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NEW DELHI: Even as India plans to include Pfizer and Moderna vaccines in its covid-19 immunisation bouquet, a World Health Organization (WHO) expert panel is reviewing cases of people developing myocarditis after receiving these doses in other countries.

Myocarditis is inflammation of the heart muscle and pericarditis refers to inflammation of the lining that surrounds the heart. While it can cause serious illness, it is frequently mild and responds well to conservative treatment.

The covid-19 subcommittee of the WHO Global Advisory Committee on Vaccine Safety (GACVS) is reviewing reports of a small number of cases of myocarditis reported in individuals vaccinated with the covid-19 mRNA vaccines. It was noted that in most of the reported cases the individuals have recovered. The subcommittee has solicited and is monitoring for additional information to assess for any relationship to covid-19 vaccination.

On May 17, the US Advisory Committee on Immunization Practices (ACIP), Covid-19 Vaccine Safety Technical (VaST) Work Group concluded that there are few reports of myocarditis to date and that these cases seem to occur predominantly in adolescents and young adults, more often in males than females, especially after the second dose, and typically within 4 days after vaccination. However, most cases appeared to be mild.

The GACVS subcommittee noted that most of the information received so far is based on “spontaneous, passive reporting". "More rigorous studies using alternative data sources, and more robust study designs including a comparison of vaccinated and unvaccinated populations are needed to assess a potential causal association between the event and the vaccine," said WHO in a statement.

Some countries, such as Israel, the UK, and the US have embarked upon such studies. The subcommittee also underscored the importance of having a harmonized case definition. A draft case definition for myocarditis has been developed recently by the Brighton Collaboration.

While acknowledging the clear benefits of mRNA vaccines in reducing deaths and hospitalisation due to covid-19 infections, the subcommittee said that health professionals should report adverse effects or cases of myocarditis post-vaccination.

“Open, transparent, and evidence-based communication about the potential benefits and risks to recipients and the community is essential to maintain trust," the statement said.

With India already having low reportage of adverse events following immunisation (AEFI), public health experts claim that the country will require to keep a strict review on such cases. Experts believe that there is going to be a problem for the country to manage such cases which require follow up and further treatment.

There is a shortage of manpower especially in rural areas, the anaphylactic shocks meaning allergic reactions or conditions arising after vaccination are difficult to handle. In the current scenario, we don’t know if follow-ups after vaccination are being done or not, the situation in the future for myocarditis will be unclear," said Dr Lalit Kant, a scientist and former head of epidemiology and communicable diseases at the Indian Council of Medical Research (ICMR).

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