This is not an anti-vaxxer question
January 11, 2022 10:27 AM Subscribe
My partner (healthy fit early 30s cis male) had chest pains after his second Pfizer dose last year but did not seek medical attention (I know). Our boosters are coming up and he’s concerned about his risk of myocarditis.
We were vaccinated last summer and just recovered from mild cases of omicron. No health conditions. Our boosters will be available soon and we are worried about what the right decision is for my partner (I’m female, had no problems with the last shots and will get boosted regardless).
It really seems given the chest pains and the fact that he just had Covid, not getting the booster is the safest thing to do, but getting it is certainly the easiest — we need vaccine passports for most everything here and I’m certain they will be amended to require a booster at any time. It seems very difficult to get an exemption here.
Looking for any data, advice, reassurance on how to proceed.
We were vaccinated last summer and just recovered from mild cases of omicron. No health conditions. Our boosters will be available soon and we are worried about what the right decision is for my partner (I’m female, had no problems with the last shots and will get boosted regardless).
It really seems given the chest pains and the fact that he just had Covid, not getting the booster is the safest thing to do, but getting it is certainly the easiest — we need vaccine passports for most everything here and I’m certain they will be amended to require a booster at any time. It seems very difficult to get an exemption here.
Looking for any data, advice, reassurance on how to proceed.
Response by poster: Wintersweet — we don’t have family doctors as we live in a Canadian city where it is very difficult to get one. Seeing a doctor happens at a walk-in clinic. This is definitely an option for information but it’s not the “trusted relationship with a doctor who knows you” that you are probably thinking of.
posted by vanitas at 10:37 AM on January 11, 2022 [1 favorite]
posted by vanitas at 10:37 AM on January 11, 2022 [1 favorite]
Seconding a discussion with a doctor. For all you know, those chest pains may not have been myocarditis at all - they may have been weird gas pains that were just coincidentally at the same time.
posted by EmpressCallipygos at 10:38 AM on January 11, 2022 [5 favorites]
posted by EmpressCallipygos at 10:38 AM on January 11, 2022 [5 favorites]
Best answer: And a follow-up after a too-late review: a doctor could also advise you now, even if it's someone you haven't seen before, since they would likely know about the risk factors involved.
posted by EmpressCallipygos at 10:39 AM on January 11, 2022 [2 favorites]
posted by EmpressCallipygos at 10:39 AM on January 11, 2022 [2 favorites]
Nthing to talk to a doctor, any doctor about this. It seems like a really big leap for your bf to assume he was experiencing myocarditis and forgo the booster based on that assumption.
posted by cakelite at 10:47 AM on January 11, 2022 [14 favorites]
posted by cakelite at 10:47 AM on January 11, 2022 [14 favorites]
my partner experienced a tachycardiac episode following his booster. you can memail me if you want my opinion.
anyone who wants to know how this sort of thing is tracked via the medical establishment in the USA (spoiler: literally NOT AT ALL) is also welcome to memail me.
posted by fingersandtoes at 10:48 AM on January 11, 2022 [6 favorites]
anyone who wants to know how this sort of thing is tracked via the medical establishment in the USA (spoiler: literally NOT AT ALL) is also welcome to memail me.
posted by fingersandtoes at 10:48 AM on January 11, 2022 [6 favorites]
Chest pains could be caused by 101 different underlying reasons - doesn't mean that every time you get any chest pain you need to run to the doctor, because many of those 101 are quite benign.
But - if you have chest pain that is preventing you from achieving other desirable outcomes in your life, then seeing whatever kind of doctor is available is probably a good next step. Would be the same if his chest pain was e.g stopping him from exercising or sleeping well. If it's getting in your way, see a doctor.
posted by rd45 at 10:50 AM on January 11, 2022 [3 favorites]
But - if you have chest pain that is preventing you from achieving other desirable outcomes in your life, then seeing whatever kind of doctor is available is probably a good next step. Would be the same if his chest pain was e.g stopping him from exercising or sleeping well. If it's getting in your way, see a doctor.
posted by rd45 at 10:50 AM on January 11, 2022 [3 favorites]
Myocarditis Risk Higher with Covid-19 Infection Than Vaccination
Cases of heart inflammation reported post-COVID vaccination are usually mild and get better quickly, experts say.
