There is not an increased risk of heart inflammation from Pfizer’s Covid vaccine in British adults and older teenagers, the world’s biggest study into the issue suggests.
According to analysis by Oxford and Edinburgh universities, myocarditis is occurring at an average of 3 per million jabs in patients aged 16-40.
This was in no way different from the average rate for that age group within the general population.
Early in the rollout, reports of myocarditis among young people in Britain and in teenagers from other countries complicated discussions about whether British children should get a shot. Data from Israel and US — where the dosage gap is only three weeks — suggested the condition was more common.
Experts think that Britain’s 12-week interval has helped to keep myocarditis rates low and reduced the risk.
The data was described by scientists as being reassuring to teenagers. The data does not specifically address teenagers, leaving questions unanswered about the incidence of teenage suicide.
After the Government resigned on the rollout of the vaccine, all over-12s can now get the Pfizer vaccine.
The Joint Committee for Vaccination and Immunisation — the independent group advising ministers on vaccine policy — is now locked in discussions on whether to recommend vaccines to children as young as five.
Chair of the panel Professor Lim Wei Shen hinted today that the decision would be taken before Christmas.
Many scientists are still unsure about the safety of vaccinating young children because they know how small the risk is.
The advisers at No10 were initially hesitant about approving them, as the benefits didn’t clearly outweigh any risks. It was unlikely that the virus would cause serious illness or death in children.
The University of Oxford and Edinburgh found no instances of ultrarare heart inflammation in the second doses of Pfizer (labelled BNT162b2 below) and AstraZeneca (labelled ChAdOx1) vaccines. This was across all age groups. Pfizer’s vaccine caused excess admissions for under-40s after the first and second doses. It also led to three extra admissions per one million.
The graph shows hospital admissions for cardiac arrhythmia, myocarditis and pericarditis between April 2019 and October 2021. Myocarditis admissions are down throughout 2021, but they have not been significantly higher since the introduction of the vaccine.
Published in Nature Medicine, the study examined data from 38 million people who had been vaccinated during December 1-August 24th. Only a little over eighteen million of these were younger than 30.
Researchers calculated ‘excess’ myocarditis cases — those which would not have occurred without jabs or Covid infection — for each vaccine type.
Zero cases were found in people aged 16 to 40 who had AstraZeneca — although very few in the age group were given the company’s vaccine.
People who received a second dose were at risk of three extra cases per million, whereas those who took the first one were only affected by two.
Moderna showed a higher rate of incidence with 8 per million doses and 15 per millions doses.
Covid itself caused 10 excess cases of myocarditis per million infections — higher than both doses of Pfizer’s and AstraZeneca’s vaccines, but lower than in second doses of Moderna’s vaccine.
The MHRA has approved Moderna’s vaccine for 12–17-year-olds. This is the official sign-off to any drug used in Britain.
The JCVI does not recommend this, and Pfizer is the only company that offers such a treatment.
Research had shown that men were more at risk. It did not reduce rates among younger adults.
Independent experts believe that there is a lower risk of developing myocarditis in young children than it is among adolescents.
Pfizer found that children aged 12 to 15 years old who have not been vaccinated are three times more likely to contract Covid than those who were fully vaccinated earlier in the week.
Are there any risks to children under five years old from vaccines or Covid?
Covid
After being infected by Covid, most children experience only mild symptoms.
Only one child in 300,000. is diagnosed with Covid, according to UK Government data.
The chance of you being admitted to ICU or hospitalized is also very low.
Children with severe underlying medical conditions are at greater risk.
The JCVI is yet to issue updated guidelines on vaccinating children under 11 years old.
Its latest advice regarding recommending first jabs over-12s indicated that one Pfizer dose prevents 131 hospitalizations per million 12-15 year-olds.
The second doses can only stop nine hospital admissions per million that are administered to this age group.
For children aged five to 11, who are more susceptible to the virus, these figures will likely be lower.
Vaccines
Myocarditis — an ultrarare form of heart inflammation — is the main side effect of the Pfizer vaccine that concerns experts.
The risk of developing cancer in teenagers is higher than in adults. This includes boys.
