Myocarditis associated with Covid-19 compared to mRNA vaccines | Hacker News Reader

Myocarditis associated with Covid-19 compared to mRNA vaccines

nature.com

156 pointsmderazon300 comments

This probably sounds harsh, but are all vaccine-bashing readers deliberately selectively-illiterate? In the abstract (academic for "TL;DR") it literally states that Covid is between 7 and 40 times more likely to cause Myocarditis.

And a lot of you write about palpitations, which can also be caused by stress and anxiety. I'm 30, in good physical shape, and used to have weekly episodes with irregular heartbeats due to severe stress. Now I'm vaccinated (which is for 99.999% of us obviously completely irrelevant to experiencing this, but a lot of commenters draw that conclusion) and the palpitations are gone. Let's not base conclusion on anecdotal evidence, please. For the same reason that my grandpa lived until 85 while smoking since he was 13.

Strange, right? So much focus on edge cases.

If you already had Covid, should you get vaccinated?

Yes. See https://yourlocalepidemiologist.substack.com/p/omicron-updat...

"Cases of reinfection with COVID-19 have been reported, but remain rare . "

https://www.cdc.gov/coronavirus/2019-ncov/your-health/reinfe...

They can't be that rare. I heard about multiple from my social circle.

Curious enough, almost everyone I know who had COVID once at least thinks they got it at least one more time. Obviously anecdata etc., I’m not substantiating any argument at all with this, but this fact of my personal experience didn’t occur to me until reading your comment!

Nice. We have reached the point where hearing from your social circle is equivalent to data.

It's not. However if somebody claims that something almost never happens and you, being completely average person, know few people that claim it has happned to them then something might be up.

Somebody's might be mistaken. Probably those few people but I'd like to see stronger evidence for the general claim as well.

Especially if claim is extraordinary. We know very few illnesses where being sick once gives you immunity for life.

"Updated Aug. 6, 2021"

You can post something from last century, it will be as wrong as this link. Omicron has shown extremely increased reinfection risk compared to all the other variants. So the correct answer is:

yes, you absolutely do need to get a vaccine after the infection if you want to lower your reinfection chances.

Most likely yes. Look at the chart at the last page of this PDF.

https://www.medrxiv.org/content/10.1101/2021.12.04.21267114v...

If I'm reading the charts correctly, the incidence of infection after recovering from Covid is around 13-15 per 100k after 6-8 months, and after recovering from Covid + Vaccination is around 10-14 per 100k after 6-8 months.

So it seems like vaccination does not present a clear benefit for someone that recovered from Covid? (The confidence intervals overlap)

I think the main benefit is that taking vaccine re-sets the timer on your dimnishing immunity from prior infection.

So if you had covid 8 months ago, but took the vaccine last month you have significantly better immunity than if you didn't.

While a person that took vaccine 8 months ago and was also sick even further back (for example 12 months ago), has roughly the same immunity as a person who was sick 8 months ago and didn't vaccinate.

>does not present a clear benefit

It sounds like youre operating from a premise of unnecessary doses being slightly bad, vs slightly good. Is there a clear benefit to not taking pascals wager?

The premise that injecting experimental substances in my body is not necessarily a good thing.

With over 6 billion doses taken worldwide it's currently about as experimental as aspirin.

We know how and why aspirin works, and we've had it for decades. I don't want to live through class actions and apologies for long term vaccine effects.

lets say you have 40 years of life left. are you going to wait 40 years for data? is the 10 they have not enough? 1 more year? 5?

the premise that long term effects exist is also quite a leap.

i think a premise of "this is bad until i know it is good" will be one youll never satisfactorily escape.

I'm not interested in vaccines and it's not my job to be. There are scientists who dedicate their lives, and I'm waiting for results. Asking when I'm satisfied is asking a Las Vegas algorithm when its satisfied - it's irrelevant.

This is the result. After 10+ years they deemed it safe and gave it to 60% of the planet.

Youre saying youre waiting for some "results". The scientists say they are satisfied, but you say you cant hear them say they are satisfied. It's not that they arent, its your, in as polite of french as i have, fingers in your ears.

Youve decided they arent satisfied, despite their statements to the contrary.

I do take aspirin. I love it. Amd I'll take one/two/three/four covid shots in 10+ years when they're deemed safe. Right now, though, I'm wondering why so many athletes are getting injured all of a sudden, and why I hear people complaining of shortness of breath and such.

No, do not do it. Not worth the risk, while your natural immunity is way more effective than even 3 shots of vaccine. If you are above 60 years old, get the vaccine.

No. Ask yourself if the low chance of getting covid again (lower than if you were only vaccinated) is worth the complications from unforeseen issues.

Without taking the vaccine you introduce none of the potential risks of the vaccine. If there are any you simply can't get them if you don't take it.

>it literally states that Covid is between 7 and 40 times more likely to cause Myocarditis.

There is no control group for unvaccinated people in this study. Everyone who got myocarditis from COVID had at least one dose of the vaccine. So the correct statement is "COVID is between 7 and 40 times more likely to cause myocarditis IF you have gotten at least one dose of the vaccine"

That's a very fair point. Hard to do anything about right now, since they unfortunately didn't include those.

However, while very hand-wavy on my part, I believe there's plenty of evidence that Covid on its own wreaks havoc on our cardiovascular system, so I'm definitely leaning towards it being the biggest sole risk here.

From what I've read it's more so the current state of cardiovascular health that leads to problems relating to COVID, e.g. comorbidities.

The study is “self-control” which means patients are compared before and after the exposure (vaccine or covid) for the outcome (myocarditis). So there is a control - the control for each person is their pre-exposure selves.

If you want to argue against the article I suggest considering the bias of being 1 year older after the exposure than before it. For a large population that might matter for myocarditis incidence. I suspect they have corrected for this however.

I think the point here is that the article should have said that Covid is between 7 and 40 times more likely to cause Myocarditis _for vaccinated people_ because unvaccinated people weren't studied.

No, because this study doesn't exist in a vacuum. The contribution is to quantify the relative risk between Covid and vaccines. We already know that Covid has a significant myocarditis risk on its own (as has any viral infection). On the other hand, the authors explicitly state they see no indication for an interaction after 28 days.

You are free to challenge the latter part, but so far there is no evidence that the vaccines "stay in your body" or something similar.

I think you might have misread the paper. Here is the relevant section about SARS-CoV-2 infections:

Amongst those with at least one dose, there were 3,028,867 (7.8%) individuals who had a SARS-CoV-2 positive test. Of these, 2,315,669 (6.0%) individuals tested positive before vaccination; while 713,198 (1.8%) and 298,315 (0.7%) tested positive after the first and second vaccine doses, respectively.

Nit, the 1 year is more noteworthy as time since vaccination, not age.

If these effects take 1 year to manifest, then it’s hard to identify the causal factor with this setup

The abstract says that for all older than 16, but look at he data per age group.

> are all vaccine-bashing readers deliberately selectively-illiterate?

Yes, that's how discourse is done these days: text is a corpus from which you select the statements that support your position and discard the rest.

You are not immune. I promise you

> Now I'm vaccinated (which is for 99.999% of us obviously completely irrelevant to experiencing this, but a lot of commenters draw that conclusion) and the palpitations are gone. Let's not base conclusion on anecdotal evidence, please.

I am not claiming anything either way (neither pro-vax nor anti-vax) but your statement is a tad ironic since you literally draw a conclusion from your own, singular, anecdotal evidence.

That was the joke

So it was a joke? Sorry, they fly over my head when it comes to Covid. Everyone is so outraged about anything about it these days regardless in which they camp they fall.

Read it again. They implied that the vaccine cured their palpitations, to demonstrate the absurdity.

Exactly that - apologies for not elaborating myself. At least I couldn't have put it better myself. Thanks for being good sports about it, both :-)

> used to have weekly episodes with irregular heartbeats due to severe

Off topic, but this happened to me as well. I was having up to 20,000 PVCs a day, and I believe they were brought on by stress. What did you end up doing to reduce them? Or did they slowly resolve on their own?

Try a good Magnesium supplement, this will bring down your general anxiety and also regulate heart contractions:

> In the heart, magnesium plays a key role in modulating neuronal excitation, intracardiac conduction, and myocardial contraction by regulating a number of ion transporters, including potassium and calcium channels.

https://pubmed.ncbi.nlm.nih.gov/29793664/

I’ve had palpitations before from having too much caffeine regularly (yes, while stressed).

Anecdotal evidence is some of the strongest evidence because it's real, personally observed data. It's easy to convince someone of something when they see it, and you don't have to trust anyone but your senses.

That's a perfect example of how the public has no idea how science works.

Anecdotal evidence is the bases of witchcraft, homeopathy and a host of other confused dogmas. They're built on taking one coincidence and creating a castle of speculation, all the while thinking "I have figured out something those scientists have missed!"

It takes a host of data to create information. On spec of data is largely useless for illuminating any complex subject.