If you’re vaccinated, an infection might not make you super sick, but don’t count on it making you super immune, either.
posted by oceano at 11:07 AM on January 11, 2022 [8 favorites]
Cases of heart inflammation reported post-COVID vaccination are usually mild and get better quickly, experts say.
If you’re vaccinated, an infection might not make you super sick, but don’t count on it making you super immune, either.
posted by oceano at 11:07 AM on January 11, 2022 [8 favorites]
Given the wide public and personal health concerns at this time, it’s in your best interest to seek professional opinion. Maybe even more than one! I’m curious when the chest pains came on. Do you have the option to get a booster in a clinic and with a doctor? If he said to the person administering the shot that he “had chest pains” before, they might decline to give the shot depending on the environment, have a special waiting area or person he could talk with about his issue, or have some specific advice. But don’t wait for that person, get out ahead of it. It’s irresponsible to diagnose a heart condition without medical oversight.
posted by amanda at 11:10 AM on January 11, 2022
posted by amanda at 11:10 AM on January 11, 2022
Why not just get J&J or AZ for the booster? That's what I'd probably do. My child had an allergic reaction to Pfizer and I will be opting for a different type of vaccine for a booster, if available at that time.
posted by haptic_avenger at 11:10 AM on January 11, 2022 [1 favorite]
posted by haptic_avenger at 11:10 AM on January 11, 2022 [1 favorite]
FWIW, Israel has boosted more people and done a good job of tracking adverse events. Their data on myocarditis after boosters is here (last page).
tl;dr for whatever reason, myocardis it is relatively much rarer after the third (and first) dose of Pfizer than the second dose.
IANAD and you should talk to one though, because your partner isn't a randomly selected Israeli. He's a specific person who has described symptoms that may change how he should think about a third dose.
posted by caek at 11:13 AM on January 11, 2022 [5 favorites]
tl;dr for whatever reason, myocardis it is relatively much rarer after the third (and first) dose of Pfizer than the second dose.
IANAD and you should talk to one though, because your partner isn't a randomly selected Israeli. He's a specific person who has described symptoms that may change how he should think about a third dose.
posted by caek at 11:13 AM on January 11, 2022 [5 favorites]
A very few people will get myocarditis after vaccination (also the risk is much higher after getting COVID). It generally self-resolves within 10 days. If he has chest pains that concern him after vaccination, he should go to the walk-in clinic.
There is no evidence at this point that getting COVID is preferable to getting vaccinated. Not getting boosted is NOT SAFER.
It is not particularly risky to experience post-viral myocarditis if you happen to be in the .0002% of people who get it post-vaccination. We don't actually know the rate of people have had it, undetected, after flu or other viruses, because it is so rarely clinically detectable, but it is something that happens. It is only a problem if it does not resolve. As a temporary condition, it's only really a threat if he is an athlete or planning to take on something physically strenuous in the 10 days after vaccination. He could just not do so.
This is an excuse, it is not a reason.
posted by Lyn Never at 11:13 AM on January 11, 2022 [15 favorites]
There is no evidence at this point that getting COVID is preferable to getting vaccinated. Not getting boosted is NOT SAFER.
It is not particularly risky to experience post-viral myocarditis if you happen to be in the .0002% of people who get it post-vaccination. We don't actually know the rate of people have had it, undetected, after flu or other viruses, because it is so rarely clinically detectable, but it is something that happens. It is only a problem if it does not resolve. As a temporary condition, it's only really a threat if he is an athlete or planning to take on something physically strenuous in the 10 days after vaccination. He could just not do so.
This is an excuse, it is not a reason.
posted by Lyn Never at 11:13 AM on January 11, 2022 [15 favorites]
tl;dr for whatever reason, myocardis it is relatively much rarer after the third (and first) dose than the second dose.
posted by caek at 11:13 AM on January 11 [+] [!]
