Boston doctors can't say whether teenage boys should get a COVID-19 booster shot as data shows a greater risk of myocarditis among the demographic.
Experts say the risk is small for myocarditis, a rare inflammatory heart condition that has been found mostly in young men and is thought to be related to testosterone levels. U.S. regulators were hesitant to approve booster shots for younger people for that very reason, but the Centers for Disease Control and Prevention ultimately encouraged older teens to get it.
Three top Boston doctors called for more data on the risk of myocarditis from booster shots in teenage boys but emphasized that it is safe for other children during NBC10 Boston's weekly "COVID Q&A" series Tuesday.
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Should Teenage Boys Get Boosted?
More data is needed in order to answer that question completely, according to Dr. Shira Doron, hospital epidemiologist at Tufts Medical Center.
"I would like to see some really good data on the booster in a young, healthy, teenage male without comorbidities, because I don't... I'm not able to answer that question well for that for that category," she said.
"What is the risk of myocarditis from COVID-19 or hospitalization really due to COVID-19 in a double vaccinated 16 or 17 year old male? And are we really certain that the benefit of the booster outweighs the the risk of myocarditis in that very specific subgroup? That's what I'd like to see next."
The age demographic with a greater risk for myocarditis is specific to teenage boys, doctors said, pointing to data from the Vaccine Adverse Event Reporting System. But the increased risk does not extend to younger children, the experts emphasized.
"That immediately post-pubertal age, that 16-, 17-year-old age group is highest risk, even though the risk is low, and the risk will be lower in younger children," Doron said. "So that gives us sort of the maximum risk, and we can only expect that to go down."
Boston Medical Center's Dr. Sabrina Assoumou emphasized that according to the current data, the benefits of vaccination still outweigh the risk. However, she agreed with Doron on the need for further research on the risk-benefit analysis of a booster dose for teenage boys.
Even prominent vaccine experts disagree on this question, Doron noted.
"I've watched many, many, many hours of the Vaccines and Related Biological Products Advisory Committee -- the advisory committee for Immunization Practices at the CDC -- and there are a lot of unknowns there," she said. "And a lot of concerns and need for continued monitoring for that very specific demographic."
Dr. Daniel Kuritzkes, chief of infectious disease at Brigham and Women's Hospital, said that most cases are mild and pointed to an Israeli study that argued young men have a higher risk of myocarditis from COVID-19 infection than from an mRNA vaccine.
"The overwhelming number of these still rare cases were mild and people recovered," he said. "It's important to put these things in perspective. So it's not absolutely risk free, but a tiny risk and a risk that overall still weighs towards more benefit than risk."