From:
[email address]
Sent:
Tuesday, 7 September 2021 1:31 pm
To:
Sarah Hartnall (WDHB)
Subject:
RE: Myocarditis and other vaccine complications
BE CYBER SMART - This email is from an external sender - Please do not click links or open attachments from unknown sources - Forward suspicious emails to [email address]
Kia Ora Sarah
Many thanks for your email.
I will pass your email onto the pandemic response subcommittee.
Ngā mihi
Adrian
From: Sarah Hartnall (WDHB) <[email address]>
Sent: 07 September 2021 13:03
To: '[email address]' <[email address]>
Cc: Anthony Jordan (ADHB) <[email address]>; Matt Hannant (CMDHB) <[email address]>; Alexis Starkey (NRA) <[email address]>
Subject: FW: Myocarditis and other vaccine complications
Kia Ora Adrian,
The communication below was raised at our PHO leaders forum. I’m concerned that this messaging has not been formally endorsed or recommended by either IMAC/MoH (or more locally by the NRHCC) – we need messaging to be clear, consistent
and co-ordinated otherwise we risk confusing our primary care colleagues who we’re intending to help/inform.
Nga Mihi,
Sarah
Dr Sarah Hartnal I Clinical Lead, Primary Care, Northern Region Health Co-ordination Centre
Planning, Funding & Outcomes I Waitemata DHB
North Shore Hospital, Private Bag 93 503, Takapuna, Auckland 0740
m: s9(2)(a)
www.waitematadhb.govt.nz I www.safetyinpractice.co.nz
Please note, my usual working days for this role are Thursday and Friday.
From: sarah hartnal [mailto:sarah.hartnal @gmail.com]
Sent: Tuesday, 07 September 2021 11:08 a.m.
To: Sarah Hartnal (WDHB)
Subject: Fwd: Myocarditis and other vaccine complications
BE CYBER SMART - This email is from an external sender - Please do not click links or open attachments from unknown sources - Forward suspicious emails to [email address]
1
---------- Forwarded message ---------
From: RNZCUC Pandemic Response Subcommittee <[email address]>
Date: Mon, 6 Sep 2021 at 9:28 AM
Subject: Myocarditis and other vaccine complications
To: Sarah Jane Hartnall <[email address]>
Dear member / clinic,
Advice from the Immunisation Advisory Centre is copied below, advising mycocarditis is a rare post-
vaccination complication, seen 11 times more commonly with Covid than after vaccination.
Members may find the following additional information useful, particularly when consulting vaccine-
hesitant patients.
Myocarditis
Per US data, NZ can expect one presentation with vaccine-related myocarditis per 100,000 vaccinated, ie
approx. 45 cases (likely there will also be subclinical cases), 80%+ male, generally younger, mainly after
the second dose.
Pericarditis – 1.8/100,000, or around 80 cases presenting in New Zealand; older population; same male
preponderance
Singapore government has advised:
“that al vaccinated persons, in particular adolescents and younger men, who have received any dose of the
mRNA COVID-19 vaccines, should avoid any exercise or strenuous physical activity for one week after
vaccination. During this time, the vaccinated persons should seek medical attention promptly if they
develop chest pain, shortness of breath or abnormal heartbeats. Al doctors should also be vigilant around
such clinical presentations after vaccination.”
We support informal advice from IMAC as follows:
“from a sensible pragmatic point of view and with limited evidence our advice would be to not vigorously
exercise after receipt of a vaccine if you are feeling any vaccine side effects”
Consulting vaccine hesitant patients concerned about adverse reactions:
United States studies find myocarditis is around 22 times more common with Covid19
(22/100,000) than after vaccination (1/100,000). This is in line with Israeli data cited below.
A recent BMJ study finds thrombotic events are again far more common with Covid than after
vaccination – summarised below:
2
To help protect you r priv acy, Microsoft Office prevented automatic download of this picture from the Internet.
graph
With best wishes,
David Gollogly, Jasmine Mackay, Richard Chen, Kelvin Ward
Pandemic Response Subcommittee
To help protect your privacy, Microsoft Office prevented automatic download of this picture from the Internet.
rnzcuc-mail-logo
IMAC email:
Today the Ministry of Health issued a press release regarding the death of a woman in the days
following vaccination with the Pfizer COVID-19 vaccine. The Ministry of Health states the
case has been referred to the Coroner and the cause of death has not yet been determined.
