https://www.telegraph.co.uk/health-fitness/body/critics-claim-covid-jabs-causing-heart-problems-do-have-proof/Critics claim Covid jabs are causing heart problems – do they have any proof?
While there have always been anti-vaxxers, this new concern is drawing in people from outside usual conspiracy theory
On Monday evening, the American football player
Damar Hamlin collapsed on the field after colliding with an opponent. He suffered a cardiac arrest and needed to be twice resuscitated. Within hours, social media was rife with speculation that the 24-year-old Buffalo Bills star was the victim of a Covid jab, his heart – it was speculated – having been dangerously weakened by the vaccination.The British cardiologist Aseem Malhotra tweeted about the incident. “One obvious question many are asking is whether he had the mRNA jab,” he wrote, going on to point out that myocarditis (heart inflammation) – a side-effect linked to the vaccine – increases “sudden cardiac death risk in contact sports”, where “blunt impact to the chest” is common.
Fortunately Hamlin’s condition is improving. At the time of writing, although the player was still in intensive care, doctors report he was awake and talking to his family and medical team at the University of Cincinnati Medical Center.Even before the Hamlin incident, the link between vaccines and heart problems is a theory that has gained momentum in recent months, with the Conservative MP Andrew Bridgen calling for a halt to the roll-out of mRNA vaccines like Pfizer and Moderna.“The mRNA vaccines are not safe, not effective and not necessary,” he told Parliament last month. “The Government's current policy on the mRNA vaccines is on the wrong side of medical ethics, is on the wrong side of scientific data, and ultimately it will be on the wrong side of history.”So what is driving this renewed wave of vaccine scepticism? Does the vaccine actually affect the heart? And even if it does, do the benefits still outweigh the risks?
A renewed fear
While there have always been anti-vaxxers, this new concern is drawing in people from outside usual conspiracy theory circles. In a recent article published in the Journal of Insulin Resistance, Dr Malhotra praised vaccines as “one of medicine’s greatest achievements”. He was one of the first doctors to receive two doses of Pfizer to protect his patients. He even appeared on TV’s Good Morning Britain encouraging vaccine uptake.
“Traditional vaccines are one of the safest medicines we’ve got,” he told The Telegraph. “They are the Holy Grail of medicine, and it was not even a possibility for me that they could do any harm.”
But the death of his father changed his mind. Dr Kailash Chand, former deputy chair of the British Medical Association (BMA), was a seemingly fit 73-year-old, when he suffered a fatal cardiac arrest last July.
A post-mortem revealed severe blockages in two of three major arteries. Even though Dr Chand had his booster vaccine six months earlier, his son believes it was a factor.
“I knew my dad’s medical history inside out,” said Dr Malhotra. “He was one of the fittest guys I knew, who kept up his 10,000 steps a day even in lockdown. Just a few weeks before we were walking up mountains together.
“We did some heart scans a few years earlier and all was clear, so when the post-mortem showed severe blockages I couldn’t understand it, even though it was my [area of] expertise.
“At the time people were trolling me, saying it was the vaccine, and I got really angry and blocked them, because that was not my mindset. But then I started to notice increased incidences in cardiac deaths and I started to wonder.”