To quote baseball umpires, "It ain't bothin' till I call it." If something works, I want to see why. If something doesn't work, I want to see why.

You want people to believe in global warming, coronavirus, and healthy foods, make global warming, coronavirus, and healthy food test kits. I hate to burst your bubble, but when the rubber hits the road, science journals are just text on paper, disconnected from reality. Gravity, radiation, magnetism, etc were discovered through experimentation and demonstrations. We live in a dark age of irreproducibility.

Take health industry and cybersecurity industry for example. The former publishes controversial results every weekend, and the latter has us trust closed source systems due to appeal to authority.

Anecdotal data isn't much but it's your data, and that sure is better than wrong data.

It's pretty much identical to wrong data. One data point is nothing. It's a comprehensive mistake to give it any weight.

At least for complex subjects like health, weather etc. "I saw a snowflake! Global warming has to be wrong!" is not any kind of conclusion.

What's the alternative? "5% of crops died in a country halfway around the world, that's used to dead crops. You should buy a Tesla now." "Humans have been eating saturated fats for 2 million years but half rancid PUFA are healthier."

No, I can look at and trace the proofs in any mathematical publication. I can look at and trace any open source code. If something works, I should be able to test it. And it's your flaw to assume people will play along with the onus.

>People were considered eligible for inclusion in each study cohort if they had received at least one vaccine dose, were at least 16 years old and were admitted to hospital with, or died from, the outcome of interest between 1 December 2020 and 24 August 2021

Am I missing something? There is no control group for unvaccinated people. Who is to say that COVID didn't exacerbate the conditions delivered via the vaccine? Why wouldn't they put an unvaccinated control group?

Why is there so much emphasis on myocarditis/pericarditis when the study claims that Cardiac arrhythmias were far more plentiful?

Uh, we don't really have a control group anymore. This whole rollout has been rife with callous disregard for the usual protocols.

https://www.npr.org/sections/health-shots/2021/02/19/9691430...

The severity of vaccine-induced myocarditis is far worse than virus-induced too. You have to have a very severe infection for the spike protein to accumulate in your heart, whereas the LNP delivery system gravitates to the heart due to its fat content. We have seen this in various biodistribution studies.

The severity of the myocarditis after vaccines was generally described as mild.

I also strongly doubt your statements about spike protein distribution, all cells have lipid membranes. The vaccine is injected into the muscle in your arm. Why would it accumulate in the heart?

And it is not unusual that you can't do real placebo studies once you have a very effective treatment. Denying effective treatment to people just to be able to do these studies would be extremely unethical.

Myocarditis has an extremely high fatality rate. Why is it considered mild when getting it via COVID/Vaccine as opposed to the usual ways?

Because myocarditis is not myocarditis. The cases observed after vaccines were mostly mild. The myocarditis after vaccines does not necessarily have the same severity as myocarditis in general, and from observations so far it looks to be milder:

> In COVID-19 mRNA-vaccine-associated myocarditis, >90% of patients will functionally completely recover, usually after a chest pain syndrome (see Supplementary information). To date, only eight deaths owing to COVID-19 mRNA-vaccine-associated myocarditis have been reported (>99% survival) (see Supplementary information).

https://www.nature.com/articles/s41569-021-00662-w

> Most patients with myocarditis or pericarditis who received care responded well to medicine and rest and felt better quickly.

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/my...

Thanks, that's reassuring at least

> Myocarditis has an extremely high fatality rate.

Only for severe cases. Like any inflammation it can be mild to life-threatening.

You can get myocarditis from any infection, and also allergies. Mild forms are quite common, if I remember correctly (not a doctor).

> I also strongly doubt your statements about spike protein distribution, all cells have lipid membranes. The vaccine is injected into the muscle in your arm. Why would it accumulate in the heart?

I was under the impression that accidental injection into the bloodstream was likely the culprit. The linked study doesn't speculate on a mechanism however.

The odds of hitting a blood vessel seem pretty small, and the odds of adverse reactions when it does happen also seem pretty small. The article claims an incidence rate of 1-10 per million.

From what I managed to find out, the IV injection is flagged as a danger only for AZ and due to clot risk, not due to inflammation risk. At least that's the idea behind aspiration before injection in Denmark.

I wonder though. I know someone under 40 who has complained of heart arrhythmia, sudden severe fatigue and a squeezing pressure on his chest. He had Moderna but it happened >7 days afterwards. He never reported it because he assumed it was psychological instead and that doctors would dismiss it with anti-depressants.

The paper doesn't give a rate for this type of thing, only for people who went to hospital. But if this is really one-in-a-million stuff I really wonder how I happen to know someone who has it. Also there are only ~21 million software developers in the world, HN has only a fraction of them reading let alone commenting and yet this thread is filling up with people describing the exact same thing that happened to my friend.

I find it hard to believe these things are really as rare as they're implying. Perhaps there's a reason they don't give rates for the "squeeze+tiredness+irregular heartbeat" problem.

> But if this is really one-in-a-million stuff I really wonder how I happen to know someone who has it

Do we teach statistics in school anymore? This is such a nonsensical remark.

That's perfectly well-grounded. If a large chunk of your acquaintances were to be predisposed to something due to selection bias, you might be in similar groups and be predisposed to similar things.

> The vaccine is injected into the muscle in your arm. Why would it accumulate in the heart?

Here is an interesting read:

https://www.bhf.org.uk/what-we-do/news-from-the-bhf/news-arc...

"The spike protein binds to cells called pericytes which line the small vessels of the heart. This binding triggers a cascade of changes which disrupt normal cell function, and can lead to the release of chemicals that cause inflammation. This happened even when the protein was no longer attached to the virus... The spike protein can remain in the bloodstream after the virus has gone and travel far from the site of infection."

This article is talking about the spike protein aquired from infection, but I wonder if it is similar from vaccine, since the spike protein is also in the vaccine:

"First, COVID-19 mRNA vaccines are given in the upper arm muscle. The mRNA will enter the muscle cells and instruct the cells' machinery to produce a harmless piece of what is called the spike protein. The spike protein is found on the surface of the virus that causes COVID-19."

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different...

The bhf article you linked explicitly states that there is no reason to believe that vaccine spikes behave the same way, and that getting vaccinated is the best way to avoid the spike-caused heart damage.

More specifically, it said:

"This research only looked at the spike protein found on virus cells."

The impression is that, since they did not look at the spike protein from vaccines, then that is the reason there is indeed no evidence of this from vaccines, since there was no study on that. Sounds like there should be a study.

The severity of heart issues decreases with age. The risk of covid death increases with age. This children should not be getting vaccinated.

Thank you for posting this.

I received my 1st Pfizer vaccine in June and around 3 weeks after the vaccine I started experiencing frequent irregular heartbeats. Sometimes it was every day, then sometimes once or twice a week. I still experience ectopic heartbeat now (although much less frequently) as a result of the vaccine 6 months later.

I used to drink lots of coffee, but quit all caffeine in my life due to the risk to my heart! I reported this to the yellow card scheme, but I'm very glad to see more research being done and awareness.

> as a result of the vaccine

Can you really know that?

Yeah, I think I’m experiencing the same thing :/… I just hope it goes away

> I received my 1st Pfizer vaccine in June and around 3 weeks after the vaccine I started experiencing frequent irregular heartbeats. Sometimes it was every day, then sometimes once or twice a week. I still experience ectopic heartbeat now (although much less frequently) as a result of the vaccine 6 months later.

Way before Covid I had a panic attack which led me to believe that my heart was not working properly. I got everything checked and it was all good but in the following months I regularly noticed irregularities which have since subsided. I'm almost sure that this was not due to any actual change but the main reason was that I was simply observing my heartbeat much more closely, feeling my heart racing etc. which was in turn actually making my heartbeat more irregular.

Of course your problem might be more physiological but I just want to point out that mind and body are closely connected and it's very difficult to observe such an effect and pinpoint it to a certain event (for example the vaccination).

Plus, we humans are really bad at disentangling cause and effect in daily life. Everyday there's people that get sick or notice something, so if we all take a vaccin, by definition some will get sick or notice something right after the vaccin, albeit by accident.

That's not to say that's the case here, it's simply why, as the parent (and OP) also states (so I think we're all on the same page here, just adding another thought), research is important.

https://www.standard.co.uk/news/health/post-pandemic-stress-...

It is just stress...

I think now, almost everybody knows someone with your problem. Really sorry to heard, I hope you will recover!

No vaccine should damaged an healthy person, and nobody should be forced to a treatment (Norimberga anyone?). We need more studies and data like this.

Why governments don't push for studies? I remember doctors and media denying AstraZeneca Blood cloths for months, before they added to the official adverse reaction list, finally.

> Why governments don't push for studies?

Where do you get that idea? I mean, you literally are commenting on a study run by people involved in a government decision-making process.

I think now, almost everybody knows someone with your problem.