The JCVI has not released data on how many cases are expected in children aged five to 11 but studies show children in younger age groups are less at risk than teenagers.
The study found that myocarditis occurred in between 2.6 million and 17.7million children who received their first dose of vaccines at the age of 12 and 15.
The condition was detected in 20.9-42.2% of the children within the same age range, per one million seconds of the doses.
Co-author of this study Professor Aziz Sheikh from the University of Edinburgh stated: “Overall, the message is, these risks are substantially greater in those who develop SARSCoV-2.
‘The numbers are very small — but I think overall these data are reassuring for young people as well.’
Professor Nicholas Mills from the university is a consultant cardiacologist. He said that he doesn’t see any evidence to change his recommendation regarding vaccinations for children.
The Omicron super mutant variant is thought to increase myocarditis danger. However, there are no data available.
Retired consultant for communicable diseases control, Dr Peter English said that: “The take-home message.” [is]Get vaccinated if you do not want to contract myocarditis and pericarditis.
“If you are not vaccinated with the ever-growing spread of SARS/CoV-2 viruses, you will soon get Covid. The risks of getting vaccinated far outweigh them all.
Current discussions between government advisers and the Government about expanding the roll-out of the program to all people over five by Christmas.
Other nations, such as the US or all EU member countries have also done this.
Professor Lim stated today to the Science and Technology committee that MPs are currently discussing the matter.
“We are also waiting for vaccine approval by MHRA.”
Greg Clark was the chairman of the committee. He asked, “So would you expect a decision to be made before Christmas on it?”
Professor Lim said: “I would expect that, we try to keep in line with the approval process.” He did not give a more specific time frame.
Some experts call for the Omicron strain to be rolled out to older patients to prevent the impending flood of hospitalisations.
SAGE adviser Professor John Edmunds, an epidemiologist at the London School of Hygiene and Tropical Medicine, called for jabs for five to 11-year-olds ‘as soon as possible’.
The number of cases has been the highest among under-18s in November. There were more than 32,000 per day in this age group last week. This compares to less than 1,000 in over-75s according to ZOE data released today.
Professor Edmunds spoke at the Royal Society of Medicine Event. He stated: “We have, had, a large number of patients over the past few months and unfortunately high amounts of hospitalizations and 100-150 deaths per day.
“I don’t claim that all of this has been caused by children. But, unfortunately, a lot of it has.
“So, from a population standpoint, it seems pretty obvious that we need to vaccinate all our children.
Uncover: What is the international response to Covid vaccinations in children’s health?
At the beginning of November, Pfizer vaccines were being offered in the United States to children aged five through eleven years old.
The US Centers for Disease Control and Prevention (CDC) convened a group of experts to decide how broad the recommended shot for each age group.
The US Food and Drug Administration authorized the vaccination in the above age group on Nov 29.
The World Health Organisation has asked countries and corporations that manage the supply of vaccines around the globe to supply COVAX first, as there are still many people in need.
Below is a partial list of countries who have approved, or are contemplating, vaccinating their children.
EU COUNTRIES
- Pfizer and BioNTech’s Covid vaccinations were approved by the EU’s medicines regulator on November 25, 2015.
- Denmark stated in June it would give Covid shots to 12-15-year-olds to improve their immunity.
- France began vaccinating children aged 12 and above, provided that they are consented by their parents.
- Germany has agreed that vaccination will be available for all children between 12 and 17 years of age in August.
- Austria started to vaccinate children between 12 and 15 years old.
- Estonia may begin vaccinating teenage children by autumn according to public broadcaster ERR, reporting the Head of Estonia’s Covid Council.
- According to Xinhua, Hungary began vaccinating 16-18-year-olds mid-May.
- Italy approved, on May 31, the expansion of Pfizer’s vaccine for 12-year-olds to include 15-year olds. The government also supported the Moderna vaccine being used for children 12-17-years-old on July 28.
- News site Delfi reports that Lithuania’s prime Minister suggested the country might start vaccinations for children at 12 years old in June.