I can't access that data - does it stratify for age and gender, and prior myocarditis? Best answer is for Mr. Vanitas to access a cardiologist somehow, by private pay if necessary.
posted by haptic_avenger at 11:15 AM on January 11, 2022
posted by caek at 11:13 AM on January 11 [+] [!]
I can't access that data - does it stratify for age and gender, and prior myocarditis? Best answer is for Mr. Vanitas to access a cardiologist somehow, by private pay if necessary.
posted by haptic_avenger at 11:15 AM on January 11, 2022
I'm here with reassurance (I guess?) while home recovering from the booster shot I got yesterday. So far, I've had a fever and tachycardia (+30 bpm over usual, spiking to 110 bpm from walking 20 steps) after:
- shot #2 in the Novavax trial in March
- getting Delta in September (this was by FAR the worst, lasted for days instead of hours)
- and now, getting a Pfizer booster
Tachycardia and myocarditis can go together, but there's no way to know about the latter just from symptoms. I wouldn't be completely surprised if I had some heart inflammation after my infection, but I haven't been worried enough to pursue it, because while the first few weeks of recovery were exhausting, a month later I felt basically back to normal even during and after exercise.
In your partner's case, you seem to be talking about a self-limited chest pain with no other symptoms, though you don't specify how long they lasted. Chest pains can be due to all kinds of non-heart related sources (gas, GERD, reflux exacerbated from lying in bed recovering from a COVID shot, probably some other things I'm not thinking of). Unless there's some symptomology you haven't told us about, I don't think that's enough of a concern to not get boosted, but I will say that I waited on my booster for a bit under the (reasonable, IMO, as a non-clinical biologist) assumption that my Delta infection was booster enough to cover me for a couple months, but that I should probably get boosted sooner than 6 months later.
Whatever you all decide, I suspect it's a very good sign that your partner had a mild Omicron case with no heart symptoms. Myocarditis is a pretty common thing after viral infections, much more so than with vaccination.
posted by deludingmyself at 11:16 AM on January 11, 2022 [4 favorites]
- shot #2 in the Novavax trial in March
- getting Delta in September (this was by FAR the worst, lasted for days instead of hours)
- and now, getting a Pfizer booster
Tachycardia and myocarditis can go together, but there's no way to know about the latter just from symptoms. I wouldn't be completely surprised if I had some heart inflammation after my infection, but I haven't been worried enough to pursue it, because while the first few weeks of recovery were exhausting, a month later I felt basically back to normal even during and after exercise.
In your partner's case, you seem to be talking about a self-limited chest pain with no other symptoms, though you don't specify how long they lasted. Chest pains can be due to all kinds of non-heart related sources (gas, GERD, reflux exacerbated from lying in bed recovering from a COVID shot, probably some other things I'm not thinking of). Unless there's some symptomology you haven't told us about, I don't think that's enough of a concern to not get boosted, but I will say that I waited on my booster for a bit under the (reasonable, IMO, as a non-clinical biologist) assumption that my Delta infection was booster enough to cover me for a couple months, but that I should probably get boosted sooner than 6 months later.
Whatever you all decide, I suspect it's a very good sign that your partner had a mild Omicron case with no heart symptoms. Myocarditis is a pretty common thing after viral infections, much more so than with vaccination.
posted by deludingmyself at 11:16 AM on January 11, 2022 [4 favorites]
There is no evidence at this point that getting COVID is preferable to getting vaccinated. Not getting boosted is NOT SAFER.
You can't say that for individual cases.
posted by haptic_avenger at 11:16 AM on January 11, 2022 [7 favorites]
You can't say that for individual cases.
posted by haptic_avenger at 11:16 AM on January 11, 2022 [7 favorites]
I can't access that data - does it stratify for age and gender, and prior myocarditis?
Yes, yes and no. It's on the last page of the linked PDF.
posted by caek at 11:16 AM on January 11, 2022 [1 favorite]
Yes, yes and no. It's on the last page of the linked PDF.
posted by caek at 11:16 AM on January 11, 2022 [1 favorite]
It's not at all clear that being not getting a booster is safest for your partner.
