Covid-19 Vaccination-Associated Myocarditis in Adolescents (PDF; Aug 22) | Hacker News Reader

Covid-19 Vaccination-Associated Myocarditis in Adolescents (PDF; Aug 22)

pediatrics.aappublications.org

27 pointsloceng13 comments

"Results:

63 patients with a mean age of 15.6 years were included. 92% were male. All had received an mRNA vaccine and, except for one, presented following the 2nd dose. Four patients had significant dysrhythmia. 14% had mild left ventricular dysfunction on echocardiography which resolved on discharge. 88% met the diagnostic cardiac magnetic resonance (CMR) Lake Louise criteria for myocarditis. Myocardial injury was more prevalent in comparison to MIS-C patients. None of the patients required inotropic, mechanical, or circulatory support. There were no deaths. Follow up data obtained in 86% of patients, at a mean of 35 days showed resolution of symptoms, arrhythmias, and ventricular dysfunction.

Conclusions:

Clinical characteristics and early outcomes are similar between the different pediatric age groups. There is evidence of myocardial inflammation and injury following mRNA COVID-19 vaccination as seen on CMR. The hospital course is mild with quick clinical recovery and excellent short-term outcomes. Close follow up and further studies are needed to understand the long-term implications and mechanism of these myocardial tissue changes."

Vaccination should not be encouraged for people under 25. There is too much muddy discussion about infection outcomes for kids, but basically, if you are young, not malnourished or obese, your outcomes will generally be fine without being vaccinated.

We need to be clear-headed about our health goals here, not just chanting "get vaxxed" in lockstep to all and sundry.

Is the heart still growing until age 25 and that's why you think it's safer then to avoid damage to heart tissue?

I think there's potential that the vaccines are harming everyone's hearts but it's only strongest immune responses of teenage boys that are sounding an alarm like a canary signal.

In order to use these findings to argue for or against vaccination, you'd first need to know what percentage of Covid-19 infections will cause myocarditis, and then compare them to the number caused by vaccinations.

My understanding is that Covid-19 infections will cause similar side effects at a far higher rate than vaccinations, but I am not sure whether it's also true for this specific age group.

I've not heard a single report of myocarditis from COVID, have you?

We also don't know true numbers for who's COVID recovered, but there certainly doesn't seem to have been reports of tens of thousands of teenagers reported with myocarditis after COVID - asymptomatic or symptomatic?

I recall raeading that myocarditis was 6x higher in people with COVID than from vaccines

So... I have heard it and went on a quick Google search to find some research about it [1].

> Human coronavirus-associated myocarditis is known, and a number of coronavirus disease 19 (COVID-19)–related myocarditis cases have been reported. The pathophysiology of COVID-19–related myocarditis is thought to be a combination of direct viral injury and cardiac damage due to the host’s immune response. COVID-19 myocarditis diagnosis should be guided by insights from previous coronavirus and other myocarditis experience.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199677/

This is a study of 1597 athletes who were tested positive for Covid-19. 2.3% were diagnosed with myocarditis: https://wexnermedical.osu.edu/mediaroom/pressreleaselisting/...

As far as I know, you can get all the side effects that you get from the vaccines also from a real Covid-19 infection.

So that would seem to suggest the spike protein used in the vaccines is in fact cytotoxic - harmful to human tissue?

Haven't read study yet but wondering if they studied control group too, similar athletes who didn't get COVID? E.g. was rate higher in COVID or about equal?

absolutely yes.

Also blood clotting.

> All were doing well clinically with resolution of their symptoms in most. Seven patients (13%) reported non-specific symptoms including intermittent atypical chest pain (4), palpitations (2) and mild fatigue with minimal activity (1). All patients had normal ventricular function, based on echocardiography. The 4 patients who had presented with arrhythmias earlier continue to be in normal sinus rhythm with no recurrence.

> Follow up CMR studies have been scheduled and are pending at the time of this submission for rest of the patients. There were no acute events, re- hospitalization or deaths reported.

> Although myocarditis following immunizations against smallpox, influenza, and tetanus is well recognized, 13-16 the experience in children with vaccine associated myocarditis, other than following COVID-19 vaccination is limited. Importantly, myocarditis was not reported following the clinical trials of mRNA COVID-19 vaccines.17,18 This may be related to the limited number of patients in the clinical trials and reflective of the apparent rarity of this complication.19

> The present study adds the following information to our understanding of myocarditis related to the COVID-19 vaccine: 1. Myocarditis following mRNA vaccines is associated with acute myocardial injury and edema of the myocardium, in the presence of preserved ventricular function. 2. The initial clinical course and short-term outcomes are good and reassuring. 3. There is no apparent difference in clinical characteristics and outcomes between 12–15- year-olds and older adolescents. 4. The clinical picture is distinct from multisystem inflammatory syndrome in children (MIS- C) and appears to be less severe.

> Limitations of our study include its retrospective nature, combining patients from 16 different institutions which used similar, but not identical approaches during the work-up and management of childhood myocarditis. Our cases represent a selected cohort which may not necessarily be representative of the general pediatric population.

Also, preprint despite being through peer-review might change their conclusions based on the fact that the discussion section conflicts, low N values, etc.

Seems less of a problem than the blood-clots, though should be something doctors be aware of while vaccinating children to be certain it isn't happening. Looks like it's being treated successfully and heals appropriately, though, with existing medicine.

Can someone give a good reason why VAERs reporting of AEFIs is not strictly enforced?

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