Is It Safe for Teens with PVCs to Get the BNT Vaccine?

Can I receive the BNT vaccine while being monitored for premature ventricular contractions?

Hello, doctor.
My daughter is currently 14 years old and in the third year of junior high school.
She was diagnosed with premature ventricular contractions two years ago, but since it was not severe, the doctor advised continuous observation without the need for medication.
Recently, high school students have started receiving the BNT vaccine, but there are potential risks of myocarditis associated with it.
I would like to ask if there are any risks for my daughter in receiving the BNT vaccine.
What should we pay attention to? If there are concerns about safety, is it acceptable to forgo the vaccination? Thank you.

Liang, 50~59 year old female. Ask Date: 2021/09/10

Dr. He Dongjin reply Cardiology

Hello, it is not serious and does not require medication, so it's fine.
The BNT vaccine does have a potential risk of myocarditis, but in fact, any vaccine carries some risk, approximately 1 in 100,000.
However, the rate of severe illness from infection is over 5%, which is a risk difference of 5,000 times.
Based on the concept of risk management, it is still advisable to get vaccinated as it poses a relatively lower risk.
What should you pay attention to? It is normal to experience some reactions or discomfort after vaccination; however, if shortness of breath persists for more than two weeks, please seek further evaluation from a cardiologist.
Changhua Hospital cares about your well-being.

Reply Date: 2021/09/10

More Info

When considering the safety of the BNT (Pfizer-BioNTech) vaccine for a 14-year-old with a history of premature ventricular contractions (PVCs), it is essential to weigh the benefits of vaccination against any potential risks associated with the underlying heart condition.

Premature ventricular contractions are common and often benign, especially in adolescents. They can occur in healthy individuals without any underlying heart disease. In most cases, PVCs do not require treatment unless they are frequent or associated with other symptoms such as dizziness, palpitations, or syncope. Since your daughter has been advised to continue monitoring her condition without medication, it suggests that her PVCs are not causing significant concern from a medical standpoint.

The BNT vaccine has been associated with a very small risk of myocarditis and pericarditis, particularly in younger males after the second dose. However, these occurrences are rare, and the benefits of vaccination—especially in the context of the ongoing COVID-19 pandemic—generally outweigh the risks for most adolescents. Vaccination can significantly reduce the risk of severe illness, hospitalization, and long-term complications associated with COVID-19.

For your daughter, it is crucial to consult with her healthcare provider, preferably a cardiologist familiar with her case. They can provide personalized advice based on her specific health status, the frequency and severity of her PVCs, and any other relevant factors. If her PVCs are infrequent and asymptomatic, the cardiologist may consider her at low risk for complications related to the vaccine.

Here are some general considerations and recommendations for teens with PVCs receiving the BNT vaccine:
1. Pre-Vaccination Assessment: Ensure that a thorough evaluation is conducted before vaccination. This includes discussing her history of PVCs and any symptoms she may have experienced.

2. Monitoring After Vaccination: After receiving the vaccine, it is advisable to monitor for any unusual symptoms, particularly those related to heart function, such as chest pain, palpitations, or shortness of breath. If any concerning symptoms arise, seek medical attention promptly.

3. Stay Informed: Keep abreast of any updates regarding vaccine safety, particularly concerning myocarditis and pericarditis. Health authorities continuously monitor vaccine safety and efficacy, and recommendations may evolve based on new data.

4. Consider the Risks of COVID-19: Weigh the risks of potential myocarditis from the vaccine against the risks of severe COVID-19, which can also lead to myocarditis and other serious complications. Vaccination is a critical tool in preventing COVID-19 and its associated risks.

5. Consultation with Specialists: If there are lingering concerns, consider seeking a second opinion from a pediatric cardiologist or a specialist in adolescent medicine who can provide further insights into the risks and benefits of vaccination in the context of her PVCs.

In conclusion, while there is a theoretical risk associated with the BNT vaccine for individuals with PVCs, the overall risk is low, and the benefits of vaccination are significant. Engaging in a detailed discussion with her healthcare provider will help you make an informed decision that prioritizes your daughter's health and well-being.

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