The COVID-19 Vaccine Independent Safety Monitoring Board (CV-ISMB) considered that the
myocarditis was probably due to vaccination. The CV-ISMB noted that there were other
medical issues occurring at the same time which may have influenced the outcome following
vaccination.
3
Key points for vaccinators and other health professionals
A risk of heart inflammation (myocarditis, pericarditis, or both) has been observed in people
who have received mRNA COVID-19 vaccines in overseas studies, particularly in males under
30 years of age after the second vaccine dose.
IMAC emphasises that the overwhelming benefits of vaccination in protecting against COVID-
19 greatly outweigh the rare risk of these conditions, and Comirnaty (Pfizer mRNA vaccine)
used in New Zealand continues to be recommended for al people ≥ 12 years of age who do not
have any contraindications to the vaccine.
Myocarditis symptoms such as chest pain, shortness of breath or feelings of having a fast-
beating fluttering, or pounding heart may appear within a few days of having the vaccine.
Anyone who experiences these symptoms after having the vaccine should seek medical
attention.
Myocarditis or pericarditis reports have been more common following the second dose and in
younger males.
The risk of myocarditis from COVID-19 infection is much greater than from COVID-19
vaccination: Recent data from Israel showed three cases of myocarditis per 100,000 following
Comirnaty vaccination versus 11 per 100,000 with COVID-19 infection.
Most myocarditis and pericarditis cases linked to mRNA vaccination have required
hospitalisation for assessment and monitoring but most cases have been mild and patients
have recovered quickly with standard treatment. Longer-term follow-up of these cases is
ongoing. However, sudden death may be a complication of myocarditis so careful assessment
and management of suspected cases is important.
All episodes of myocarditis and pericarditis following Comirnaty should be notified to
CARM.
More information about myocarditis and the COVID-19 vaccine in New Zealand is available
on our website.
For further advice or support please call 0800 immune or [email address].Ngā
mihi,The Immunisation Advisory Centre
Legal Disclaimer
4
From:
Kelvin Ward <[email address]>
Sent:
Tuesday, 7 September 2021 2:16 pm
To:
Sarah Hartnall (WDHB)
Cc:
[email address]; [email address]
Subject:
Re: Myocarditis and other vaccine complications
BE CYBER SMART - This email is from an external sender - Please do not click links or open attachments from unknown sources - Forward suspicious emails to [email address]
Dear Sarah,
Could you please advise which aspects of the email communication that you are concerned about being inaccurate or inconsistent?
Kind Regards
Kelvin Ward
From: Sarah Hartnall (WDHB) <[email address]>
Sent: 07 September 2021 13:03
To: '[email address]' <[email address]>
Cc: Anthony Jordan (ADHB) <[email address]>; Matt Hannant (CMDHB) <[email address]>; Alexis Starkey (NRA) <[email address]>
Subject: FW: Myocarditis and other vaccine complications
Kia Ora Adrian,
The communication below was raised at our PHO leaders forum. I’m concerned that this messaging has not been formally endorsed or recommended by either IMAC/MoH (or more locally by the NRHCC) – we need messaging to be
clear, consistent and co-ordinated otherwise we risk confusing our primary care colleagues who we’re intending to help/inform.
Nga Mihi,
Sarah
Dr Sarah Hartnal I Clinical Lead, Primary Care, Northern Region Health Co-ordination Centre
Planning, Funding & Outcomes I Waitemata DHB
North Shore Hospital, Private Bag 93 503, Takapuna, Auckland 0740
m: s9(2)(a)
www.waitematadhb.govt.nz I www.safetyinpractice.co.nz
<image001.jpg>
Please note, my usual working days for this role are Thursday and Friday.
From: sarah hartnal [mailto:sarah.hartnal @gmail.com]
Sent: Tuesday, 07 September 2021 11:08 a.m.
To: Sarah Hartnal (WDHB)
Subject: Fwd: Myocarditis and other vaccine complications
BE CYBER SMART - This email is from an external sender - Please do not click links or open attachments from unknown sources - Forward suspicious emails to [email address]
1
---------- Forwarded message ---------
From: RNZCUC Pandemic Response Subcommittee <[email address]>
Date: Mon, 6 Sep 2021 at 9:28 AM
Subject: Myocarditis and other vaccine complications
To: Sarah Jane Hartnall <[email address]>
Dear member / clinic,
Advice from the Immunisation Advisory Centre is copied below, advising mycocarditis is a rare post-
vaccination complication, seen 11 times more commonly with Covid than after vaccination.