A worrying increase in heart deaths
Dr Malhotra is right to say that
heart deaths have increased alarmingly in the last few years. According to the
British Heart Foundation there have been around 30,000 more deaths than expected involving heart disease since the pandemic began – more than 230 additional deaths over expected rates each week. In some weeks last year, there were more than 1,000 excess deaths with cardiovascular disease mentioned on the death certificate. But if we are looking for a reason for the rise, there are plenty to choose from without needing to point a finger at Covid vaccines.A Covid infection itself is known to raise the risk of a stroke and heart attack, so the virus was likely to be a significant factor in the increase, at least in the first year of the pandemic. Turmoil within the health service is also taking its toll. There has been widespread disruption to heart care services since ‘Protect the NHS’ mandates were enacted by the Government, meaning patients often did not get critical treatment in time. While suspected heart attack patients should be picked up by ambulance within 18 minutes, that figure has risen to 48 minutes, and there are 350,000 heart patients currently waiting for time-sensitive treatment – an increase of 50 per cent since the pandemic began. These systemic problems have been exacerbated by lockdowns and work from home edicts, which contributed to more sedentary lifestyles and a rise in alcohol intake at a time when Britain was already facing historic levels of obesity and heart disease. While Dr Malhotra acknowledges that other causes are a factor, he remains convinced that vaccines are also playing a role. He cites Pfizer’s own trial data, which showed there were four cardiac arrests in those who took the vaccine compared with just one in the placebo group. And he points to a controversial study published in the journal Circulation by the US cardiologist Dr Stephen Gundry, who claimed that inflammatory markers in his patients soared after they received vaccines – taking their five-year heart attack risk from 11 per cent to 25 percent. “That is a massive jump,” he said. “If I decided to smoke 40 cigarettes a day, ate junk food, drank and didn’t exercise I couldn’t get anywhere near that.”The Gundry study was heavily criticised, and has been significantly amended to make clear the biomarker increases were observational, there was no control group, no unvaccinated patients were included, and no statistical comparison was conducted.
A link to vaccines and heart problems
It is certainly true that
some people have experienced heart problems following the Moderna and Pfizer mRNA vaccines.The Medicines and Healthcare Products Regulatory Agency (MHRA) asks doctors to report side-effects via its ‘Yellow Card’ scheme, and since the roll-out there has been a steady trickle of heart complaints suspected to be linked to the jabs. Figures up to November 23 2022 show the MHRA has received 851 reports of myocarditis – inflammation of the heart muscle – linked to the Pfizer vaccination. There have also been a further 579 reports of pericarditis – inflammation of the lining outside the heart – linked to the jab.Most cases were mild, with individuals recovering in a short time, although there have been seven deaths. By comparison, there were 241 reports of myocarditis and 226 reports of pericarditis linked to Oxford’s AstraZeneca jab, and six deaths. For Moderna there were 251 reports of myocarditis and 149 of pericarditis, and two deaths. The problems are only now coming to light because Phase 3 clinical trials have too few people enrolled to pick up rare events, particularly if the heightened risk occurs in a small subgroup – such as young men.But although these figures may seem high, they must be set against the sheer volume of vaccinations that have been carried out since 2020. By last autumn, 53 million first doses had been administered in Britain, and more than 90 million boosters. Of these, Pfizer makes up 57 per cent of all jabs, AstraZeneca 29 per cent and Moderna 14 per cent. So although the risk is there, it is very small. Overall, the myocarditis reporting rate for Moderna is around 14 complaints for every million doses, for Pfizer it is 10 in a million and for AstraZeneca, five in a million. For pericarditis, the reporting rate is eight in a million doses for Moderna, six in a million for Pfizer and five in a million for AstraZeneca.Britain would usually expect around 60 new cases of myocarditis per million people each year, and 100 new cases of pericarditis, so it does seem that the vaccines have caused a rise in the normal background rate. However it is also important to remember that Covid also carries a risk of myocarditis – and one that is far higher than the vaccine, at 1,500 cases per million infections.This is why experts believe that the benefits of a jab far outweigh the risk. The British Heart Foundation told
The Telegraph: “The scientific consensus is that the benefits of Covid vaccination, including a reduced risk of severe illness or death, far outweigh the very small risk of rare side effects like myocarditis or pericarditis for the vast majority of people, especially as people get older. “This is why it’s particularly important if you’re over 50 that you have a booster when offered it to give you even greater protection.”
