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'Adolescents, younger men' should avoid strenuous activity for a week after 2nd Covid-19 vaccine dose as precaution: Expert committee

SINGAPORE — The expert committee for Covid-19 vaccination has advised “adolescents and younger men” to avoid strenuous physical activity for a week after their second dose as a precaution against a “small risk” of heart inflammation. They should also seek medical attention promptly if they develop chest pain, shortness of breath or abnormal heartbeats.

SINGAPORE — The expert committee for Covid-19 vaccination has advised “adolescents and younger men” to avoid strenuous physical activity for a week after their second dose as a precaution against a “small risk” of heart inflammation. They should also seek medical attention promptly if they develop chest pain, shortness of breath or abnormal heartbeats.

Despite this, the benefits of getting vaccinated still outweigh the risk, the committee under the Ministry of Health (MOH) stressed in a news release late Friday (June 11) night.

In Singapore, as of June 7, the Health Sciences Authority (HSA) has reported four men aged 18 to 30 having myocarditis or pericarditis after they received their second jab of the Pfizer-BioNTech and Moderna vaccines.

Another two cases involved one man and one woman who are both above 40 years old, HSA added in a separate news release late Friday night. 

These are inflammatory conditions affecting the heart muscles (myocarditis) and the outer lining of the heart (pericarditis). 

"Most of the cases were reported to have occurred within a few days after receiving the second dose of the vaccine," HSA said, adding that all the people affected have recovered or have been discharged well from hospital.  

More studies and investigations are ongoing on such cases, the expert committee said.

Its recommendation was made after an assessment of international reports showing that a higher-than-expected number of young men have experienced heart inflammation after their second dose of the vaccines that use messenger ribonucleic acid (mRNA) technology. 

This has been observed overseas in Israel and the United States in adolescents and young men under 25, the committee noted. 

“The risk of this has been estimated to be 1.6 cases per 100,000 doses for mRNA vaccines in the US, which is comparable to the risk of anaphylaxis (severe allergic reactions) observed in Singapore,” it said. 

HSA said that the two cases in Singapore of those above 40 years of age "is within the baseline incidence rate", while the four involving the men aged 18 to 30 "is at the upper end of the expected range for this age group, based on background incidence rates".

Both the Pfizer-BioNTech and Moderna vaccines approved for the national vaccination programme use mRNA technology. 

There is no observed incremental risk of the conditions after the first dose of the vaccines, the committee said.

It also said that most cases of myocarditis and pericarditis are mild. 

Patients recover without the need for significant intervention and do not suffer any long-term effects, it added, “although very rarely, severe cases may result in damage to the heart muscles”.

These occur more often in men compared to women and are separate and distinct conditions from heart attacks, which are caused when blood flow to the heart is blocked.

HSA said that globally, regulatory authorities, including those in Israel and the US, continue to recommend vaccination for those aged 16 to 30 years to protect them from Covid-19. 

The 14-member expert committee on Covid-19 vaccines is chaired by Associate Professor Benjamin Ong, who is the senior adviser to the director of medical services at MOH and the senior vice-president of health education and resources at the National University of Singapore.

The committee includes other experts in infectious diseases, immunology and other relevant fields. 

Related topics

Covid-19 coronavirus vaccine mRNA heart inflammation myocarditis HSA

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