Members may find the following additional information useful, particularly when consulting vaccine-
hesitant patients.
Myocarditis
Per US data, NZ can expect one presentation with vaccine-related myocarditis per 100,000 vaccinated, ie
approx. 45 cases (likely there will also be subclinical cases), 80%+ male, generally younger, mainly after
the second dose.
Pericarditis – 1.8/100,000, or around 80 cases presenting in New Zealand; older population; same male
preponderance
Singapore government has advised:
“that al vaccinated persons, in particular adolescents and younger men, who have received any dose of the
mRNA COVID-19 vaccines, should avoid any exercise or strenuous physical activity for one week after
vaccination. During this time, the vaccinated persons should seek medical attention promptly if they
develop chest pain, shortness of breath or abnormal heartbeats. Al doctors should also be vigilant around
such clinical presentations after vaccination.”
We support informal advice from IMAC as follows:
“from a sensible pragmatic point of view and with limited evidence our advice would be to not vigorously
exercise after receipt of a vaccine if you are feeling any vaccine side effects”
Consulting vaccine hesitant patients concerned about adverse reactions:
United States studies find myocarditis is around 22 times more common with Covid19
(22/100,000) than after vaccination (1/100,000). This is in line with Israeli data cited below.
A recent BMJ study finds thrombotic events are again far more common with Covid than after
vaccination – summarised below:
2
To help protect you r priv acy, Microsoft Office prevented automatic download of this picture from the Internet.
graph
With best wishes,
David Gollogly, Jasmine Mackay, Richard Chen, Kelvin Ward
Pandemic Response Subcommittee
To help protect your privacy, Microsoft Office prevented automatic download of this picture from the Internet.
rnzcuc-mail-logo
IMAC email:
Today the Ministry of Health issued a press release regarding the death of a woman in the days
following vaccination with the Pfizer COVID-19 vaccine. The Ministry of Health states the
case has been referred to the Coroner and the cause of death has not yet been determined.
The COVID-19 Vaccine Independent Safety Monitoring Board (CV-ISMB) considered that the
myocarditis was probably due to vaccination. The CV-ISMB noted that there were other
medical issues occurring at the same time which may have influenced the outcome following
vaccination.
3
Key points for vaccinators and other health professionals
A risk of heart inflammation (myocarditis, pericarditis, or both) has been observed in people
who have received mRNA COVID-19 vaccines in overseas studies, particularly in males under
30 years of age after the second vaccine dose.
IMAC emphasises that the overwhelming benefits of vaccination in protecting against COVID-
19 greatly outweigh the rare risk of these conditions, and Comirnaty (Pfizer mRNA vaccine)
used in New Zealand continues to be recommended for al people ≥ 12 years of age who do not
have any contraindications to the vaccine.
Myocarditis symptoms such as chest pain, shortness of breath or feelings of having a fast-
beating fluttering, or pounding heart may appear within a few days of having the vaccine.
Anyone who experiences these symptoms after having the vaccine should seek medical
attention.
Myocarditis or pericarditis reports have been more common following the second dose and in
younger males.
The risk of myocarditis from COVID-19 infection is much greater than from COVID-19
vaccination:Recent data from Israel showed three cases of myocarditis per 100,000 following
Comirnaty vaccination versus 11 per 100,000 with COVID-19 infection.
Most myocarditis and pericarditis cases linked to mRNA vaccination have required
hospitalisation for assessment and monitoring but most cases have been mild and patients
have recovered quickly with standard treatment. Longer-term follow-up of these cases is
ongoing. However, sudden death may be a complication of myocarditis so careful assessment
and management of suspected cases is important.
All episodes of myocarditis and pericarditis following Comirnaty should be notified to
CARM.
More information about myocarditis and the COVID-19 vaccine in New Zealand is available
on our website.