This seems unlikely, given the relative rarity of these events.

No vaccine should damaged an healthy person

Every vaccine ever created can have adverse effects on healthy people.

Why governments don't push for studies

You are literally commenting on a study.

I remember doctors and media denying AstraZeneca Blood cloths for months

Your memory is wrong.

>> I remember doctors and media denying AstraZeneca Blood cloths for months

> Your memory is wrong.

There are "fact-checks" still online claiming that AZ doesn't cause blood clots.

https://eu.usatoday.com/story/news/factcheck/2021/03/25/fact...

The early "fact-check" you linked to doesn't claim "that AZ doesn't cause blood clots". Its conclusion:

"Whether there is an actual connection is still under investigation and will be closely monitored as vaccination with AstraZeneca's vaccine resumes."

You linked to an article that literally concludes with the sentence:

"Whether there is an actual connection is still under investigation and will be closely monitored as vaccination with AstraZeneca's vaccine resumes."

This is exactly what we should all expect to happen. I don't doubt for a second that there will be citable examples of doctors or media claiming that this particular vaccine did not—or was unlikely to—cause clots. But the statement "I remember doctors and media denying AstraZeneca Blood cloths for months" is clearly intended to misrepresent the actual situation.

> Your memory is wrong.

I don't think so, you can still find the traces of it everywhere.

You can't deny the fact that the people in charge decided to misinform the public several times for specific reasons. It started with masks: people wanted to wear them and all the media was parroting that "there is no evidence that masks protect against COVID-19" (or was it called the "Wuhan virus" still back then?). While technically correct, it was against common sense and the aim was to limit the demand for masks used by healthcare institutions. Once they secured the masks, they turned 180 degrees and started to force everyone to wear the masks. What a great way to build credibility.

Regarding vaccines, more openness would be great. What we were promised was efficiency at the level of >90%. What we see now, after mutations and with time after taking the vaccine, the efficiency levels are much lower and it looks like - at least in some countries - people will have to take the vaccine perpetually 2 or maybe even 3 times a year in order to be able to work. In this case, we better study the possible adverse reactions well and assess the overall lifetime risk, especially for younger persons.

> I remember doctors and media denying AstraZeneca Blood cloths for months, before they added to the official adverse reaction list, finally.

29.1.2021: EU approval for the vaccine is granted

~10.3.2021: first countries pause usage, EMA officially starts investigating.

18.3.2021: risk of blood clots is added to list of known potential side effects

so not even 2 months.

EDIT: and to pre-empt hair-splitting which list counts:

7.4.2021: moved from "potential side effect" to "known side effect". ~ 2 months and a week.

"This project involves data derived from patient-level information collected by the National Health Service (NHS), as part of the care and support of cancer patients. The SARS-Cov-2 test data are collated, maintained and quality assured by Public Health England (PHE). "

"BRC. M.S.-H. is supported by the National Institute for Health Research Clinician Scientist Award (NIHR-CS-2016-16-011). J.H.-C. and K.M.C. are supported by the NIHR Oxford Biomedical Research Centre. N.L.M. and K.M.C. are supported by the British Heart Foundation (Chair Awards CH/F/21/90010, CH/16/1/32013), Programme Grant (RG/20/10/34966) and Research Excellence Awards (RE/18/5/34216, RE18/3/34214). A.S. is supported by the Health Data Research United Kingdom BREATHE Hub. This research is part of the Data and Connectivity National Core Study, led by Health Data Research United Kingdom in partnership with the office of National Statistics and funded by United Kingdom Research and Innovation (grant MC_PC_20029)"

In what universe isn't this the government pushing for the study?

I had an EKG done like a month ago for this reason. Turns out irregular heartbeats are a very normal thing in the amount I was experiencing them. In addition, I spent a lot of time indoors, sitting or lying on a couch, stressing about my health and the world, thus overreacting to normal changes in heart rhythm due to the sympathetic and parasympathetic system handing off to each other.

I've been fully vaccinated since August.

edit: Spelling, wording

> I still experience ectopic heartbeat now (although much less frequently) as a result of the vaccine 6 months later.

Are you confident that this is related to getting vaccinated?

I also got irregular heartbeats a couple of years ago (long before I got vaccinated against Covid), mine are called premature heart beats (https://en.wikipedia.org/wiki/Premature_heart_beat) and they're harmless as long as they stay under a certain of times per minute, according to my cardiologist (after extensive tests).

Same here. I couldn't go for runs for 4-5 weeks after the first dose. I also had COVID prior and was back on my feet after 3 days. I'm fine now but worried about getting boosted.

The study states that 0.004% of vaccine recipients were hospitalized from myocarditis. 1,615 out of 38,615,491.

NIH estimates that 31.1% of U.S. adults will experience an anxiety disorder at some point in their lives. https://www.nimh.nih.gov/health/statistics/any-anxiety-disor....

I would encourage you to discuss with a licensed medical professional about which you are more likely to be experiencing.

Does anxiety produce ectopic heartbeats?

Yes https://www.nhs.uk/conditions/heart-palpitations/

Not sure about irregular heart beats. But when I was burning out from my PhD a very heavy and intense heart beat was the most notable physical symptom. There was no underlying problem, I was just going through a great deal of emotional stress.

The problem with anxiety is that it leads to intense heart beating and your anxiety then leads you to assume something physically wrong with your heart. You don’t think rationally on stress!

Does myocarditis produce ectopic heartbeats?

You have the priors the other way round. The old adage "when you hear gallopping think horses, not zebras" is not valid if you're in a place where zebras are common and horses aren't.

What you say could be true if this person had experienced such events prior to vaccination as well.

Otherwise the probability of having a first episode of ectopic beats within 28 days of the vaccine is far less likely to be due to anxiety in the absense of previous history of anxiety, let alone one with rare symptomatology.

Except where there is so much disinformation from anti-vaxxers that it induces anxiety in people that are hesitant to get vaccinated

Vaccines causing myocarditis isn't disinformation.

Stating without context that "vaccines cause myocarditis" is indeed disinformation, because it encourages people to irrationally focus on a particular (edge-case) negative outcome, whilst disregarding the (common) positive outcome.

Add the context, and the potential for disinformation goes away: "Vaccines cause myocarditis, but overall at a lower rate than the disease itself. Additionally, the disease has many other, much more significant, risks that are mitigated by vaccination."

The point I'm making is that disinformation is a psychological effect. A statement can be factually true and still be disinformation ("100% of child abusers found to have consumed dihydrogen monoxide", etc.)

Can't tell if sarcastic...

Anxiety is exacerbated during times of stress. Covid is placing unprecedented stress on all of us right now. Getting a vaccine and then hearing it "may cause myocarditis" can be very stressful, and we lose the ability to internalize the caveat that it's attached to a 0.004% incidence rate.

Anxiety also causes you to perceive normal bodily sensations, that you otherwise filtered out, with heightened sensitivity.

"With health anxiety there is the misinterpretation of discomfort and normal bodily sensations as dangerous. The body is very noisy. Healthy human bodies produce all sorts of physical symptoms that might be uncomfortable, unexpected, and unwanted, but not dangerous." https://adaa.org/learn-from-us/from-the-experts/blog-posts/c...

Also worth remembering that in many locations people will get a survey about side effects after vaccination. That means they be asked "did you experience any heart issues" which is not something they think about every day. If they really think about it, maybe they did that week. And it may or may not be something they experienced before.

You're riding a horse through the zoo, but still thinking it's likely zebras even though you're in the snake house.

I'm not sure if it's the same thing but a few weeks after my 2nd shot of Moderna I feel like my chest (heart? lungs?) squeezes for a few seconds and then I have problems breathing normally for a few hours after that. This repeats almost every day. I had my heart and lungs checked but found no obvious problems. I don't know what to do or what additional tests necessary but hope this goes away :(

Please interpret my comment in a benevolent way: Have you considered that you perhaps experience panic attacks? It is pretty common especially for males to experience panic attacks as primarily physical. Can you perhaps find a pattern in your behaviour or experiences before you have those squeezes (i.e. some part of your work routine, or specific thought patterns)? Whether physical or psychological, it might be worthwhile to write some kind of symptom diary after each event.

Thanks for your comment, I haven't looked at it this way. It happens randomly also often when I'm in an inactive and relaxed state. But I'll pay closer attention to external circumstances.

> I feel like my chest (heart? lungs?) squeezes for a few seconds

Do you feel pain when this happens?

> then I have problems breathing normally

Does your breathing rate increase? (hyperventilation)

Next time this happens you can undertake a small test. Take 15 g of sugar in one go and see whether you experience an immediate improvement. This test will show whether the condition is related to decreased ATP production which is known to cause panic attacks in some people (false hypoglycemia). If you see an improvement from sugar then it means it is related (you can take a look at my other posts to see how to manage that).