An increased risk in young men
For younger people – particularly young men – the risk does seem to be higher, which could explain why people are linking the vaccine to the collapse of athletes such as Hamlin.Rumours about the vaccine affecting sports stars first started circulating after
Denmark’s Christian Eriksen suffered on-field cardiac arrest during the Euro 2020 championship. A study published in the European Heart Journal
in 2021 also suggested that myocarditis can increase the risk of life-threatening heart arrhythmias caused by a blunt impact to the chest, particularly in contact sports. Inter Milan has since confirmed that Eriksen had not been vaccinated at the time of his collapse, and despite claims on social media, there does not appear to be a significant rise in players collapsing in recent years.However, it remains the case that younger men are more at risk following the vaccine. One large European study estimated that in the week following a second Pfizer jab there would be around 27 more cases of myocarditis per million in 12 to 29-year-old males than would be expected in an unvaccinated population. For Moderna there would be an extra 132 cases per million.Longer follow-ups find more cases. A second European study suggested that within 28 days of a second mRNA jab there would be an extra 57 cases of myocarditis than usual for males aged 16 to 24 with Pfizer, and 188 per million with Moderna. But the benefits appear to outweigh the risks. A major review by the US Centers for Disease Control and Prevention (CDC) found that although there would be up to 47 more cases of myocarditis in 12 to 29-year-old males per million vaccines, the jabs would prevent 11,000 Covid infections, 560 hospitalisations, 138 ICU admissions and six deaths. It is the reason that most experts do not believe the heart issues are cause for alarm. Dr Chenyu Sun, of Saint Joseph Hospital Chicago, who recently carried out a meta-analysis of myocarditis after vaccination involving 58 million people, said: “When myocarditis or pericarditis develop after a Covid vaccination, the symptoms are usually less severe and largely self-remitting compared with other cases. “As a clinician, I strongly recommend that people get a Covid vaccine unless there are absolute contraindications such as known allergies.”
A possible explanation
So what is it about mRNA vaccines that is driving this small increased risk?The new vaccines work by delivering a genetic blueprint which teaches the body to produce the spike protein that Covid uses to enter cells. This process usually lasts a few weeks before the mRNA breaks down and no longer conveys its message. Some experts believe that these spike proteins cause damage in a similar way to how the virus itself can trigger clotting abnormalities and damage to the cells that line blood vessels.There may also be an issue known as ‘molecular mimicry’ where the antibodies produced against Covid also react with important heart muscle proteins, causing inflammation.The mRNA vaccines may also cause the over-activation of cells known as cytokines, which act as flags, warning immune cells that it is time to ramp up and clear out an infection. Too many can cause a deadly condition known as a ‘cytokine storm’ in which the immune system runs wild.Experts believe mRNA jabs may be particularly prone to this because they contain a compound called polyethylene glycol – a non-pharmaceutical ingredient added which helps maintain the water content in the vaccine.The compound may stimulate a stronger immune response, and men may be more at risk from a reaction because testosterone boosts the effect. Testosterone levels tend to peak in adolescence and early adulthood, which could explain some of the age and sex disparity in reaction to the jab. Chinese researchers have also proven it is possible to induce myocarditis by injecting mice with mRNA vaccines. However a report in the Lancet medical journal suggested that rare heart problems may simply be a side-effect of all vaccines, and not specific to Covid vaccines or the spike protein. They suggest that the number of reports seems greater because of the large scale of the vaccination roll-out and the unprecedented scrutiny it has received.
What now?