For further advice or support please call 0800 immune or [email address].Ngā
mihi,The Immunisation Advisory Centre
Legal Disclaimer
Dr Kelvin Ward
Chair, Executive Committee
Member, Board of Censors, PRS, FAC
Level 2, 110 Lunn Ave, Remuera, Auckland 1072, New Zealand
P. s9(2)(a)
https://smex12-5-en-ctp.trendmicro.com:443/wis/clicktime/v1/query?url=www.rnzcuc.org.nz&umid=455493de-d2c4-4b59-91a3-2c903c896fc7&auth=ae5df323da80597a92aaa0a8b5168c30a6db536c-0781192b313e85440fdf9593f20ca12c869e7440
4
From:
Stephenie Quinn <[email address]>
Sent:
Wednesday, 8 September 2021 12:30 pm
To:
Sarah Hartnall (WDHB)
Subject:
FW: Webinar - COVID, Vaccinations and the risk of myocarditis
Attachments:
THG GP Webinar Invitation 9.09.2021.pdf
BE CYBER SMART - This email is from an external sender - Please do not click links or open attachments from unknown sources - Forward suspicious emails to [email address]
Fyi
Ngā mihi,
Stephenie Quinn
General Manager
t: 09 488 3074 | f: 09 489 3186 | m: s9(2)(a)
e: [email address] | w: https://smex12-5-en-ctp.trendmicro.com:443/wis/clicktime/v1/query?url=www.shorecare.co.nz&umid=ccd8f0c4-a713-4aca-9d0f-
f4ed29744316&auth=1b63ca7083806b9e0b02672b5c8ce3362a73d480-172db908248e944cf1408137bc86c8d9bb19e559
a: Management Offices, Ground Floor AIA Building
74 Taharoto Road, Smales Farm
P.O. Box 31-188, Milford 0741
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you may not use, review, or copy it for any purpose or disclose its contents to any person. If you have received this message in error,
please immediately notify us by telephone call (09 488 7777) and delete this message. Thank you.
-------- Original message --------
From: [email address]
Date: 8/09/21 12:21 pm (GMT+12:00)
To: [email address]
Subject: Webinar - COVID, Vaccinations and the risk of myocarditis
*** Caution: External MAIL - Do not click links or attachments unless you recognize the sender and know the content is safe ***
Dear Medical Directors and Practice Managers
The Heart Group in Auckland is putting on a free webinar tomorrow, 9th September, at 1930, about myocarditis and the COVID vaccination.
They have advised me that this webinar is open to all clinicians around the country, and so I have attached their information, which includes the Zoom link.
As our vaccine programme continues apace, we are likely to see patients concerned about a diagnosis as well as actual cases of myocarditis presenting through urgent care. Could you please share details of this educational opportunity with your
clinicians as they might find it beneficial?
Ngā mihi,
Dr Guy Melrose
Director of Professional Development
Level 2, 110 Lunn Avenue, Remuera, Auckland 1072, New Zealand
P. 64 9 527 7966 https://smex12-5-en-
ctp.trendmicro.com:443/wis/clicktime/v1/query?url=www.rnzcuc.org.nz&umid=ccd8f0c4-
1
a713-4aca-9d0f-f4ed29744316&auth=1b63ca7083806b9e0b02672b5c8ce3362a73d480-
8502802a104a216d8d90e481edbb20edb8d733d3
Disclaimer
The information contained in this communication from the sender is confidential. It is intended solely for use by the recipient and others authorized to receive it. If you are not the recipient, you are hereby notified that any disclosure, copying, distribution or taking action in
relation of the contents of this information is strictly prohibited and may be unlawful.
This email has been scanned for viruses and malware, and may have been automatically archived by Mimecast, a leader in email security and cyber resilience. Mimecast integrates email defenses with brand protection, security awareness training, web security, compliance
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2
7th September 2021
ZOOM WEBINAR INVITATION
COVID, Vaccinations and the Risk of Myocarditis
Dear Doctor,
As New Zealand’s largest private cardiology practice, The Heart Group are very committed to
supporting you as a medical practitioner during the Covid-19 delta variant. Whilst we have
been running a very limited service for acute patients, we have been very proactive in providing
virtual appointments through Telehealth for our patients and also providing advice for you as
practitioners. The most commonly asked question we receive is around vaccine safety for
patients with heart disease and also the risk of Myocarditis from Covid vaccination. To assist
you to better understand these areas we would like to invite you to a Zoom Webinar to be held
at 7.30pm on Thursday this week 9th September 2021.
