Patients with heart failure are often hesitant to be vaccinated against COVID-19 due to concerns about a rare side effect of mRNA vaccines. But they also are three times more likely to die from COVID-19 if they haven’t had the shots, researchers say.

Investigators analyzed electronic records for more than 7,000 patients in the Mount Sinai Health System in New York City with heart failure from January 2021 through January 2022. Fully 45% of these patients were not vaccinated against COVID-19. Nine percent were partially vaccinated with one dose of a vaccine.

Partially vaccinated and unvaccinated heart failure patients had dramatically worse COVID-19 outcomes than their vaccinated peers. When compared to fully vaccinated or boosted patients, these patients were:

  • 3 times more likely to die from COVID-19-related illness;
  • 15% more likely to be hospitalized; and
  • twice as likely to be admitted to an intensive care unit.

The researchers hope that other clinicians will use the results to encourage their heart failure patients to get vaccinated. Myocarditis is a rare side effect of the mRNA Pfizer-BioNTech and Moderna vaccines, but it is more commonly caused by a COVID-19 infection, they said.

Reluctant patients

“I launched this study because our heart failure patients often express fear of getting the COVID-19 vaccine after hearing reports of vaccine-related myocarditis, which would cause another cardiac setback for them,” said Anurhada Lala, M.D., of the Icahn School of Medicine at Mount Sinai, in a statement. 

“I have used these results to help educate reluctant patients and in many cases this has been effective in encouraging them and getting them to follow through with full vaccination,” Lala added.

Cardiovascular disease is the largest diagnostic category in skilled nursing facilities, and heart failure may affect more than 25% of residents, according to some estimates. 

Full findings were published in the Journal of Cardiac Failure.

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