Israel reports link between Pfizer 2nd shot and heart problem in males under 30

Myocarditis side effect is extremely rare and in most cases mild; experts say finding unlikely to affect decision on vaccinating 12- to 15-year-olds

Illustrative: An Israeli health worker administers a dose of the Pfizer-BioNtech Covid-19 vaccine at Clalit Health Services, in a gymnasium in the central Israeli city of Hod Hasharon, on February 4, 2021. (JACK GUEZ / AFP)
Illustrative: An Israeli health worker administers a dose of the Pfizer-BioNtech Covid-19 vaccine at Clalit Health Services, in a gymnasium in the central Israeli city of Hod Hasharon, on February 4, 2021. (JACK GUEZ / AFP)

Israel’s Health Ministry reported Tuesday that there is a probable link between the second dose shot of the Pfizer-BioNtech vaccine and dozens of cases of myocarditis, an inflammation of the heart muscle, in males under 30.

According to the ministry, they found that from December 2020 until May 2021, there were 275 cases of myocarditis reported across the country, 148 of them in close proximity to when the patient received a vaccine dose.

Twenty-seven cases, including 11 people with preexisting conditions, were reported shortly after the first dose, out of 5,401,150 who received a shot. However, that increased to 121 cases, including 60 people with preexisting conditions, out of 5,049,424 within 30 days of the second shot.

The ministry said the vast majority of those affected were men under 30, particularly those between the ages of 16 and 19. Most cases were mild, with patients released from the hospital after four days, the report found, as is usual with myocarditis.

A vial of the Pfizer vaccine for COVID-19 in Seattle, January 24, 2021. (Ted S. Warren/AP)

One death was linked to myocarditis, but not conclusively proven, the report said.

The report found that the link between the vaccine and myocarditis dwindled as the age increased.

The findings are significant with Israel set to decide on expanding the vaccine drive to include people aged 12 to 15 in the coming days. Some health experts have suggested only giving younger people one shot to avoid the second dose side effects.

Experts said it was unlikely the findings would stop the expansion of the vaccine drive.

“I think they will decide to vaccinate teens, but not like with adults when there was a very clear recommendation in favor of vaccination,” Prof. Dror Mevorach, head of internal medicine at Jerusalem’s Hadassah Medical Center and an author of the report, told The Times of Israel ahead of its official release.

“Rather, they will say you should vaccinate your children but you should know there is the possibility of this side effect, leaving it to parents to decide. I predict that 50% of parents won’t vaccinate,” he said.

The US Centers for Disease Control and Prevention’s vaccine safety group is also investigating “relatively few” reports of the condition in vaccinated American young adults. The vaccines are believed to have come from Pfizer-BioNtech — the brand given to most Israelis — which is approved in the US for ages 12-plus, and Moderna, which is approved for those 18 and older.

Registered Nurse Jennifer Reyes inoculates Andres Clara, 12, with the first dose of the Pfizer COVID-19 vaccine at the Mount Sinai South Nassau Vaxmobile parked at the De La Salle School, Friday, May 14, 2021, in Freeport, N.Y. (AP Photo/Mary Altaffer)

“I can’t imagine it’s going to be anything that would cause medical people to say we shouldn’t vaccinate kids,” Douglas Diekema, a pediatrician and bioethicist at Seattle Children’s Hospital, told ScienceMag after the Israeli report was released.

Israel’s decision to vaccinate young people is less pressing, with the pandemic almost entirely absent in the country and almost all restrictions lifted.

Israel got the first taste of a post-pandemic reality Tuesday, as the last of a series of restrictions in place for over a year lapsed amid a continuing fall in case numbers.

The Green Pass and Purple Badge systems, which had set guidelines for who can enter public venues and how those venues can operate, expired starting June 1, meaning that Israelis no longer require proof of vaccination or recovery to enter various venues, and capacity limits at stores, restaurants and other sites are lifted. There are now no caps on gatherings, indoors or outdoors.

Most businesses and schools have already returned to normal and enforcement of many health requirements that remained on paper have largely fallen away.

The only major restrictions remaining are a mandate requiring masks to be worn indoors, which is expected to be lifted soon as well, and quarantine requirements for unvaccinated people entering the country.

Israelis enjoy the beach in Tel Aviv on May 22, 2021. (Miriam Alster/FLASH90)

The scrapping of restrictions takes effect as active case numbers have fallen to just 356, with only a handful of new daily cases. On Tuesday, only 15 new cases were recorded.

This comes after an intense coronavirus crisis, which saw 839,511 cases in a country of just over 9 million people, and 6,413 deaths. At the height of the pandemic, there were 88,000 active cases in the country, with thousands more added daily, and 1,228 serious cases.

The restriction rollback has largely been made possible by the country’s world-leading vaccination drive. Over 70 percent of those in Israel aged 20 or over have received two doses of the coronavirus vaccine, and the government is expected to approve vaccination of adolescents as young as 12 in the coming days.

However, 46 patients with the virus remain in serious condition, 32 of them on ventilators, according to Health Ministry data published Tuesday afternoon. That number is down from over 100 seriously ill patients at the start of May, and over 1,200 in January, at the height of Israel’s third wave of infections.

Nathan Jeffay contributed to this report

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