In addition, to a range of Heart Group Cardiologists speaking on the topics, we are delighted to
have with us Assoc Prof Helen Petousis-Harris who will give us an overview of the Covid
vaccination programme in New Zealand. The programme for this Webinar is detailed below.
• 7.30pm: Introduction
• 7.30pm: Assoc Prof Helen Petousis-Harris: COVID vaccination programme in NZ.
• 7.45pm: Prof Ralph Stewart, Cardiologist, Data Safety Monitoring Committee COVID
vaccinations: Vaccine safety in patients with heart disease.
• 7.55pm: Dr Ruvin Gabriel, Cardiologist. Myocarditis. What is it?
• 8.00pm: Dr Ross Nicholson, Paediatric Cardiologist. An 18-year-old with chest pain 3
days after his COVID vaccination. Has he got Myocarditis? Triaging the anxious
community.
• 8.10pm: Dr Wil Harrison, Cardiologist. Reaching out to underserved and vaccine
resistant populations.
• 8.20pm: Discussion and Questions
Dial in Details:
You are invited to a Zoom webinar.
When: Sep 9, 2021 07:30 PM Auckland, Wellington
Topic: Cardiology and Covid 19 Vaccinations
Please click the link below to join the webinar:
Out of scope
With kind regards
Dr Fiona Stewart
Dr Ruvin Gabriel
Cardiologist
Cardiologist
From:
Andy Dixon <[email address]>
Sent:
Wednesday, 15 September 2021 10:10 am
To:
Sarah Hartnall (WDHB)
Cc:
Stephenie Quinn; Sarah Peters
Subject:
RE: Myocarditis and other vaccine complications
BE CYBER SMART - This email is from an external sender - Please do not click links or open attachments from unknown sources - Forward suspicious emails to [email address]
Hi Sarah
Thanks so much for the confirmation.
Cheers
A
Ngā mihi,
Andy Dixon
Clinical Director
t: 09 486 7777 | f: 09 489 3186
e: [email address] | w: https://smex12-5-en-ctp.trendmicro.com:443/wis/clicktime/v1/query?url=www.shorecare.co.nz&umid=b83ae15d-3f6b-4c80-91f3-
915b5d1735c4&auth=7d2d0abb068e5711621b1d94b8fe61c48225f872-5089845c644801bee410ccd867a93c071c2f9b58
a: 74 Tahoroto Road, Takapuna
P.O. Box 31-188, Milford 0741
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The information contained in this E-mail message is CONFIDENTIAL and may also be PRIVILEGED. If you are not the intended recipient,
you may not use, review, or copy it for any purpose or disclose its contents to any person. If you have received this message in error,
please immediately notify us by telephone call (09 488 7777) and delete this message. Thank you.
From: Sarah Hartnall (WDHB) <[email address]>
Sent: Tuesday, 14 September 2021 3:37 PM
To: Andy Dixon <[email address]>
Cc: Stephenie Quinn <[email address]>; Sarah Peters <[email address]>
Subject: FW: Myocarditis and other vaccine complications
*** Caution: External MAIL - Do not click links or attachments unless you recognize the sender and know the content is safe ***
Kia Ora Andy – see email below from Emma Best (IMAC). Cardiologist advice is no formal communication on this at this stage FYI.
Nga Mihi,
Sarah
Dr Sarah Hartnal I Clinical Lead, Primary Care, Northern Region Health Co-ordination Centre
Planning, Funding & Outcomes I Waitemata DHB
North Shore Hospital, Private Bag 93 503, Takapuna, Auckland 0740
m: s9(2)(a)
www.waitematadhb.govt.nz I www.safetyinpractice.co.nz
1
Please note, my usual working days for this role are Thursday and Friday.
From: Emma Best (ADHB)
Sent: Tuesday, 14 September 2021 1:01 p.m.
To: Sarah Hartnal (WDHB)
Subject: RE: Myocarditis and other vaccine complications
It’s a very good question but there is no official word on strenuous activity – however Singapore have a very clear information sheet on this for all for 1 week post (gives advice on what is considered strenuous etc)
Our cardiology advice has not been to go with this as general advice yet but we are increasingly being asked by Drs also – it needs to come from MOH or CVTAG
IMAC updated some of our post vaccine advice to indicate if you have ‘adverse events/don’t feel’ well post vaccine then hydrate and avoid vigorous activity until feel better’ to be as non specific as possible
What is the RNZCUC ?
