Boys more at risk from Pfizer jab side-effect than from Covid, suggests study | Hacker News Reader

Boys more at risk from Pfizer jab side-effect than from Covid, suggests study

theguardian.com

39 pointsforgingahead18 comments

> They estimate the rate of myocarditis after two shots of Pfizer/BioNTech vaccine to be 162.2 cases per million for healthy boys aged 12 to 15 and 94 cases per million for healthy boys aged 16 to 17. The equivalent rates for girls were 13.4 and 13 cases per million, respectively. At current US infection rates, the risk of a healthy adolescent being taken to hospital with Covid in the next 120 days is about 44 per million, they said.

This is a bad comparison. We're all going to get covid eventually, so we should compare the risk of getting the vaccine with the risk of being unvaccinated when you do get exposed and/or infected, not with the risk limited to an arbitrary time interval.

What is a non-arbitrary time interval, then? Over what period of time should these risks be assessed? It's common sense that one would want to know what the results are over the months following the jab, so how is that arbitrary?

not OP but the point I believe is that while only portions of the population will be exposed to COVID over smaller time ranges like 4 months. Given that the disease is seemingly endemic, the probability of any individual person being exposed to it at any point in the future goes up so restricting it to 4 months includes those exposed and not exposed. To compare the relative risks, it might be more accurate to compare the risk of hospitalization for those individuals who have gotten a covid diagnosis versus those who have been vaccinated.

Lifetime, or maybe more realistically the timespan over which the vaccine is effective (could end either based on fading immunity or the dominant strain evolving to escape).

What's an expected timeframe for the hypothesis that "everyone" will get it? What is the risk reduction of getting it despite being vaccinated? The overwhelming majority of Myocarditis cases happen on the second shot, what are the implications of administering booster shots? All of these questions remain to be answered.

Furthermore, new vaccines, treatments and prophylaxes are still being developed. Those may have a more favorable risk profile.

It turns out the opposite is also true:

COVID poses higher risk of myocarditis than (Pfizer) vaccine in male teens – US study

https://www.theguardian.com/world/2021/sep/10/boys-more-at-r...

Healthy boys may be more likely to be admitted to hospital with a rare side-effect of the Pfizer/BioNTech Covid vaccine that causes inflammation of the heart than with Covid itself, US researchers claim.

Interesting, so the specific issue almost exclusively occurs with the second dose. The researchers suggest that only doing a single dose may be a happy medium.

”The overwhelming majority of myocarditis appears after the second dose of vaccine, so offering single shots could protect children while reducing their risk of the side effect even further.”

It’d be interesting to have single dose trial data to see how that would affect % effectiveness.

There's no way to show these shots are efficacious in the under 18 group with any amount of doses.

Where I live, 0.05% (yes, 5 per 10k) of total deaths (remember, we're only comparing confirmed cases, actual cases much larger) affected those under 50. For those under 18, deaths since the pandemic began are literally single digits.

You might decry comparing deaths of a demographic against total cases, but it's essential. People under 50 simply aren't as vulnerable to having any symptomatic level of infection.

Since we're talking single digit deaths under 18, I don't think there's a scientific way to say those deaths were caused by this pandemic in any fashion. It's beyond statistically insignificant, these are most likely children on chemo or have some other very serious underlying condition.

Hmm. Meanwhile, Norwegian data suggests that a single dose is highly protective against serious disease, yet largely ineffective (20% or so) against infection. Perhaps the best strategy is to give young people a single dose, then let the infection run its course.

The next question is what the rate of myocarditis from COVID after a single shot is. I assume myocarditis counts as serious disease, but I don't know enough to say that for certain.

Given that it may be related to an immune priming effect, if adopting this strategy, potential recipients must be tested for antibodies (as a result of natural infection) prior.

As andecdata, I had pretty severe cytokine release / flulike syndrome after the first dose of Moderna (and I likely had a prior infection early in 2020; should have had antibody testing before getting vaccinated), whereas most describe this reaction after the second dose.

Ok... this "study" was searching for myocarditis symptoms in the VAERS database and extrapolating from there.

> this retrospective epidemiological assessment reviewed reports filed between January 1, 2021, and June 18, 2021, among adolescents ages 12-17 who received mRNA vaccination against COVID-19. Symptom search criteria included the words chest pain, myocarditis, pericarditis and myopericarditis to identify children with evidence of cardiac injury. The word troponin was a required element in the laboratory findings.

But further, myocarditis occurs at a rate of about 200/million in general [1]. That somewhat reduces the impact of a study searching for general terms that finds an incident rate the same as what we'd normally expect.

It's frankly irresponsible journalism to have a headline like this. We are talking about what's essentially an exploratory study that needs a LOT of followup before taking action and pushing it in a way that's going to cause people to run scared.

Even though the article calls out some of these points, that's just not good enough.

[1] https://pubmed.ncbi.nlm.nih.gov/32127272/

> this "study" was searching for myocarditis symptoms in the VAERS database and extrapolating from there

It's fair to be critical of this study. However it's important to be aware that the CDC is conducting their own investigation of myocarditis and myopericarditis associated with vaccination. The CDC reviews VAERS reports and then actively investigates them, keeping a tally of the cases that meet the CDC's own stringent criteria.

According to the CDC (as of August 18th), for males age 16-17 the reporting rate of myopericarditis after 2 doses of Pfizer is 71.5 per 1 million doses administered (0.0071%). For males aged 18-24 the reporting rate after 2 doses of Pfizer or Moderna is ~37 per 1 million doses (0.0037%) [1]. They note that for males the observed cases exceed the expected cases by a significant amount in age groups through 49 years.

> myocarditis occurs at a rate of about 200/million in general

For accurate scientific discussion it's important to stratify by age. Following the reference chain from your citation, the important nuance is that "more than one-half of all cases [of myocarditis in the pediatric population] are seen in the first year of life" [2]. Consequently the incident rate you've cited isn't quite as representative as you suggest. This fact is in alignment with the CDC mentioning that the observed cases of vaccine associated myocarditis are greater than expected, particularly for male teenagers.

> It's frankly irresponsible journalism to have a headline like this

I disagree - the title accurately reflects available evidence and official data from government sources.

> that's going to cause people to run scared

People shouldn't be scared by this data. The vast majority of young adults recover quickly from clinical and subclinical myocarditis [1], although the long-term effects aren't well established. It's important to note that viral infection can also cause myocarditis, so this phenomenon isn't just a knock against vaccination. The takeaway is that these findings are an important factor to consider when considering vaccination strategies for children and teenagers - we should proceed with an abundance of caution, but not fear.

[1] https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-...

[2] The Diagnostic and Clinical Approach to Pediatric Myocarditis: A Review of the Current Literature https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352488/

Would the risk curve also be the same for the Moderna shot? (or no way to tell?)

The 3rd paragraph mentions that "similar side-effect is seen with the Moderna jab".

No more mandates.

No vaccine mandates at all or just this one?

I'm okay with everything else in settings like working in hospitals or to dorm in public colleges where updated vaccine records are required, where we were already doing it before. But not this one.

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