Experts admit that they are still unsure whether there are long term heart risks associated with the vaccine. The British Heart Foundation is now looking into whether myocarditis – caused by either the vaccine or the virus – can cause scarring of the heart muscle, which might lead to future health problems. Certainly that is what some experts fear is happening and why they want the issue taken more seriously. Dr Malhotra believes the jab can rapidly speed up the development of heart disease, and now includes vaccine damage in his diagnoses of patients.“When you’ve got a pre-dose angiogram and a post-dose one that shows damage that usually takes years to trigger, you have to think of the most likely explanation,” said Dr Malhotra. In November, Heidelberg University carried out post-mortems on 25 people who had died unexpectedly within 20 days of a Covid vaccination and linked four deaths to myocarditis, although stopped short of saying the vaccine was to blame. Based on the report, Florida Surgeon General Dr Joseph Ladapo has launched a study with the University of Florida to look for signs of myocarditis in people who died within a few weeks of Covid vaccination.But the majority of experts are still unconvinced vaccines are having a significant impact in death figures. So far in Britain there have been 15 deaths from myocarditis or pericarditis, while it is estimated that vaccination in Britain saved 112,000 lives in the first year alone.“Following a careful assessment of the available data, we concluded that the evidence does not support an association between the Covid vaccines and an increased risk of cardiac-related death,” a spokesperson for the MHRA told the Telegraph.“As part of our robust safety surveillance processes we continue to evaluate emerging safety information and will take action to protect public health if new safety concerns arise.“Vaccines are the best way to protect people from Covid and have already saved tens of thousands of lives.”
Q&A
Does the Covid vaccine cause heart problems?
There have been rare cases of inflammation of the heart muscle (myocarditis) following the Moderna and Pfizer vaccines in the UK. Patients with this condition tend to report mild symptoms such as chest pain, shortness of breath and abnormal heart rhythms, which usually quickly resolve. In serious cases it can cause abnormal heart rhythms, or make it more difficult for the heart to pump blood. So far there have been 15 deaths linked to heart inflammation after the vaccine although most of these patients had serious underlying conditions. Covid itself is much more likely to cause myocarditis than the vaccine. It is estimated that vaccination in Britain saved 112,000 lives in the first year alone.
What is myocarditis and pericarditis?
Myocarditis means that your heart muscle is inflamed and usually happens after catching a virus. Pericarditis is inflammation of the lining around the heart.
What is the risk of getting myocarditis or pericarditis after the vaccine?
The risk alters with age, but is small for all age groups. Those aged 18-29 are most at risk, although there have been just 24 reports of suspected myocarditis or pericarditis for every million first doses of the Pfizer vaccine and 29 per million for a second dose, since the roll-out began. The risk falls with age, with just four reports from a first dose for the over-70s. For the Moderna jab, the highest risk was also in the 18-29 years age group with 61 reports. The risk of myocarditis from Covid-19 itself is around 1,500 in a million. Research suggests that heart inflammation – myocarditis or pericarditis – is no more likely to be triggered by a Covid vaccine than any other vaccine, including the flu jab.
Are children and young people at risk?
In the UK up to November 23, 2022, there were 83 cases of myocarditis or pericarditis reported in under-18s following the Pfizer vaccine, an average of 11 cases per million doses. Pfizer is the only vaccine recommended for children in Britain. There have been no reports of suspected myocarditis or pericarditis following booster doses in under-18s.
Is there a risk of cardiac arrest from the Covid vaccine?
No. There is no evidence that people are at risk of cardiac arrest in the days or weeks following the vaccine. A large study of four million vaccinated people in Denmark, published in the BMJ, also found there were no deaths or diagnoses of heart failure in people who were diagnosed with myocarditis or pericarditis after being vaccinated. In contrast, Covid can significantly increase your risk of cardiac arrest and stroke.
How would I know if I had myocarditis after the vaccine?
Symptoms generally appear within three to five days, and usually no more than a week, after having the vaccine. They include pain or tightness in the chest, which may spread across the body, pain in the neck that may spread across the shoulders and/or arms, shortness of breath when walking or doing gentle exercise, difficulty breathing when resting, or feeling light-headed, palpitations and feeling sick. Some people have reported feeling a faster heartbeat in the days after their Covid vaccine. This can be part of the body’s normal immune response to the vaccine and is not normally a cause for concern.
I've had myocarditis or pericarditis in the past – should I have a Covid vaccine?
Yes. There is currently no evidence that people with a history of myocarditis or pericarditis are at increased risk of a relapse following the Covid vaccine. However, you should always take advice from your GP or consultant.
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