From: Sarah Hartnall (WDHB) <[email address]>
Sent: Tuesday, 14 September 2021 12:35 pm
To: Emma Best (ADHB) <[email address]>
Subject: FW: Myocarditis and other vaccine complications
Kia Ora Emma,
I have a quick question from a provider – is there any planned position statement or communication in regard to advising no strenuous activity fol owing covid vaccination (myocarditis risk)? RNZCUC sent out a communication which implied they
were recommending this and I’d asked them to refrain from sending out these types of messages to ensure our clinicians are receiving consistent messages from a source of truth FYI.
Thanks!
Nga Mihi,
Sarah
Dr Sarah Hartnal I Clinical Lead, Primary Care, Northern Region Health Co-ordination Centre
Planning, Funding & Outcomes I Waitemata DHB
North Shore Hospital, Private Bag 93 503, Takapuna, Auckland 0740
m: s9(2)(a)
www.waitematadhb.govt.nz I www.safetyinpractice.co.nz
Please note, my usual working days for this role are Thursday and Friday.
From: Andy Dixon [mailto:[email address]]
Sent: Tuesday, 14 September 2021 12:15 p.m.
To: Sarah Hartnal (WDHB); Stephenie Quinn
Cc: Sarah Peters
Subject: RE: Myocarditis and other vaccine complications
2
BE CYBER SMART - This email is from an external sender - Please do not click links or open attachments from unknown sources - Forward suspicious emails to [email address]
Hi Sarah
Just wanting to follow up regarding any official MOH position about refraining from strenuous physical activity for 1 week after COVID vaccinations?
Any word?
Take care
A
Ngā mihi,
Andy Dixon
Clinical Director
t: 09 486 7777 | f: 09 489 3186
e: [email address] | w: https://smex12-5-en-ctp.trendmicro.com:443/wis/clicktime/v1/query?url=www.shorecare.co.nz&umid=83a576ec-64ec-459e-8523-
2245c77b0369&auth=30e3f2e30e464276dede9a7f1c0d737f933697d5-a26d3fb7a88ba89a4cf1c2012916eddab8c9a3e0
a: 74 Tahoroto Road, Takapuna
P.O. Box 31-188, Milford 0741
Follow us on facebook|
The information contained in this E-mail message is CONFIDENTIAL and may also be PRIVILEGED. If you are not the intended recipient,
you may not use, review, or copy it for any purpose or disclose its contents to any person. If you have received this message in error,
please immediately notify us by telephone call (09 488 7777) and delete this message. Thank you.
From: Sarah Hartnall (WDHB) <[email address]>
Sent: Tuesday, 7 September 2021 1:57 PM
To: Andy Dixon <[email address]>; Stephenie Quinn <[email address]>
Cc: Sarah Peters <[email address]>
Subject: RE: Myocarditis and other vaccine complications
*** Caution: External MAIL - Do not click links or attachments unless you recognize the sender and know the content is safe ***
Yep, already have ;-)
Hope you guys are good! xx
Nga Mihi,
Sarah
Dr Sarah Hartnal I Clinical Lead, Primary Care, Northern Region Health Co-ordination Centre
Planning, Funding & Outcomes I Waitemata DHB
North Shore Hospital, Private Bag 93 503, Takapuna, Auckland 0740
m: s9(2)(a)
www.waitematadhb.govt.nz I www.safetyinpractice.co.nz
Please note, my usual working days for this role are Thursday and Friday.
3
From: Andy Dixon [mailto:[email address]]
Sent: Tuesday, 07 September 2021 1:28 p.m.
To: Sarah Hartnal (WDHB); Stephenie Quinn
Cc: Sarah Peters
Subject: RE: Myocarditis and other vaccine complications
BE CYBER SMART - This email is from an external sender - Please do not click links or open attachments from unknown sources - Forward suspicious emails to [email address]
Hi Sarah
Are you able to escalate this so that uniform advice is provided to the community?