Other tests that may be helpful for you: HOMA-IR, A1c, Low-Density Lipoprotein (LDL), High-Density Lipoprotein (HDL), Cholesterol, Triglycerides, Gamma-glutamyl Transferase (GGT).

Thanks for your comment! I'll do the sugar test and check if there are some blood tests from your list I haven't done yet.

> Do you feel pain when this happens?

No, just weird unpleasant "squeeze" sensation in chest.

> Does your breathing rate increase? (hyperventilation)

Not sure but probably not. It makes me breath way deeper, but frequency seems the same.

> just weird unpleasant "squeeze" sensation in chest.

If the hypothesis of a non-satisfactory ATP production applies to you, then this is the moment of energy production decompensation. It causes the feeling of a sudden and unexplainable "halt" in consciousness/breathing/muscle activity, after that you become very alert and subconsciously start racing the heart/lungs, feeling that you are not ok. Some people even feel that they may pretty much die.

But the exact manifestation varies from person to person. An example of a real-world situation is presented in [1].

> It makes me breath way deeper, but frequency seems the same.

This also counts as hyperventilation. It's either frequency increase, deepness increase, or both.

[1] https://news.ycombinator.com/item?id=29139740

P.S. I will monitor this thread from time to time in the following months. Just drop a reply if I can be of further help.

Thank you so much again. Not sure if it's my case (I'll check with sugar) but analysis of this level is way above any doctor I ever visited. One minor note though, I find these attacks happening even when inactive and relaxed, not only under heavy physical/mental activity or stress.

> I find these attacks happening even when inactive and relaxed

In the initial stages, attacks do occur mainly under the mental/physical load. The condition slowly but steadily progresses to everyday attacks over several weeks/months.

In the later stages, attacks may even occur during the night when a person sleeps or tries to sleep. A person may have several attacks during the day at this point.

You could ask your doctor about a D-Dimer test, https://medlineplus.gov/lab-tests/d-dimer-test/ . In the US, it costs about $200 without insurance and can be ordered directly by the patient.

This story describes one diagnostic process for vax-induced myocarditis, https://nymag.com/intelligencer/2021/05/what-its-like-to-hav...

Thank you, this is so helpful, I'll definitely order this test.

I didn't see a dimer mentioned in that article, and on a brief glance its not in any of the algorithms I saw for diagnosing myocarditis.

Perhaps walterbell suspects your symptoms are related to blood clots and that is why he recommended a dimer. D-dimer is often used as a screening test when there is relatively low suspicion for pulmonary embolism. I can't say either way, but if you're most concerned about myocarditis a dimer would probably only muddy the waters imo. With your symptoms and a positive dimer you might end up getting a chest CT (you say you've already had some workup done, not sure if that was included).

Your best bet is probably to find another doctor or pursue further workup with your current doctor as there are a lot of nuances not easily captured through an internet discussion board. For all we know you may have asthma.

Thanks for your response. I did echo, lung CT, cardiac stress test but neither of these shown any anomalies. One doctor suggested angiocardiography "just in case" but it requires taking pills for a few days to lower heart rate. I'm still not sure lowering my heart rate with meds is a good idea.

If you did a lung CT they probably looked for blood clots (your doctor would know if they did or not), in which case dimer is not going to help you.

Ironically, if you are having panic attacks, a drug that lowers your heart rate may help treat them.

Right. I visited a pulmonologist a couple of days ago and she said clots doesn't seem to be my case. And yes, asthma is her main hypotheses now. Which seems strange given I'm in my late 40s.

Thanks for the follow up!

I also experienced an irregular heartbeat for several months after receiving the Moderna vaccine (June, 2021) up to this month (December, 2021). It seems to be getting better, but is accompanied by a mild pain, tightness in the chest and shallow breath. This is despite regular diet, exercise and otherwise normal health. I am 31 years old.

The damage to your heart is too mild to be considered worthy of study.

Asymptomaptic covid-19 is more worthy of study and effort to prevent it.

Heart problems did increase in young people in a significant way. To my knowledge this trend began before Covid though.

Same, I first went to my doctor about this 6 months ago now and only just now have they acknowledged it might be myopericarditis. Anxiety has been discussed but it is unlikely as it gets worse with exercise.

I’m still waiting on an echocardiogram after 5 months.

PVCs and other irregular rhythms are quite common and related to stress and a lot of other things. They’re also highly disconcerting. But anyway, it’s always tempting to find a cause or one something to blame, very human to do but easy to scapegoat the wrong thing. Not saying you’re wrong but Be careful about attributing causation without solid evidence, which is often hard to come by.

I hope someone else appreciates the ridiculousness of quitting caffeine for health, but gladly accepting an unapproved experimental drug into their body.

> The risks are more evenly balanced in younger persons aged up to 40 years, where we estimated the excess in myocarditis events following SARS-CoV-2 infection to be 10 per million with the excess following a second dose of mRNA-1273 vaccine being 15 per million

So according to this study, if you're under 40 and have taken the Moderna vaccine, you are more likely to develop Myocarditis than after a Covid infection.

There is also question of severity:

> Whilst myocarditis can be life-threatening, most vaccine-associated myocarditis events have been mild and self-limiting [0]. The risk observed here is small and confined to the 7-day period following vaccination, whereas the lifetime risk of morbidity and mortality following SARS-CoV-2 infection is substantial.

In general, even if you will have very mild infection and you are under 40, COVID-19 can do a lot more damage than vaccine. Long COVID among people that were not hospitalized is quite common (more than 10% after 3 months [1] [2]) with wide ranging symptoms. From loss of smell to being debilitating enough to prevent you from working. And medicine has very little idea what is happening with these people or how to help them.

[0] https://news.ycombinator.com/item?id=29564815

[1] https://www.ons.gov.uk/peoplepopulationandcommunity/healthan...

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8478214/

How do they know the lifetime risk of Covid-19?

Indeed, they can not know quantitatively lifetime risk of COVID-19 after 24 months of observation. But we do know from clinical experience that COVID-19 is damaging a lot of people in very severe ways. I was also quoting data on long COVID that indicate that a lot of people (10% and more) suffer long COVID after 3 and even 6 months.

We also have some data on SARS survivors [0]. The SARS virus is closely related to SARS-CoV-2, but it is a lot more severe.

> Dr. Paula Gardner, a psychologist at St. John’s Rehab in Toronto, has been documenting the health of survivors, post-SARS.

> “They’re still, after 10 years, experiencing problems. Issues such as fatigue, muscle and joint pain, shortness of breath and some newly developing problems such as neuropathy, numbness in the feet and hands,” she said.

We have also experience with the general chronic fatigue syndrome that seems to be related to infectious diseases: https://en.wikipedia.org/wiki/Chronic_fatigue_syndrome#Viral...

[0] https://globalnews.ca/news/404562/sars-10-years-later-how-ar...

Just to prevent confusion, I think it's good to realise that this article is mainly discussing the risk of COVID-19 on myocarditis (etc), not on anything, while that doesn't seem to be it's biggest impact (which is an important point you make already).

With every booster being taken, the risk of Myocarditis is increasing.

The vaccine-induced spike proteins (which damage your cells and internal organs) can stay in your body for 12 months, which means that if you're regularly boosting, you're not getting rid of them.

This is not the case with Covid, and people rarely if ever get Covid twice.

That's quite few statements you put out there, any chance you can direct us to some sources or further reading?

It's all from Peter McCullough on the Joe Rogan show and he mentions all the studies on which he bases his statements.

https://open.spotify.com/episode/0aZte37vtFTkYT7b0b04Qz

I love Joe Rogan and his podcast, but be aware that we live in such a complex world, any representation will be a mis-representation to some extend.

How much of a mis-representation is extremely hard to judge, because often it's not done deliberately.

Wikipedia says about Peter McCullough:

"During the COVID-19 pandemic, McCullough promoted misinformation and falsehoods about COVID-19, the COVID-19 vaccine, and COVID-19 treatments."

That's definitely concern to be very skeptical.

It's good to be skeptical, and yet I hope you have an open enough mind to listen to the interview.

An open mind definitely, likely not the time to do it though. I've gone down similar rabbit holes for a number of related issues, and every single time what started as a disagreement with the scientific consensus in say, issue A, turned into a disagreement also with B, C, D, E, F and so on.

What remained was the disagreement with the scientific consensus. How likely is that?

If it's any helpful, that's my heuristic to spot valid criticism.

I'm not saying trust McCullough, because I listened to some of that podcast and some of what he said I really think is bullshit and wrong... BUT...

I also seriously don't trust any tech platform on covid information at this point. It's clear there is something along the lines of massive regulatory capture of tech platforms by the official FDA, CDC, NIH lines and they hardly ever allow dissent. Time and time again it's been proved that the censorship has been too much. Lab leak hypothesis, vaccine safety, vaccine stopping the spread to name a few. It's clear that the black and white censorship that's happened (it's not a lab leak, vaccines are safe), is just not true. Both those things are pretty gray areas, as this study shows.

