The Atlanta Journal-Constitution
Why it’s good for heart patients to get vaccine
Experts say it can protect even those with severe disease.
More than 30 million people in the United States have heart disease, which alone kills hundreds of thousands each year. It’s also a significant risk factor for developing serious complications from another major threat right now — COVID-19.
That’s because the virus often attacks the lungs, forcing the already injured heart to fight that much harder.
Both the American Heart Association and the American College of Cardiology are urging eligible individuals — including heart patients — to get vaccinated. The American College of Cardiology has even issued a health policy statement to provide guidance on how to prioritize certain cardiac patients for vaccination.
So it makes sense that some heart patients might wonder how well the coronavirus vaccine will protect them. Will it shield them from severe illness, hospitalization or worse? Will it keep them from getting infected at all?
“It’s reasonable to say, ‘Hey, if everyone else is protected from severe disease, but we know that I’m subject to a more severe disease anyway, am I going to be protected?’” said Mitchell Elkind, president of the American Heart Association.
The short answer? Yes.
Q: Is the vaccine safe for people with heart disease?
A: Health experts say that although there have been no large studies looking particularly at the safety and effectiveness of the vaccine for patients with cardiovascular disease, the vaccine trials did include patients with heart conditions. Patients with HIV, hepatitis C and rheumatological diseases were also represented, said Antonio Abbate, a cardiologist at Virginia Commonwealth University’s Pauley Heart Center.
And the advantages of the vaccines were undeniable for almost everyone in the trials, health experts say.
In the real world, because older patients have been among the first to receive the vaccines and because heart conditions, including heart failure, are more prevalent in that population, the medical community has been able to observe them post-vaccination.
“As far as we can tell right now, there does not appear to be any increased side effects or safety issues of vaccinating people with heart failure or other cardiac conditions,” said Thomas Maddox, a professor of medicine at the Washington University School of Medicine in St. Louis and chairman of the American College of Cardiology’s Science and Quality Committee.
Regarding vaccine effectiveness, Maddox said that is somewhat more difficult to know, but added, “We also have not heard of higher than expected rates of COVID transmission among vaccinated patients with cardiac conditions.”
What is known is that patients with heart disease who are not vaccinated are at a much higher risk of developing more severe cases of COVID-19, as well as seeing a higher risk of hospitalization and death. “So the rationale is even more compelling to get vaccinated,” he said.
Q: Will the vaccine protect heart patients from serious illness?
A: According to the best current medical knowledge, yes.
Health experts say that based on currently available data, they can extrapolate that once patients with underlying cardiovascular disease — even congestive heart failure — are vaccinated, they will be much less likely to develop severe COVID-19 complications.
And since these patients are already at a much higher risk of poor outcomes, the experts agree it is even more important these patients get the shots, as well as continue taking precautions such as mask-wearing, hand-washing and social distancing to minimize their exposure.
That said, vaccinated heart patients who become infected with COVID-19 may nevertheless face risks because the virus tends to be harder on them.
“Those with underlying heart failure could still have a more severe case of COVID than those without heart failure, but the vaccine should protect everybody significantly,” said Elkind, who is a professor of neurology and epidemiology at Columbia University and a neurologist at New York-Presbyterian Hospital.
One potential caveat is for patients with immediate or severe allergic reactions to any components of the vaccines, according to federal health authorities. Such patients should consult their physicians about getting the shots.
Q: Are there any real-world data on the effectiveness of the vaccine for patients with heart disease?
A: Yes.
In a massive real-life test in Israel, researchers recently found the Pfizer-BioNTech vaccine to be 94% effective at preventing symptomatic COVID19 infections among nearly 600,000 people —about 7% of whom had heart disease.
The study, which was published last month in the New England Journal of Medicine, also found that among the people who did get an infection, the vaccine was 92% effective in preventing severe disease. The authors noted that protection was consistent across age groups, “with potentially slightly lower effectiveness in persons with multiple coexisting conditions.”
In addition to heart disease, the study tracked patients with one or more other conditions likely to increase the risk of severe COVID-19 complications. Among them were chronic obstructive pulmonary disease, asthma, cerebrovascular disease, hypertension, diabetes and obesity.
Based on the findings, Elkind said vaccination is much more likely than not to protect a patient with congestive heart failure or other cardiovascular conditions from a severe disease. Even patients who still got COVID-19 would be much more likely to have a mild case, he said.
In addition, research into coronavirus vaccinations and specific cardiovascular conditions is currently underway.
Maddox said the American College of Cardiology and the American Heart Association are working with hospital systems to gather data on patients with heart disease who have been brought in with COVID-19. He said the intent is to understand the relationship between COVID-19 treatment, recovery and long-term complications among patients with cardiovascular conditions.
The bottom line?
Yes, people who are older or have certain underlying diseases “are at greater risk of all kinds of problems, including adverse outcomes if they were to get COVID,” Elkind said. “But the benefits of getting vaccinated are still present for everyone.”
“Get your vaccine. It doesn’t matter which one,” he added. “It’s the best way to protect yourself, your family and to get us closer to the end of this pandemic so we can restore a sense of normalcy to our lives.”