Regards
Andy
Ngā mihi,
Andy Dixon
Clinical Director
t: 09 486 7777 | f: 09 489 3186
e: [email address] | w: https://smex12-5-en-ctp.trendmicro.com:443/wis/clicktime/v1/query?url=www.shorecare.co.nz&umid=9ccc39ef-14d1-423f-998d-
aa7714df97e2&auth=f5919179c8736197a129bb174c8f63e880123064-ba53265cbfbd38a779e28e25442cf1fbc15766ba
a: 74 Tahoroto Road, Takapuna
P.O. Box 31-188, Milford 0741
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The information contained in this E-mail message is CONFIDENTIAL and may also be PRIVILEGED. If you are not the intended recipient,
you may not use, review, or copy it for any purpose or disclose its contents to any person. If you have received this message in error,
please immediately notify us by telephone call (09 488 7777) and delete this message. Thank you.
From: Sarah Hartnall (WDHB) <[email address]>
Sent: Tuesday, 7 September 2021 12:52 PM
To: Stephenie Quinn <[email address]>
Cc: Andy Dixon <[email address]>; Sarah Peters <[email address]>
Subject: RE: Myocarditis and other vaccine complications
*** Caution: External MAIL - Do not click links or attachments unless you recognize the sender and know the content is safe ***
Thanks Steph I found it in my personal email!
I’m concerned that this (advice from another country and “informal” advice from IMAC) has gone out to the rnzcuc membership without consultation or formal endorsement from IMAC/MOH etc – important that the messaging is consistent so we
don’t cause confusion for our primary care colleagues.
Nga Mihi,
Sarah
Dr Sarah Hartnal I Clinical Lead, Primary Care, Northern Region Health Co-ordination Centre
Planning, Funding & Outcomes I Waitemata DHB
North Shore Hospital, Private Bag 93 503, Takapuna, Auckland 0740
m: s9(2)(a)
www.waitematadhb.govt.nz I www.safetyinpractice.co.nz
4
Please note, my usual working days for this role are Thursday and Friday.
From: Stephenie Quinn [mailto:[email address]]
Sent: Tuesday, 07 September 2021 11:15 a.m.
To: Sarah Hartnal (WDHB)
Cc: Andy Dixon; Sarah Peters
Subject: FW: Myocarditis and other vaccine complications
BE CYBER SMART - This email is from an external sender - Please do not click links or open attachments from unknown sources - Forward suspicious emails to [email address]
Hi Sarah
As discussed on zoom.
Steph
Ngā mihi,
Stephenie Quinn
General Manager
t: 09 488 3074 | f: 09 489 3186 | m: s9(2)(a)
e: [email address] | w: https://smex12-5-en-ctp.trendmicro.com:443/wis/clicktime/v1/query?url=www.shorecare.co.nz&umid=259c1adc-b724-4450-b9bf-
99b4605e5aaa&auth=a274b9305a0a6774f29265a98f8f893dbafe8641-012ef33fb603a56fd8dae0cfca551dbaa290d4fd
a: Management Offices, Ground Floor AIA Building
74 Taharoto Road, Smales Farm
P.O. Box 31-188, Milford 0741
Follow us on facebook|
The information contained in this E-mail message is CONFIDENTIAL and may also be PRIVILEGED. If you are not the intended recipient,
you may not use, review, or copy it for any purpose or disclose its contents to any person. If you have received this message in error,
please immediately notify us by telephone call (09 488 7777) and delete this message. Thank you.
From: [email address] <[email address]> On Behalf Of RNZCUC Pandemic Response Subcommittee
Sent: Monday, 6 September 2021 10:27 AM
To: Stephenie Quinn <[email address]>
Subject: Myocarditis and other vaccine complications
*** Caution: External MAIL - Do not click links or attachments unless you recognize the sender and know the content is safe ***
Dear member / clinic,
5
Advice from the Immunisation Advisory Centre is copied below, advising mycocarditis is a rare post-
vaccination complication, seen 11 times more commonly with Covid than after vaccination.
Members may find the following additional information useful, particularly when consulting vaccine-
hesitant patients.
Myocarditis
Per US data, NZ can expect one presentation with vaccine-related myocarditis per 100,000 vaccinated,
ie approx. 45 cases (likely there will also be subclinical cases), 80%+ male, generally younger, mainly
after the second dose.