The vaccine is basically turning into a personal trolley problem for everyone. Do I take the vaccine and make an active decision and take a small risk, or do I not take action and take a slightly bigger risk?

It's clear there isn't a risk free option, which is what vaccines were sold as.

So, tldr, I think taking that sentence from wikipedia as some sort of indicator is not a good idea.

I find it interesting how your (assumed) US based 'feel' is different from my Netherlands based one, which could be a difference between us, our countries, or both. We've been getting - in my opinion - rather fair and unbiased information, including when and where they simply did not know, were uncertain or disagreed (that's not to say I agree with all decisions or lack thereof).

I see the 'it's not a lab leak' as China's narrative, which, well, by definition I can not see as black and white. It has never been communicated or pushed as a 'fact' here either, as far as I can remember.

As for vaccine safety, possibly side effects have always been taken seriously here, halting vaccination when there was doubt (astra I believe) and giving certain vaccines (not) to certain age groups. Also, I personally think vaccines are safe. No, there's no flat out 100% guarantee that you will NOT have any side effects, but chances are so small and they are often temporary. I still call that safe.

Yes, there's a chance you're that very unlucky one. It's something you can say to yourself throughout the entire day, when you get in the car, get on a plane, ride your bike, walk through the city at night, eat food, enjoy nature, or even sneeze. Yet we don't, we just go and live our lives. I do understand it feels different when it's a conscious choice you have to make, but that doesn't change the numbers.

Ah, that's 3hrs of audio. I couldn't find any shownotes either. Can't help but notice Peter McCullough's Wikipedia doesn't put him in the list of most neutral, factual sources though. But sure, how do we know we can trust _that_.

So in other words, covid is a vaccine against covid that actually works, and the vaccines are not vaccines against covid, don't, and also have cumulative negative externalities.

Why are people still talking about mandating this nonsense?

The vaccines against Covid actually work, and (probably) come with a small risk. Sure, just getting Covid does too and probably a bit better, but comes with a great risk.

Now, does that warrant mandating? I'm not so sure, that's a much more difficult discussion swaying us (among other things) back and forth the between freedom of one person and the health of another.

Not for kids and people talk about mandating vaccination for them. Aside from that it should be voluntary for adults as well.

Yeah for kids it is even more difficult to defend a mandate, even to defend their vaccination altogether (we don't do general vaccination for kids here in the Netherlands, yet). There still IS something to discuss, as we see kids spread it (a lot), which does eventually increase the risk of adults for which the vaccine doesn't work. But to me that's not enough.

As for adults, what we've seen here (86% of 18+ vaccinated) is a lot of pressure on health care (and especially, the people working there) directly and on people in need of non-immediate, non-covid care indirectly (as that gets dialed down), as well as society as a whole through new lockdown like measures. This pressure came from unvaccinated people, initially mostly, later still disproportionately (and after boosts, possibly mostly again). It's a crazy difficult dilemma. Luckily we've managed to stay away from mandates so far, but it's costing.

It's not settled yet, but it's pretty likely that males under 12 are at still higher risk of a severe course of illness (hospital care) than they are at risk of myocarditis following vaccination.

And how many would that would be? 15 people? Please, elaborate in regard to the demographics of any country of your choice.

I am (somewhat speculatively) comparing rates of a specific demographic. I expect it will be true everywhere that vaccinating younger males leads to an overall reduction in harm to the vaccinated.

At most, moderately higher risk, and that's assuming 100% would get covid (just like the government wants 100% to take the vaccine). You can't compare infection vs vaccine if only 50% would ever have caught Covid (without even counting children with previous infections who are practically guaranteed to never be hospitalized from it), while 100% will get vaccinated; the risk-benefit is likely to shift into the mostly-nefarious territory.

Also keep in mind that risk-of-myocarditis-from-infection is overestimated, because plenty of people are utterly asymptomatic and aren't counted in the stats.

Correct, higher risk from infection than from vaccination.

In Germany in the last summer we had monetary incentives to reduce intensive care units. Active ones, as you got funding for reducing the amount of beds in intensive care. To now blame the situation on unvaccinated instead of policy makers is misattributed. Also, we had severe problems even before covid became a problem too.

I heavily doubt that the 14% are the cause of the problems instead of being a very convenient excuse.

German stats unfortunately mis-attribute the number of cases in the unvaccinated very severely. Actually what they do is so bad it is really just making the numbers up. Article is sadly paywalled:

https://www.welt.de/politik/deutschland/plus235442252/Fakten...

But what it says is that the German authorities don't have data on the vaccination status of most COVID cases. Instead of admitting this they just relabel all people of unknown status as unvaccinated.

Germany stats all COVID cases wrt vaccination? Ah, in the Netherlands most if not all stats I've seen involve hospitalisation and especially IC. Those are often misattributed the other way around, 50/50 sounds equal, until you consider 85% of the population is vaccinated (and most of the 50% vaccinated IC patients are old / sick / immunodeprived).

Yes, the German stat I'm talking about is all cases.

Hospitalization and IC numbers have other problems, especially with confounding. I don't think Germany provides enough data to check for problems and anyway their stats are meaningless for as long as they are playing such obviously dishonest games.

But the UK data seems to be more honest. There a problem can be seen: vaccines don't get administered to the very sickest people who are dying anyway, which makes vaccines look artificially good / non-vaccination look artificially bad. This shows up in the UK data as a spike in deaths in unvaccinated people for non COVID causes that correlates with vaccine rollouts. Obviously, that's not biologically caused. Rather it's because the sickest people aren't given the vaccines because there's no point, and end up concentrated into the unvaccinated cohort. Then they pick up COVID in hospital anyway as so many do, and this is used as evidence for why everyone should take the shot without de-confounding.

Paper explaining the problems with the UK data that appear to show this confounding:

https://www.researchgate.net/publication/356756711_Latest_st...

They also try to control for this problem and when they do, effectiveness goes away, which is very distressing. VE against death is supposedly very strong so it shouldn't disappear when the rigor of the analysis is increased.

There are other problems, like the standard delay period where people have been given a vaccine but count as unvaccinated. In one study, buried in the appendix, they show data that when this period is included the incidence between those who were vaccinated and those who weren't was equal, i.e. no effectiveness.

This article summarizes some of these statistical issues:

https://dailysceptic.org/2021/12/12/is-vaccine-effectiveness...

It's very problematic that these data issues can occur but inevitable. Normally you want RCT evidence exactly to avoid these confounders, but COVID kills so few people that nobody was able to mount a trial big enough to show impact on mortality. Actually in the Pfizer trial more people died in the vaccine arm than the control arm, but there were so few deaths in total (from anything) they said this wasn't significant / meaningful. Hence you end up trying to find evidence in real-world observational data but those are hard to control.

That's interesting, such confounding is an example for how difficult such research is. It's also two articles hammering on a single piece of data and making conclusions using Occam's razor. The comments on the second article don't help either.

Most importantly it's not just death I'm worried about, it's also not getting hospitalised (or worse, staying in coma for days on the IC). Not only for the individual, but also for society. At least here in the Netherlands, that was spot on the point we had to go back to lockdown like measures. There's a lot of numbers that suggest vaccins do wonders for that, for all ages (a bit less for elderly actually). An obvious one is the much bigger amount of daily infections we could now support with less beds compared to before vaccinations. These numbers are dropping, possibly because vaccinations being longer ago. Hopefully boosters will mitigated this.

The second article also discusses the problem of the 2 week delay period and links to the study appendix - different data and argument.

Hospitalization is unfortunately also hopelessly confounded by the same factors - if you don't vaccinate people who are already dying then they are much more likely to be or end up in hospital - but then additional problems too. Again, RCT data didn't prove any effects on hospitalization, that just wasn't an end point they cared about.

Why not? Well, partly because it's extremely subjective. To be hospitalized for a disease like COVID you must either catch it in hospital, or choose to go. COVID isn't a sudden collapse like a heart attack or stroke where bystanders may rush you to hospital in an ambulance. It's a steady degradation and at some point someone has to call a doctor or emergency number and say, I think I need to go to the hospital. Hospitals can turn you away if your COVID isn't serious enough but in many places they have monetary incentives not to do so, and that's ignoring all the psychological issues - if you have some spare beds giving someone who's terrified some attention may be better than turning them away.

In normal/sane times this wouldn't really matter, as we can hope that people are roughly OK at judging whether they need this or not, and hospitals wouldn't spend resources on cases that aren't really needing to be there. But with COVID, years of relentless misinformation from newspapers and authority figures have totally destroyed people's understanding of the severity of the disease. US adults over-estimate the risk of hospitalization if you're unvaccinated by orders of magnitude:

https://news.gallup.com/opinion/gallup/354938/adults-estimat...