In Canada the recommendation in the context of myocarditis and pericarditis is that if you are under 30 then choose Pfizer ahead of Moderna. If you are 30 or over it doesn't make enough difference to matter. In either case, wait 6 months after your second dose to get the booster. There's no evidence about repeated myocarditis episodes after repeat vaccination (that is, there's no data on whether myocarditis as as side effect happens to the same people more than once).
For nearly everyone getting the booster is still safer than not getting it, with the main (but not only) exception being previous anaphylactic shock or other allergic reaction to the vaccine or one of its components. In general, for every potential direct side effect of the vaccine the same but worse or more likely can happen as a complication of Covid. In addition, his recent Covid infection does not seem to mean that your partner has increased protection from getting Covid in the future in the way that we would want to be true.
That's why people are suggesting that approaching a doctor is the thing to do. A doctor can review what happened to him and suggest a sensible course of action.
posted by plonkee at 11:21 AM on January 11, 2022 [2 favorites]
In Canada the recommendation in the context of myocarditis and pericarditis is that if you are under 30 then choose Pfizer ahead of Moderna. If you are 30 or over it doesn't make enough difference to matter. In either case, wait 6 months after your second dose to get the booster. There's no evidence about repeated myocarditis episodes after repeat vaccination (that is, there's no data on whether myocarditis as as side effect happens to the same people more than once).
For nearly everyone getting the booster is still safer than not getting it, with the main (but not only) exception being previous anaphylactic shock or other allergic reaction to the vaccine or one of its components. In general, for every potential direct side effect of the vaccine the same but worse or more likely can happen as a complication of Covid. In addition, his recent Covid infection does not seem to mean that your partner has increased protection from getting Covid in the future in the way that we would want to be true.
That's why people are suggesting that approaching a doctor is the thing to do. A doctor can review what happened to him and suggest a sensible course of action.
posted by plonkee at 11:21 AM on January 11, 2022 [2 favorites]
Your province likely has a telehealth service - you could call them and ask what they recommend, which might be easier than getting into a walk-in clinic these days.
posted by phlox at 11:39 AM on January 11, 2022 [4 favorites]
posted by phlox at 11:39 AM on January 11, 2022 [4 favorites]
Note that in Ontario, Pfizer is currently being reserved for people under 30 only. Which means if your partner were here, they would have to get the Moderna. I have no idea if BC has a similar policy. If they don't, you might consider that getting a booster sooner (Before they limit the pfizer) rather than later (when he might only be able to access Moderna) is one thing worse considering. (This is not an argument for or against getting the booster, just another thing to consider).
posted by If only I had a penguin... at 11:52 AM on January 11, 2022
posted by If only I had a penguin... at 11:52 AM on January 11, 2022
It is not particularly risky to experience post-viral myocarditis if you happen to be in the .0002% of people who get it post-vaccination.
My 15-year-old son was in the unlucky .0002% who had diagnosed myocarditis after his second shot. He was in the pediatric ICU at our local hospital for 2 days, and when his bloodwork (some kind of proteins?) numbers went the wrong way he was transferred by ambulance to the children's hospital cardiac ICU for 2 days after that. It was all for observation - his heart was pumping fine even though the tissue was inflamed - and ultimately he was okay. He is a competitive swimmer and after sitting out for one sports season (5 months) he was released to participate in sports and so far he has had no follow-up issues.
They did a cardiac MRI back in June - his follow-up MRI is tomorrow, in fact - and showed us very clearly on the pictures where the inflammation/damage was. We'll find out in the next few days whether that's still there or whether things are back to normal. The pediatric cardiologist recommended that he forego the booster and it has us (my wife, especially) freaked out that he's not able to get that additional protection. I printed caek's PDF and will bring it along to discuss a balance of risk with the doctors.
