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The Delta Variant Outbreak in NZ (August 2021)
At the time of writing (September 2021) the Covid-19 delta outbreak in New Zealand is hopefully starting to settle down. Even so, this variant clearly spreads more easily than the previous variants, so our advice is to remain vigilant and careful and to abide by the restrictions for your region and to wear a mask whenever you need to leave your home.
Your cardiology team will be carefully assessing who needs to come into hospital for procedures and clinic appointments. This involves balancing the risk of coming into the hospital against the potential downsides of delaying your appointment. For many people, in-person clinic appointments can be safely deferred, but you may be offered a phone or video appointment instead: this allows your medical team to check that everything is OK with you and make sure that you don’t need to be seen in-person in the clinic at this stage. Call your local cardiology team if you want to discuss these options.
The Pfizer Covid-19 Vaccine
The Covid-19 vaccines provide very good protection against Covid-19 infection. Studies show that about 95% of people who have received both doses of the vaccine are protected against getting COVID-19 symptoms. This means that once you are fully vaccinated, you are far less likely to fall seriously ill and less likely to transmit the virus to others.
Being fully vaccinated gives you a high degree of protection against Delta infection, and an even higher degree of protection against severe illness, hospitalisation and death.
Evidence currently shows the effectiveness of 2 doses of the Pfizer vaccine against illness due to Delta infection is about 88%, and the protection against hospitalisation due to Delta infection about 96%.
In New Zealand, Medsafe will continue to monitor the safety and efficacy of the vaccine as it is used. It will assess ongoing data and reporting, such as large clinical trials across the world and reporting by healthcare professionals and people who have received the vaccine. Click here to go to the Medsafe website.
Most side effects are mild, and more major side effects are rare. The most common side effects include headache, dizziness, pain at the injection site, tiredness, nausea and fever.
Lots of people have been concerned about the potential for myocarditis after the Pfizer vaccine – look at the FAQs below to get more information. New reports about this are coming out frequently in the medical journals, so we will update this section whenever important new information becomes available.
The Starship Hospital Clinical Guidelines team has recently published guidelines on the use of COVID-19 vaccination in children, including information about side effects related to the Pfizer mRNA vaccine. The Adult Congenital Heart Disease (ACHD) team at Auckland Hospital gave the following advice:
“We agree with our paediatric cardiology colleagues regarding the recommendation that most people with pre-existing heart conditions should have the vaccine. Current information would suggest that patients with more complex congenital heart disease would be at higher risk of severe infection from the COVID virus. In addition adults who have multiple health problems (not just a heart problem) including people with diabetes, high blood pressure, very overweight, lung and kidney problems are at highest risk of severe infection from the COVID virus.
We acknowledge that the vaccine carries some rare risks associated with it including inflammation of the heart (myocarditis and pericarditis). The risk of heart inflammation with the vaccine is much lower than the risk of heart inflammation from the virus itself. We again support and reinforce that discussions are important prior to being vaccinated between patients and their doctor where there is an active heart inflammation diagnosis, to work out the best timing. It is important to be aware that heart inflammation is different from congenital heart disease, and diagnoses would include myocarditis, pericarditis, endocarditis or acute rheumatic fever. Also in situations where a patient has severe heart failure with recent hospital admission, a discussion around the best timing of vaccination is recommended.”
The Pfizer Covid-19 Vaccine and Myocarditis: FAQs
Myocarditis is inflammation of the heart muscle. It’s a condition that can be caused by viruses or the body’s immune response to a virus
Chest pain is the most common symptom, but some people may notice shortness of breath or cough, an abnormal heart beat (heart racing or fluttering), or constant tiredness or weakness
The Pfizer vaccine appears to cause myocarditis as a rare side effect in a small number of people.
In most cases it happens after the second dose of the vaccine.
It happens most commonly in the first 4 days after vaccination, but can occur up to 2 weeks after the vaccine
The chance of getting myocarditis after the Covid-19 vaccine is highest in young people, particularly young males
The most recent information from the USA and the UK suggests that for every million people receiving the Pfizer vaccine, about 8-13 people will get myocarditis or pericarditis.
The highest number is in young males, and in a recent American study the rate in males aged 12-17 years was 62 per million (this means about 1 case of myocarditis for every 16,000 people getting the vaccine in this age group).
In some cases it can be a serious condition, but overseas most people with myocarditis after the Covid-19 vaccine have had a mild illness which has settled down quickly
Yes. Covid-19 infection can cause myocarditis, and this is more common than myocarditis after the vaccine.
A recent report from the USA suggested that for one million males aged 12-17 with Covid-19 infection, about 450 people will get myocarditis.
This would mean that myocarditis is up to 7 times more likely to happen after Covid-19 infection than it is after vaccination.
At this stage the government is advising that the benefits of the vaccine outweigh the risks, so they are advising people to get the vaccine.
At the moment the rates of Covid-19 remain low in New Zealand, but the graphic below this section shows how the risks and benefits compare in the USA which has high rates of Covid-19.
As far as we know, people with CHD are not any more likely to get myocarditis after the vaccine
This YouTube video explains how the Pfizer vaccine works
This graphic is from an American cardiology journal, so it applies to the experience in America, but it gives an idea of the risks and benefits of vaccination with the Pfizer Covid-19 vaccine in a situation where community Covid-19 infection is widespread