"The results show that most Americans overstate the risk of hospitalization for both groups: 92% overstate the risk that unvaccinated people will be hospitalized, and 62% overstate the risk for vaccinated people .... For unvaccinated hospitalization risk, 2% of Democrats responded correctly, compared with 16% of Republicans. In fact, 41% of Democrats replied that at least 50% of unvaccinated people have been hospitalized due to COVID-19."

41% of left leaning voters think HALF of unvaccinated people have been hospitalized for COVID! The true number is less than 1%. That's an astonishing stat. I suspect these polls aren't representative and the true numbers are better than this but even so, they are indicative of the problem.

What happens if you trust the media and government so much that you're totally convinced testing positive for COVID = required hospital visit, and then those same authority figures tell you that vaccines will "protect" you from hospitalization? Well, you're much less likely to go, even in situations where previously you would have gone straight to the ER and demanded attention. And that's fine, they'll recover on their own as they almost certainly would have done anyway, and they'll say "thank god I was vaccinated otherwise it would have been much worse".

This is the sort of confounder a rigorous trial would seek to control for, but we don't have any useful trials. The vaccine trials were complete failures: for the only end point they targeted, they reported 95% effectiveness, which started dwindling to near or even below zero in the months after the trial period ended. No usefully accurate information was provided by them, which is shocking.

So vaccines are bad because Americans overestimate risks due to trusting media and government too much (and those apparently misusing that trust) and therefore don't go to the hospital (and apparently surviving at home instead of needing to be brought into a coma at the IC, because that's only for the hospital's profit) which confounds the numbers that were missing in the original trials?

Nearly - have you reversed a part of the argument there? The argument is that people over-estimate the risk of COVID if unvaccinated, meaning they do go to hospital. You said "therefore don't go". Lots of marginal cases will end up going to hospital, right up until those people get vaccinated at which point the publicity campaign switches direction and tries to convince people with COVID to stay home because they're protected. Which indeed would hopelessly confound any attempt to determine true effects on hospitalization from simple rate data, and the trials simply didn't measure this at all. In fact the study paper:

https://www.nejm.org/doi/full/10.1056/nejmoa2034577

doesn't even contain the word hospital anywhere in it.

It's not just Americans by the way. There's a French survey that shows something similar with respect to estimated IFR. Actual value between 0.1% and 0.3% depending on study, estimated value average of 14%. The misinformation campaign has been global.

I'm not saying something as simple as "vaccines are bad" - although COVID vaccines specifically could well be for younger age ranges, where disease risk is so low that it would require an astonishingly weak sauce to avoid tipping the cost/benefit balance negative. But the actual argument is that we don't really know any of these things with the level of rigor that should be required for a forced global vaccination programme. Literally all the data is either wrong or hopelessly confounded, and scientists are not only mostly ignoring these problems but doubling down on them by insisting that analyses of side effect databases are illegitimate because they're "correlational" (which is a bogus argument but apparently enough to repeatedly get such papers retracted).

I'm not blaming anyone. I'm not even saying we need mandates. All I'm saying is that the numbers I've seen very strongly suggest that if 'all' would be vaccinated, we'd see a lot less pressure on health care, which during the last peak was where we hit the wall. I see that as an argument for mandates, not that it outweighs the arguments against.

Vaccines don't seem to reduce spread and this conclusion - which you could find on blogs long before it was officially admitted - is now the position of e.g. the UK official vaccination committee. In fact they're now arguing that the vaccines were never even designed to do that in the first place, although it would have been good if they'd said that before vaccine passports were invented.

Here's a summary of an paywalled interview in the Telegraph with former Vaccine Taskforce chief Clive Dix:

https://dailysceptic.org/2021/12/14/vaccine-taskforce-ex-chi...

"The battle over Covid transmission was lost some time ago. I am afraid that the vaccines will not stop the spread of the virus in the short or medium term – but that is not a disaster. Indeed the vaccines were not designed to end transmission. It was evident to me at the time I helped with the procurement of doses, as interim chair of the Vaccine Taskforce, that the intention was to stop people from getting severely ill or dying."

"Given that young and healthy people not only have a very low chance of suffering severe Covid in the first place, but also already have substantial immunity from severe disease thanks to the first two jabs, I cannot see how boosting them is more valuable for public health than doubling our focus on the most vulnerable and cracking down on the backlog of chronically sick patients, such as those with hypertension, diabetes or even cancer."

Yes, that indeed is a very good point that I overlooked, I agree it weakens the case for (mandating) vaccinating minors even more.

Having said that, I've also seen graphs with 4 quadrants (vaccinated or not on both axis for the two persons involved in a transmission) where the transmission was clearly higher in the case neither were vaccinated. So I'm not sure if it does absolutely nothing for transmission, but at least not enough to be a strong argument in this discussion.

I think the issue may be time related. Immediately after a second shot there seems to be some effectiveness but it decays very fast, and can even go negative.

This sounds impossible but the UK data shows very clearly that once the vaccine wears off you're nearly 2.5x as likely to catch COVID than unvaccinated people are! This kind of negative effectiveness has happened before and immunologists know about the effect. They call it "original antigenic sin" and it refers to a type of imprinting effect, whereby the immune system misfires when presented with slightly mutated viruses by re-manufacturing the same antibodies it made before.

Thus, if you trick your immune system with a vaccine, it learns to fight whatever the vaccine was targeting but that's a now obsolete and extinct 2019 strain of the virus. Then you get hit with the new strains and the antibodies it makes aren't so effective anymore, creating a delay before the body realizes its mistake and spins up new antibodies (or sometimes it seems, it may never do this - gulp). This can cause negative VE when vaccinating against something that can mutate very quickly.

When you say "work" do you mean better than an absolute risk reduction for mortality and hospitalisation of say 2%? Because that doesn't sound like "working" to me, even completely ignoring the potential side effects of endless mandated boosters, which if you don't do makes it look even more ridiculous.

I'm not arguing for mandating anything. And note that boosters boost, they are not for maintenance. A lot of existing vaccins have a booster without it being 'endless'. If Covid-19 mutates enough we might need different vaccins yes, perhaps that's what you meant, but I don't think those are technically boosters.

With "work" I mean they get rid of a large percentage of mortality, hospitalisation and (a bit less certain) long haul covid. How big that absolute risk reduction is differs per person.

But more importantly: I don't see our society getting through Covid-19 in a humane manner without vaccins. Without vaccins, the IC's will flood, or we'd need (suffocating) measures and a lot of patience. But I'm ver much open to different ideas here.

Sure it varies, and the high number on ARR is 1.32 percent. (https://pubmed.ncbi.nlm.nih.gov/33652582/) I added a margin over that for safety and its still just not impressive.

As far as getting through this without vaccines that's not the question I asked. I asked in light of the data on the ground why are people still trying to push mandates. If people want to take these products with the efficacy rate and risk factors as they are knowing the manufacturers are wholly shielded from any and all liability that's one thing. The suggestion anyone ought to be forced to is entirely another.

I'm not really debating that ARR for hospitalisation (or worse) may be only a few percent on average, but the article you linked to doesn't help. If I understand it correctly they say: more people got infected (!) in the control group, but that's still a very low percentage of the entire group. Calculating the ARR in that case is only 'absolute' for the duration of the experiment right? That didn't age well at all, especially with newer variants, it's assumed most will eventually get infected, increasing the ARR. Then again de RRR for infection seems to drop by itself, which works the other way. So the conclusion of this paper is debatable at the least, and regardless it doesn't even cover what we were discussing, ARR for hospitalisation or worse.

I really was trying to answer your question regarding pushing mandates. Again I'm not saying I'm for them (here in the Netherlands we're staying away from mandates, for now at least). Individual efficacy (vs risk) is not the ONLY argument for mandates (actually I'd find that a less strong reason by itself even with a higher ARR), my argument would be the benefit for society as a whole. Sure, we should be able to make it through also without 100% vaccination rate, that's probably why mandates are less clearly on the table in places where it's high without mandates already.

> This is not the case with Covid, and people rarely if ever get Covid twice.

Beta, Delta and Omikron just called to disagree. In particular Omikron seems to be (speculative at this point!) spreading well amongst the previously infected in South Africa.

As a reference point, we are re-infected with the other endemic human corona viruses every 1.5-2 years.

Reinfections are possible but the symptoms are almost always mild. Just like with the other coronaviruses.

https://www.nejm.org/doi/full/10.1056/NEJMc2108120

Do you have any source for the claim that myocarditis is less severe after the vaccine than after infection? I was under the impression it was the opposite due to most infections remaining in the airways.

I guess I formulated it in a confusing way. I don't know whether myocarditis caused by vaccine is more or less severe vs. myocarditis caused by COVID-19.

What the article references is a report that 76% of vaccine-associated myocarditis events were described as mild [0].

> A total of 76% of cases of myocarditis were described as mild and 22% as intermediate; 1 case was associated with cardiogenic shock. After a median follow-up of 83 days after the onset of myocarditis, 1 patient had been readmitted to the hospital, and 1 had died of an unknown cause after discharge. Of 14 patients who had left ventricular dysfunction on echocardiography during admission, 10 still had such dysfunction at the time of hospital discharge. Of these patients, 5 underwent subsequent testing that revealed normal heart function.