- According to the Health Minister, Spain started vaccinating between 12 and 17-year-olds two weeks before September academic year.
- Swedish PM states that children 12-15 years of age will receive Covid vaccine in the autumn.
- Greece said in July that it would offer vaccinations against Covid to children aged 12-15 years old with Moderna and BioNTech shot.
- Helsinki, Finland’s capital, announced in June that it would begin offering Covid vaccinations to children 12-15 years old who may be at high risk for severe coronavirus infections.
- The age limit for Covid vaccine was lowered to 12 years in Ireland on July 27th.
- Poland began offering Covid vaccinations for children aged 12-15 years.
EUROPE (NON EU).
- UK announced that it would open its COVID vaccination booking service for children aged 12-15 on October 19.
- Switzerland approved the vaccination of 12-15-year-olds using Pfizer’s shot. Moderna’s shot was approved by Moderna in August.
- Norway began offering one dose of BioNTech Covid and Pfizer vaccines to 12-15-year-olds in September.
MIDDLE EAST
- Israel offered a Covid booster for children starting at 12 in August.
- According to the United Arab Emirates, China’s Sinopharm vaccination was introduced to all children between three and 17. UAE approved Pfizer BioNtech shot emergency use for children 5-11 years of age on November 1st.
- From October 27, Bahrain approved Sinopharm Covid vaccination for children three years old and older. Meanwhile, the Gulf state approved emergency Pfizer vaccines for children five to eleven years of age on November 2.
ASIA-PACIFIC
- On November 1, Indonesia approved the Sinovac vaccine by China for children 6 years and older.
- Malaysia, on October 29, stated that it would purchase the Pfizer/BioNTech vaccine to protect children between five and eleven years of age. This was in response to a recommendation from a US panel.
- Vietnam will start inoculating 16- and 17-year olds with parental consent starting next month.
- A committee of experts to Indian regulators recommended that Bharat Biotech’s Covid Shot be used in an emergency situation for the 2-18 age range. It is still awaiting the regulator’s approval.
- In June, New Zealand’s Medicines Regulator approved the use of Pfizer’s vaccine for 12-15-year-olds.
- Australia announced on September 12, that it would expand its COVID-19 vaccination program to cover around one million children between 12 and 15.
- China approved the emergency use of Sinovac’s vaccine to protect children aged 3-17 years old on June 5.
- Hong Kong declared on June 3 that its vaccine programme would be open to children aged 12 and over.
- Singapore has opened its vaccine program to teenagers aged 12-18 since June 1.
- Japan approved Pfizer’s vaccine to be used for children 12 years and older on May 28.
- On May 26, the Philippines approved Pfizer BioNTech’s emergency vaccine to be used in cases of sudden death for children 12-15 years old.
- Jordan started vaccinating 12-year-olds and over against Covid in July.
AMERICAS
- Mexico’s only use of the Covid vaccine from Pfizer BioNTech for children at high risk will be in Mexico.
- Brazil has approved Pfizer’s vaccine to protect children older than 12.
- The Covid vaccine, produced by China’s Sinovac Biotech Ltd was approved for use in Chile on September 6.
- US FDA granted approval for the Pfizer vaccine in children between 5 and 11 years of age. Rochelle Walensky, Director at CDC, must give her recommendation before the Pfizer vaccine is allowed to be rolled out.
- Canada approved the use of Pfizer’s vaccine in May for children 12-15 years old, but it is unlikely that Canada will approve its use for those children 5-11 years.
- Cuba’s vaccine campaign covers children as young at two years of age.
- El Salvador granted permission to use COVID-19 in 6- and 11-year old children on September 13th.
- In Argentina, children are vaccinated as early as age three by Sinopharm COVID-19.
- Children as young as 6 years old can be vaccinated in Ecuador with China’s Sinovac vaccine
- Columbia is offering Pfizer, AstraZenenca, Moderna, Sinopharm and J&J’s Covid vaccines for children 12 years and above.
- Costa Rica offers vaccinations for 12 years or more.
AFRICA
- South Africa will soon begin to immunize children at the age of 12 and 17.
Reporting from Reuters
