiring medication

– Patients with congenital heart disease on medication to improve heart function

– Patients with pulmonary hypertension (high blood pressure in the lungs) requiring medication

– Patients who have undergone heart transplantation

– Patients with congenital heart disease and significant co-existing conditions e.g. chronic kidney disease or chronic lung disease.

– Any patient who was previously classified as “clinically extremely vulnerable” and advised to shield

– Patients who have been advised to receive Covid 19 vaccination by their cardiologist because of their specific clinical situation.

The Chief Medical Officers of all nations of the United Kingdom have recommended that 12-15 year olds without associated health conditions should be offered vaccination against Covid – 19 with a single dose of vaccine (Pfizer vaccine). This is based on assessment of balance of medical and educational benefits of preventing severe Covid-19 infection versus rare potential side effects of vaccination.  12-15 year olds with congenital heart disease outside the risk groups outlined above should be offered a single dose of Covid-19 vaccination in the same way as those without associated risk factors.

BCCA
14 September 2021

Vaccination against Covid-19 infection will be offered to individuals between 12-15 years of age. This is because of the risks of complications of Covid-19 infection and other factors including the impact of Covid-19 infection on being able to attend schools, colleges and other educational settings.
The occurrence of inflammation of the heart muscle (myocarditis) or inflammation of the outer lining of the heart (pericarditis) has been reported rarely following vaccination with mRNA vaccines (Pfizer / Moderna).

Young adults, adolescents and children appear more affected than older adults, and males are more affected than females.   Myocarditis / pericarditis occurs most commonly occurs within 2-3 days of vaccination (>90% within 7 days), more commonly with the second dose of vaccination than the first.

Symptoms include:

Chest pain or discomfort

Fever

Shortness of breath or pain with breathing

Palpitations or syncope

If these symptoms occur then prompt medical attention should be sought.

Investigations which may be undertaken include

• Electrocardiogram
• Blood tests to check for inflammation of the heart muscle
• Echocardiogram (ultrasound scan of the heart) to check heart function
• Magnetic Resonance Imaging to examine inflammation of the heart muscle in detail

Treatment is directed at pain relief and reduction in inflammation of the heart muscle. In the vast majority of cases the symptoms resolve rapidly with standard treatment.

UK government advice on vaccine related myocarditis may be found at the following sites:
https://www.gov.uk/government/publications/covid-19-vaccination-myocarditis-and-pericarditis-information-for-healthcare-professionals/information-for-healthcare-professionals-on-myocarditis-and-pericarditis-following-covid-19-vaccination

https://www.gov.uk/drug-safety-update/covid-19-vaccines-updates-for-july-2021

British Heart Foundation
https://www.bhf.org.uk/informationsupport/heart-matters-magazine/news/coronavirus-and-your-health/coronavirus-vaccine-your-questions-answered#inflammation

BCCA
14 September 2021