Myocarditis is a rare autoimmune inflammatory disease, where the immune system attacks the heart muscle and damages it. This process can be genetic or it can be triggered by a viral infection, including by SARS-CoV-2. When the heart muscle is attacked by the immune system, the damaged cells release a protein called Troponin into the blood stream.

Doctors can detect evidence of heart damage, even when there are few clinical signs of heart trouble, by measuring a blood Troponin level. Normally, this protein is undetectable in healthy persons who are not having a heart attack or are not experiencing myocarditis.

Though it is normally rare, it appears that myocarditis is a complication associated with COVID-19 vaccination in some people, particularly younger men and boys.

Of course, SARS-CoV-2 itself causes myocarditis in naturally infected people at quite high rates — far higher than the vaccine.

The immunological reaction targeting the heart following COVID-19 vaccination is likely related to the SARS-CoV-2 Spike protein from the vaccine finding their way to the heart and inciting an immune response there. In much the same way that SARS-CoV-2 itself targets the heart using the spike protein.

Of course, the incidence of this vaccine complication is quite low compared to virus induced myocarditis— likely one in many hundreds of thousands, if not fewer. Still, because we are mass vaccinating the entire population, a non-negligible subset of the population is at risk of developing this complication, and have already. So, we must take every measure possible, and to the best of our abilities, to protect EVERY citizen from vaccine associated complications in order to maximize the benefit derived from vaccine immunity.

It is my professional opinion, as I have expressed it vocally since before the vaccine rollout, that we ought not be vaccinating the naturally immune from prior infections. At the most fundamental level because such persons do not stand to gain much, if any benefit, from this medical procedure — but also because I am nearly certain from an immunological perspective, that vaccinating the recently infected poses a risk of inflammatory tissue damage and systemic disease in a non-negligible fraction of such vaccinated persons. This is why I’ve proposed the #ScreenB4Vaccine algorithm to identify the naturally immune and infected and avoid rushing to vaccinate them.

It is highly likely, as a some powerful anecdotal cases and observational studies are showing already, that persons previously/recently infected with the virus are more susceptible to vaccine induced adverse reactions, and immunological damage, including myocarditis.

Additionally, it is a rational clinical prediction that those who develop myocarditis following the second COVID-19 vaccine shot likely have early evidence of heart damage in their blood following the first shot. And, as I mentioned above, Troponin is a very sensitive and specific test for heart damage.

So, it is reasonable to add a Troponin blood screen to the #ScreenB4Vaccine algorithm within 10–14 days after the first shot — and especially in the case of children or adults, who may be concerned about the possibility of myocarditis. If this test comes back POSITIVE, it is clear indication of myocardial injury and warrants skipping the second shot, or delaying it until the Troponin value is normalized.

The CDC and FDA “experts” have not yet come to reason or admitted the critical importance of #ScreenB4Vaccine to maximizing safety and trust in the COVID-19 shots. It is my sincere hope that the non-negligible emergence of myocarditis as a vaccine complication in younger persons, will allow the agencies to see how important it is to use #ScreenB4Vaccine, including Troponin levels, to protect Americans from COVID-19 vaccine harm.

Here, I write for the record, that the liberal use of Troponin blood tests between the 1st and 2nd COVID-19 shots in non-immune persons, and especially young men and boys, is likely to be a powerful methods for prevention of vaccine-induced Myocarditis.

In defense of US public health,

Hooman Noorchashm MD, PhD

noorchashm@gmail.com