We also know that long term effects of COVID-19 overall i.e. not only myocarditis are not always mild and can be debilitating even for people below 40, even after mild COVID-19. See my reply here: https://news.ycombinator.com/item?id=29564815

[0] https://www.nejm.org/doi/10.1056/NEJMoa2110737

The claim about 7-day periods is circular: in trials and other studies they tend to assume anything that happens 7 days afterwards isn't related to vaccines, so don't report them, so there's no evidence for anything happening more than 7 days after the vaccines, etc.

> We estimated an extra two (95% confidence interval (CI) 0, 3), one (95% CI 0, 2) and six (95% CI 2, 8) myocarditis events per 1 million people vaccinated with ChAdOx1, BNT162b2 and mRNA-1273, respectively, in the 28 days following a first dose and an extra ten (95% CI 7, 11) myocarditis events per 1 million vaccinated in the 28 days after a second dose of mRNA-1273. This compares with an extra 40 (95% CI 38, 41) myocarditis events per 1 million patients in the 28 days following a SARS-CoV-2 positive test.

The way I read it, they counted 2+1+6=9 incidences more for one dose, another 10 for two doses (total 19), compared to 40 more if you got Covid. So basically the vaccine decreased the incidence for the infected.

Milder and you are still several orders of magnitude less likely to die because you are protected from COVID.

Only with children age <15 the cost benefit ratio gets close.

Also you have to factor in the probability to catch Covid to begin with. Some say everybody will get it eventually, but I don't think it is a given. Or maybe when you get it, it could be a less severe strain by then.

Ontario, Canada suspended Moderna for 18-24, https://toronto.ctvnews.ca/ontario-recommends-pfizer-covid-1...

Germany, France, Finland, Sweden, Denmark and Norway suspended Moderna for people under 30, https://www.forbes.com/sites/roberthart/2021/11/10/germany-f...

Moderna contains 100 mcg of mRNA vs Pfizer's 30 mcg, https://www.theatlantic.com/health/archive/2021/10/pfizer-mo...

Are there clinical trials which mix and match vaccines, e.g. as boosters?

The Moderna booster is only 50ug RNA.

There is a whole bunch of trials now on mixing vaccines, but of course the number of specific combinations is very large. It does look like mixing works well, and there are some indications that mixing leads to a better response, this has been observed in particular for AZ/Biontech.

I got three different vaccines, following the recommendations at the time. So at least here in Germany we do freely mix them.

Same here, started with AZ, got BionTech second and the booster was Moderna. One of the good things right now is, that we have quite a large choice of vaccines at the moment.

> The Moderna booster is only 50ug RNA.

Could someone take this Moderna 50ug dose as their 1st/2nd shot?

Ask your doctor.

On of the troubles with anything unconventional is it probably won't be recognised on the various vaccine passes and the like.

Wouldn't mixing significantly reduce your chance at legal recourse should you have a severe reaction?

Lawsuits against who?

The vaccine producers already have immunity.

So that leaves you to sue the local authorities, so if they recommended mix-and-match you have cover.

> Are there clinical trials which mix and match vaccines, e.g. as boosters?

https://yourlocalepidemiologist.substack.com/p/mixing-vaccin...

>Are there clinical trials which mix and match vaccines, e.g. as boosters?

Why do clinical trials when you can do live trials for free. Just wait a few month and look at the situation in France.

France bought a huge stock of Moderna but people there only want Pfizer, so now they have a huge stock of Moderna and a shortage of Pfizer. So to re-balance their inventory they decided that people over 30 can no longer have the choice of what vaccine they get.

And they have also recently speed-up vaccination effort by requiring to have a less than 7 month injection/contamination after January the 15th or be severely constrained in daily life. So in about two months, you'll have a huge influx of guinea pigs data.

So if you just turned 30 and never vaccinated you are up for the Moderna huge dose that they tell you they consider not safe for people a few days younger than you are, (and the dosage was probably too heavy because it has now been reduced for the boosters).

Thanks for the field report. Wish we could organize a open-source data collection exercise for live trials and input parameters with regional/policy path dependence. That could enable retroactive analysis across inadvertent cohorts.

It's astonishing that the majority of people can look at this situation and not recoil.

The whole "mix and match" narrative is just so misguided.

I do wonder if it's being pushed as a way to dilute possible lawsuits.

Random choices, permutations and timing of vendors will make it difficult to determine cause and effect. No control groups. If there are future adverse events, they may be attributed to a specific human rather than a cohort of peers.

This could justify more observational surveillance and testing, laying the groundwork for future personalized treatments, including unique vaccines. In that hypothetical scenario, rare injuries could lead to more live trials on those humans.

Given the CDC projected that more than 146 million estimated total infections of Americans with 1 in 4.0 (95% UI* 3.4 – 4.7) COVID–19 infections reported[1] I think the fraction of those vaccinated and developing myocarditis is even larger than the study shows vs. those who have had COVID and not in the 1 in 4.0 figure above (the other 3/4). That peak of myocarditis in the vaccinated would be even more lonelier at the top of the bar chart! The vaccines were first hopefully going to prevent the spread, remember that? Now we know they don't. They prevent serious illness and hospitalizations, however, as someone who had COVID, is unvaccinated, but is relegated to getting tested weekly and wearing a mask, while the vaccinated, who can spread infection as much as I could, is a travesty of fairness. My very healthy nephew developed myocarditis for 6 weeks a few days after getting vaccinated. My colleague at work twenty years younger than me, healthy, with two vaccinations less than a month old, developed a "break through" infection - what does that even mean anymore? He has had unusually high blood pressure for weeks after his infection. Then he just went and got boosted yesterday! There is no long-term, RCT studies, and the original control groups have been eliminated. Yeah, so test the guy every week with natural immunity and ignore that natural immunity because Fauci, the CDC, and big tech tell you to. Everyone is getting fed up. And now NYS passes mandatory masking again for adults, never mind, we have been forcing the least vulnerable, our children to mask up at school 6 hours a day. Don't tell me kids 11 and younger are at any significant risk unless of course they have a BMI over 35 and diabetes or another comorbidity. I hope the scientists of this Nature article aren't beat down by those who profess "Follow the Science" as they bury any narrative contrary to big pharma, big tech, and mainstream media.

[1] https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...

I think anyone considering a mandate with these numbers should be deeply ashamed of himself. Vaccinating children should be completely off the table in my opinion.

I agree. I am not vaccinating my healthy 2 year-old or 6 year-old child. There's no rational reason at this point. Vaccinated and boosted people can get the grandparents sick too. What has caught me off guard these past few years is tracking it all, until I stop and really pay attention. Given the vaccines don't stop the spread, although it's great that they prevent serious illness and hospitalization, and so many are vaccinated or have natural immunity like myself and my family, why all the panic, masking, and boosting still? Why are the least vulnerable, our young children, being masked all day at school, and now mandated to take vaccines in some states? It's almost criminal.

History will reveal this seemingly unavoidable folly in hindsight as a great mistake. The majority of serious illnesses and deaths are the elderly and them and others with comorbidities. There is the outlier young person who has no comorbidities, and is perfectly healthy, but it is a very, very small number. It seems a young male 24 years and younger should have the right to self-assess with their doctor on the risks of myocarditis vs. the 3.8e-5 benefits of getting vaccinated, and certainly not being mandated to be vaccinated. There is also a large number of people like myself who have had COVID, but unlike me they did not feel it enough to go get tested or treated. That will only serve to show how much more the risks are for vaccinated myocarditis. My antibodies are still sitting high a year after my infection and recovery at 116 (IgG), when > 15 is considered an indicative amount to give a positive on the test. I have not had a reinfection (that I have felt or know of), and yet I am forced to test weekly and wear a mask to keep my job. At least 10 people in a company of 150 at this location have had a noticeable infection (I refuse to call it a "break through" infection any longer, it no longer make sense). These 10 all had at least 2 shots, mainly Pfizer, and 4 had boosters! I know SARS-COV-1 from 2003 is in the family, but a different animal, however, they are still testing SARS-COV-1 recovered people from 18 years ago who still have immunity in their T-cells![1]

Will we ever learn (or Fauci from his 80s AIDS/AZT fiasco [1.1] (I was in my twenties in BKLYN)to now with the COVID crisis), or is natural immunity thrown overboard for the sake of not discouraging vaccinations, which is cruel from my perspective, and now we know this will not stop the spread anyway, so I wage my natural immunity against anyone's 2 vaccines, and I spot you two more boosters ;) Yes, I know the company line is at least one vaccine and natural immunity gives you super immunity. I don't believe it outweighs the risks for me. One of the people of the 10 mentioned above had a horrible bout of COVID after 2 shots and a booster, and he's 20 years younger than me. I don't drink or smoke. I used to exercise daily (BMI 25), but I have since put on a few pounds (BMI 29) switching from manual work at 40% if the time to office work 60% of the time, to almost 95% office work now and COVID comfort food. A lot of the people under 55 that have had serious illness or died had comorbidities such as obesity and/or diabetes and others. Look for yourself on the CDC website. Download and filter by age and comorbidities or not. You will see that this is being buried. Fat shaming etc. I also read an interesting statistical study that said of the vulnerable that died, if COVID had not accelerated it, the flu or pneumonia would have, and they statistically were likely to die within 2 years of their age given their age and pre-existing comorbidities. Temper the 800,000 US deaths with that number and see how bad you think it is after doing some research. Let that sink in. Look at the UK's NHS site for number of people who died within 28 days of their first positive test for COVID-19 [2]. It's sad but their site and they way they present data is so much better than the CDC's site. We focus so much on number of cases here, and it's hard to put together nice comparisons on the CDC site without downloading the CSV data files and doing it yourself.

