COVID mRNA Vaccines May Worsen Myocardial risk for Clozapine Patients

Introduction
A similar final common pathophysiological pathway exists between clozapine hypersensitivity, COVID infection, and certain COVID vaccines (mRNA) against heart muscle. Minimizing clozapine-related heart damage with endemic COVID necessitates further research into developing potentially safer options for this underrepresented subgroup.
Methods Literature analysis used PubMed exclusively to determine myocarditis pathophysiology and its potential relationship to clozapine, COVID, and COVID mRNA vaccines.
Results Clozapine, COVID, and mRNA vaccines can independently lead to myocarditis—a potentially fatal sequelae. COVID’s spike protein can cause myocarditis through molecular mimicry and IgE pathways against alpha myosin within cardiac muscle. Also, myocardial injury can occur in rare cases among mRNA-vaccinated individuals.
Discussion: mRNA vaccines, while preventing COVID, appear to confer myocarditis risk in rare cases. Non-mRNA vaccinations – whether it’s developing new ones which do not cause myocarditis or determining whether existing alternative vaccinations are cardiac-safe -- should be used in the Clozapine patient-taking population. Good clinical practice should prioritize safe options. We suggest that development and determination of COVID vaccination safety should be prioritized in the Clozapine-taking population of patients, due to the likelihood of higher myocardial potential within it – whether it’s from COVID infection, mRNA COVID vaccination, or the Clozapine treatment itself.
Conclusion: It is critical to vaccinate Clozapine patients with a method that is known to be safer than what currently exists when it comes to vaccination options – most commonly mRNA COVID vaccinations, a certain myocarditis risk. Doing so would save thousands of psychiatric patients world-wide.