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Heart Problems As a Contraindication to Getting Vaccinated

Why do some folks think that heart problems are a contraindication to getting vaccinated?

Maybe because there are a few contraindications to getting vaccinated if you have a few specific heart problems.

Heart Problems As a Contraindication to Getting Vaccinated

What kind of heart problems?

In general, it isn’t necessarily any specific heart problem, but rather the treatments that those heart problems might require that could trigger the contraindication.

For example, many of us are familiar with the following contraindications:

  • concomitant use of aspirin or aspirin-containing medication in children and adolescents
  • known severe immunodeficiency

How do those contraindications relate to heart problems?

“Transplant patients should not receive live virus vaccines. The live virus vaccine may cause an infection in patients with weakened immune systems.”

Vaccinations Before and After Heart Transplant

After you have had a heart transplant, you will need to take medications that suppress your immune system so that you don’t reject your new heart. And you won’t be able to get any live vaccines.

What about aspirin?

There are some heart conditions for which children and adults need to take a daily aspirin, including Kawasaki disease, following the Fontan procedure, after transcatheter closure of atrial septal defect, and patients with prosthetic heart valves, etc.

For children taking daily aspirin therapy, Flumist, the nasal spray flu vaccine is contraindicated, while there is a precaution to getting the chicken pox vaccine.

Other heart problems, like premature ventricular contractions (PVCs), premature atrial contractions (PACs), atrial fibrillation (AF), bradycardia, supraventricular tachycardia (SVT), and ventricular fibrillation, etc., are not typically associated with vaccines, although almost anything from caffeine and stress to viral infections and fever can sometimes trigger an arrhythmia in those people who already have an arrhythmia. To be clear though, these triggers don’t typically cause the arrhythmia in the first place.

That relationship is well highlighted in a case report, Paroxysmal supraventricular tachycardia precipitated by pertussis vaccine, about a child with paroxysmal supraventricular tachycardia (PST).

What if the first episode of PST (paroxysmal supraventricular tachycardia) had been after the first dose of DTP vaccine?
What if the first episode of PST (paroxysmal supraventricular tachycardia) had been after the first dose of DTP vaccine?

This child’s first episode of PST occurred when he was five weeks old, before he got his first vaccines. And no, he had not had a birth dose of hepatitis B vaccine. This was well before the hepatitis B vaccine had been added to the immunization schedule.

He was well until 5 weeks of age, when he was hospitalized for PST, with a heart rate of 270 bpm, noted during a febrile illness characterized by rhinorrhea, cough, and vomiting.

Paroxysmal supraventricular tachycardia precipitated by pertussis vaccine

He had three more episodes after getting a DPT vaccine and another episode after developing a viral infection and fever. He was also vaccinated several times without developing PST.

In another case report of an infant developing paroxysmal SVT after their DPT vaccine, the infant was found to have coarctation of aorta, which would probably put them at extra risk for an arrhythmia.

There have been rare reports of cardiac complications, including arrhythmias, after adults get the smallpox vaccine.

“Reports of cardiac complications – including myocarditis, pericarditis, and arrhythmias – following smallpox vaccination, have dated back to the 1950s in the United States, although a total of only six such cases were reported prior to 2003.”

Myocarditis and pericarditis are rare following live viral vaccinations in adults

But not after other vaccines.

“We found that the rate of myocarditis and pericarditis in the 42 days following VZV, YFV, OPV, or MMR vaccination was very low and was not statistically different than the rate of these events during unexposed, control intervals. These findings confirm that cardiovascular complications related to commonly-administered, live viral vaccination are rare in adults.”

Myocarditis and pericarditis are rare following live viral vaccinations in adults

Including other live vaccines.

Vaccine Preventable Diseases Cause Heart Problems

What is associated with heart problems?

Diphtheritic myocarditis is a thing.
Diphtheritic myocarditis is a thing.

Many vaccine preventable diseases!

“The incidence of diphtheria has decreased since the introduction of an effective vaccine. However, in countries with low vaccination rates it has now become a re-emerging disease. Complications from diphtheria commonly include upper airway obstruction and cardiac complications. We present a 9-year-old boy who was diagnosed with diphtheria. He presented with fever, tonsilar plaques, respiratory failure and an incomplete vaccination history. He was endotracheal intubated and received diphtheria antitoxin and penicillin on the first day of hospitalisation. He developed progressive arrhythmias and fulminant myocarditis despite early identification and treatment with equine antitoxin and antibiotics. After a temporary transvenous pacemaker insertion due to third-degree atrioventricular block and hypotension for 1 week, he developed myocardial perforation from the pacemaker tip resulting in pericardial effusion. The treatment included emergency pericardiocentesis and pacemaker removal. His electrocardiogram showed a junctional rhythm with occasional premature ventricular complexes. He then developed ventricular tachycardia and cardiac arrest and finally died.”

A 9-year-old boy with severe diphtherial infection and cardiac complications

In addition to diphtheria, many other vaccine preventable diseases can cause cardiac complications including measles, mumps, rubella, chicken pox, and flu, all of which can cause myocarditis.

So if you are worried about your heart, unless you have a true medical contraindication, get vaccinated and protected.

More on Vaccine Contraindications

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