I guess my point with all of this is that yes you should talk to your doctor, and yes it could be lots of things other than myocarditis, and yes even if it is/was myocarditis that may not be a big risk, and yes even if it is a big risk it may still be worth it to get the booster. BUT even though it is small numbers the instances of healthy young men and adults getting heart inflammation following their shot are real and you are sensible to think critically about it and honor your partner's experience as a real one.
posted by AgentRocket at 11:52 AM on January 11, 2022 [12 favorites]
My 15-year-old son was in the unlucky .0002% who had diagnosed myocarditis after his second shot. He was in the pediatric ICU at our local hospital for 2 days, and when his bloodwork (some kind of proteins?) numbers went the wrong way he was transferred by ambulance to the children's hospital cardiac ICU for 2 days after that. It was all for observation - his heart was pumping fine even though the tissue was inflamed - and ultimately he was okay. He is a competitive swimmer and after sitting out for one sports season (5 months) he was released to participate in sports and so far he has had no follow-up issues.
They did a cardiac MRI back in June - his follow-up MRI is tomorrow, in fact - and showed us very clearly on the pictures where the inflammation/damage was. We'll find out in the next few days whether that's still there or whether things are back to normal. The pediatric cardiologist recommended that he forego the booster and it has us (my wife, especially) freaked out that he's not able to get that additional protection. I printed caek's PDF and will bring it along to discuss a balance of risk with the doctors.
I guess my point with all of this is that yes you should talk to your doctor, and yes it could be lots of things other than myocarditis, and yes even if it is/was myocarditis that may not be a big risk, and yes even if it is a big risk it may still be worth it to get the booster. BUT even though it is small numbers the instances of healthy young men and adults getting heart inflammation following their shot are real and you are sensible to think critically about it and honor your partner's experience as a real one.
posted by AgentRocket at 11:52 AM on January 11, 2022 [12 favorites]
Yeah, statistics are great until you end up on the wrong side. But, shit happens.
That being said, get ALL THE SHOTS!!!
I'm Pfizer x3, and hope I can get a Moderna next time. Seemed that was more effective.
posted by Windopaene at 12:07 PM on January 11, 2022
That being said, get ALL THE SHOTS!!!
I'm Pfizer x3, and hope I can get a Moderna next time. Seemed that was more effective.
posted by Windopaene at 12:07 PM on January 11, 2022
In BC, you have that pre-vax consultation as well, which is about ~15 minutes where they ask you how it went the first two times, any concerns, etx. If you don't have the chance to talk to the nurse line / telehealth or a doctor, I say book the booster appointment anyway and then use that opportunity to ask your questions. Maybe they have a doctor on-call there to discuss it with, or they can refer you.
posted by tinydancer at 12:56 PM on January 11, 2022 [1 favorite]
posted by tinydancer at 12:56 PM on January 11, 2022 [1 favorite]
I give COVID vaccines. If I was your nurse I would escalate this question to my medical director and they would make a somewhat subjective recommendation.
If I was your partner I would likely pick a different vaccine for my booster, based on intuitive sense not on avaliable research.
posted by latkes at 1:46 PM on January 11, 2022 [1 favorite]
If I was your partner I would likely pick a different vaccine for my booster, based on intuitive sense not on avaliable research.
posted by latkes at 1:46 PM on January 11, 2022 [1 favorite]
Another data point - someone I am close to (30 yo M) had chest pains a few days after the second dose of the AZ vaccine - he previously had long covid so assumed it was a recurrence of that. 5 months later he ended up in hospital having finally had a chest scan - turns out he had a pulmonary embolism from the vaccine. I believe an embolism can occur with the Pfizer vaccine as well.
No doctor he has asked is comfortable signing him off for any version of the booster. If your partner hasn;t had any chest pain in the meantime then I imagine you can rule that out.
posted by Lucy_32 at 3:16 PM on January 11, 2022 [2 favorites]
No doctor he has asked is comfortable signing him off for any version of the booster. If your partner hasn;t had any chest pain in the meantime then I imagine you can rule that out.
posted by Lucy_32 at 3:16 PM on January 11, 2022 [2 favorites]
This thread is closed to new comments.
posted by wintersweet at 10:33 AM on January 11, 2022 [16 favorites]