Pericarditis – 1.8/100,000, or around 80 cases presenting in New Zealand; older population; same male
preponderance
Singapore government has advised:
“that all vaccinated persons, in particular adolescents and younger men, who have received any dose of
the mRNA COVID-19 vaccines, should avoid any exercise or strenuous physical activity for one
week after vaccination. During this time, the vaccinated persons should seek medical attention
promptly if they develop chest pain, shortness of breath or abnormal heartbeats. All doctors should also
be vigilant around such clinical presentations after vaccination.”
We support informal advice from IMAC as fol ows:
“from a sensible pragmatic point of view and with limited evidence our advice would be to not vigorously
exercise after receipt of a vaccine if you are feeling any vaccine side effects”
Consulting vaccine hesitant patients concerned about adverse reactions:
United States studies find myocarditis is around 22 times more common with Covid19
(22/100,000) than after vaccination (1/100,000). This is in line with Israeli data cited below.
A recent BMJ study finds thrombotic events are again far more common with Covid than after
vaccination – summarised below:
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graph
With best wishes,
David Gollogly, Jasmine Mackay, Richard Chen, Kelvin Ward
Pandemic Response Subcommittee
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rnzcuc-mail-logo
IMAC email:
Today the Ministry of Health issued a press release regarding the death of a woman in the days
following vaccination with the Pfizer COVID-19 vaccine. The Ministry of Health states the case has
been referred to the Coroner and the cause of death has not yet been determined.
The COVID-19 Vaccine Independent Safety Monitoring Board (CV-ISMB) considered that the
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myocarditis was probably due to vaccination. The CV-ISMB noted that there were other medical issues
occurring at the same time which may have influenced the outcome following vaccination.
Key points for vaccinators and other health professionals
A risk of heart inflammation (myocarditis, pericarditis, or both) has been observed in people
who have received mRNA COVID-19 vaccines in overseas studies, particularly in males under
30 years of age after the second vaccine dose.
IMAC emphasises that the overwhelming benefits of vaccination in protecting against
COVID-19 greatly outweigh the rare risk of these conditions, and Comirnaty (Pfizer mRNA
vaccine) used in New Zealand continues to be recommended for all people ≥ 12 years of age
who do not have any contraindications to the vaccine.
Myocarditis symptoms such as chest pain, shortness of breath or feelings of having a fast-
beating fluttering, or pounding heart may appear within a few days of having the vaccine.
Anyone who experiences these symptoms after having the vaccine should seek medical
attention.
Myocarditis or pericarditis reports have been more common following the second dose and
in younger males.
The risk of myocarditis from COVID-19 infection is much greater than from COVID-19
vaccination: Recent data from Israel showed three cases of myocarditis per 100,000 following
Comirnaty vaccination versus 11 per 100,000 with COVID-19 infection.
Most myocarditis and pericarditis cases linked to mRNA vaccination have required
hospitalisation for assessment and monitoring but most cases have been mild and patients
have recovered quickly with standard treatment. Longer-term follow-up of these cases is
ongoing. However, sudden death may be a complication of myocarditis so careful assessment
and management of suspected cases is important.
All episodes of myocarditis and pericarditis fol owing Comirnaty should be notified to CARM.
More information about myocarditis and the COVID-19 vaccine in New Zealand is available on our
website.
For further advice or support please call 0800 immune or [email address].Ngā mihi,The
Immunisation Advisory Centre
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Legal Disclaimer
Disclaimer
The information contained in this communication from the sender is confidential. It is intended solely for use by the recipient and others authorized to receive it. If you are not the recipient, you are hereby notified that any disclosure, copying, distribution or taking action in
relation of the contents of this information is strictly prohibited and may be unlawful.
This email has been scanned for viruses and malware, and may have been automatically archived by Mimecast, a leader in email security and cyber resilience. Mimecast integrates email defenses with brand protection, security awareness training, web security, compliance
and other essential capabilities. Mimecast helps protect large and small organizations from malicious activity, human error and technology failure; and to lead the movement toward building a more resilient world. To find out more, visit our website.
Legal Disclaimer
Disclaimer
The information contained in this communication from the sender is confidential. It is intended solely for use by the recipient and others authorized to receive it. If you are not the recipient, you are hereby notified that any disclosure, copying, distribution or taking action in
relation of the contents of this information is strictly prohibited and may be unlawful.
This email has been scanned for viruses and malware, and may have been automatically archived by Mimecast, a leader in email security and cyber resilience. Mimecast integrates email defenses with brand protection, security awareness training, web security, compliance
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