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Studies find mild heart problems after smallpox vaccination

Infection Control Monitor, January 16, 2004

Three recent studies found that patients can suffer heart-related complications after receiving a smallpox vaccination, but symptoms are usually mild, the Medical Letter on the CDC & FDA reports.

The rate of adverse cardiac events was about 58 per 100,000 vaccinations in data collected between January and May 2003, said Richard Schieber, MD, of the Centers for Disease Control and Prevention at the American Heart Association's Scientific Sessions 2003 in Orlando, FL.

Schieber's study identified 24 cases of adverse cardiac events among 37,876 United States civilian health care workers vaccinated as part of the nation's bioterrorism readiness program. Twenty-two of those 24 had pericarditis or myocarditis.

The average interval from vaccination to illness was about 12 days. Most patients with myocarditis had a mild form of the disease, but two of eight patients with acute coronary syndromes died suddenly within three weeks after vaccination. Five of the eight had three or more risk factors for, or a history of, coronary artery disease before vaccination.

Another study looked at 18 cases of myocarditis or pericarditis among 230,000 military personnel, and a third examined one of those 18 cases. The case involved a 29-year-old soldier admitted to the hospital with shortness of breath two weeks after receiving his smallpox vaccination.

The relationship between the vaccine and acute coronary syndromes or heart attacks is still unclear.

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