We live with SARS-COV-1 and MERS, so let's get back to normal. America needs to address its obesity, diabetes, and other health issues if you really want to save more lives or have something to panic about. I am an American BTW.

[1] https://www.nature.com/articles/s41586-020-2550-z

[1.1] https://aep.lib.rochester.edu/node/49111

[2] https://coronavirus.data.gov.uk/details/deaths?areaType=nati...

Australia has been reporting 1 in 10000 rate for myocarditis in 11-17 year olds and is ramping up their campaign to get more high school kids vaccinated.

Table 2: https://www.tga.gov.au/periodic/covid-19-vaccine-weekly-safe...

The article linked in another reply (https://toronto.ctvnews.ca/ontario-recommends-pfizer-covid-1...) for Canada suggested they stopped the Moderna Vaccines at a rate of 1 in 28000.

I wonder, what rates determine when action is taken?

When the rates become higher than for the virus itself.

Ideally yes. But keep in mind that many effect (both of the virus and the vaccines) are still not taken into account. Doing that would mean this exact point would move almost constantly, which would be good imho, but I can imagine this does not fly in general.

Keep in mind the covid-19 has a myocarditis rate of 1 in 25000 according to this same study. 4x higher than with the second dose of an mRNA vaccine. On the basis of that alone, you're better off taking your chances on the vaccine - and that's not counting all the other risks that come with a covid infection - including death.

Undeniable ratio of benefit albeit one that doesn’t necessarily bode well for the six monthly booster subscription necessary in absence of airborne transmission interrupting NPIs.

>doesn’t necessarily bode well for the six monthly booster subscription necessary in absence of airborne transmission interrupting NPIs.

Especially considering that the current booster shots are proven to be quite ineffective against the Delta and even less against the current Omicron mutation. Seemingly all of the risk, with none of the benefit.

>Especially considering that the current booster shots are proven to be quite ineffective against the Delta and even less against the current Omicron mutation. Seemingly all of the risk, with none of the benefit.

Quite the opposite. The study in South Africa showed a 70% protection against hospitalisation from Omicron, the level is even higher for Delta.

Please check the charts at the last lage of this document https://www.medrxiv.org/content/10.1101/2021.12.04.21267114v...

It seems that three doses can drop down your risk of infection below what being previously infected with covid, or even being infected and then vaccinated with two doses can provide.

I think we made a great mistake by not making this vaccine 3 doses from the start.

That's also not counting all the other risks that come with vaccination - including death.

Also that individuals have variable probability of exposure to and infection with the virus, which may be very low, while vaccination carries a 100% 'probability'.

Also that one may reasonably expect to commit to many vaccinations. Australia, where I am, has already financially committed to more than 9 per capita - if they're buying them, I expect they expect to be using them. That's a lot of rolls of the dice.

> which may be very low

Looking at the sewage data around here, your low is about 100% as well. There is no place in my country without any exposure so it's just a matter of time.

Covid-19 has higher rates of death than vaccines too. It’s also highly transmissible. The probability of exposure is very high unless someone is isolating themselves from society entirely.

> That's also not counting all the other risks that come with vaccination - including death.

All of which are one or more orders of magnitude higher [edit s/than/with] with the virus according to the data, which is excellent now that there are over 6.3 billion vaccine doses administered worldwide.

> Also that individuals have variable probability of exposure to and infection with the virus, which may be very low, while vaccination carries a 100% 'probability'.

Covid is not going anywhere. Over time the probability of being exposed to it approaches 1. The only question is do you want to be vaccinated when that happens?

> All of which are one or more orders of magnitude higher than the virus according to the data

I assume you mean lower.

Yes, thank you

Interesting how you completely ignore the risk of an corona infection and totally underestimates the infection risk. The virus will become endemic so the infection risk is near to 100%. Additonally the virus is neurotrope so late effects are possible.

How is 1:25000 4x higher than 1:10000? Isn't it 2.5x less likely? I guess the parent is referring to this piece of data: 8-12 cases per 100,000 doses.

The 1:10000 number is reported by Australia, for young men only, during the first 7 days, characterized as higher than the average. The 1:25000 number is from the study on the general population.

Indeed and the context is vaccination for high school kids. I mean, if they are observing some outliers maybe that should be investigated first rather than brushed aside?

The 1:10000 number is not from this study. The highest number in this study was 1:100,000.

>On the basis of that alone, you're better off taking your chances on the vaccine

Is it though? I may not be infected by covid and not be subjected to the risk, but if I get the vaccine then I'm definitely subjecting myself to the risk.

x * (1/25000) vs 1.0 * (1/100000)

If the probability of catching covid (x) is less than 25% then the risk of myocarditis would be greater from the vaccine, no?

Edit: what happens when you get the vaccine and then get covid? Do the current figures include that?

Given that COVID seems to be on the path to be endemic, you should consider X to be close to 100%.

Given the booster programs currently being recommended in Australia, it is entirely possible that I will be getting 3x vaccine doses before being exposed to COVID. 25% chance of getting myocarditis would make the risk comparable to normal COVID for me.

And that is assuming the vaccine is highly effective. There do seem to be questions about that, given the ongoing mutation and variants. I'd still rather get vaccinated, but I do question whether people are being obstinate about seriously discussing the pro- and con- on this topic.

It's a little bit more complicated. The severity of the mycarditis from the vaccines and corona differ.

It is true that you might not get Covid-19 any time soon. But depending on where you live the chances might be quite high in the next months. At least that is the conclusion I draw for myself, living in Germany, considering the likely immunity evading behavior of the omicron variant, its growth rate in other countries, and the unwillingness of a lot of people to follow simple hygiene rules and social distancing.

I haven't seen any evidence so far that this thing won't stick around forever, so personally, I'd estimate anyone's chances of never being infected with SARS-COV-2 to be virtually zero.

But that's assuming all strains have the same risk.

Exposure to the virus does not automatically result in developing COVID-19 (the disease). In a healthy person, the innate immune system will neutralize the virus in the mucosal membranes of the nose.

Eventually, most everyone will be exposed. Not everyone will become sick.

However, the odds of being infected with SARS-COV-2 every 6 months forever would most likely be virtually zero.

People act like it’s a dichotomy, either covid or the vaccine. The risk assessment should be made considering waning immunity, variants, etc. But no one can call this out without being censored for being anti vax. This is a dangerous precedent we are opening.

Waning immunity is overblown, and while variants might somewhat evade both natural immunity and vaccine immunity, that risk doesn't change the calculus around whether to protect yourself now against the known variants.

These are really anti-vax talking points, attempts to justify an anti-vax position. They're not imaginary concerns, but they also don't justify the former.

I always support talking about things transparently without censorship, period. But at the same time I acknowledge there's a lot of misinformation out there and most people are unable to distinguish what is important and relevant from what is not. Including myself.

If you assume that you won't ever get covid, you might assume you'll never get any cold or flu in your life, even asymptomatic ones.

It's not a good assumption unless you are planning to die in about a year for some other reasons.

Thing is there are many 'colds' and 'flus' and the chance the catch a specific one may isn't that likely depending on where and how you live.

Does that change anything? Covid is as contagious as any of them and all of them and immunity people gain against covid dimnishes in the matter of months. After few years it may drop to near zero as it is in the case of some other cold viruses.

Sure, but EU countries are now discussing limiting the duration of the covid passport to 9 months already. That would mean, at a minimum, an extra shot every 9 months.

So, here's the worldwide cumulative prevalence of COVID:

https://ourworldindata.org/grapher/cumulative-covid-cases-re...

Assuming a world population of 7.75 billion, that puts the estimated prevalence at about 3.5%.

However, that's using confirmed cases. Estimates of actual cases would put it at 4-10 times higher (https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd... or https://www.npr.org/sections/health-shots/2021/02/06/9645278...).

So that puts it at 14-35%, right around 25%.

Although that's over the last 21 months or so, it means you're more likely than not going to be infected with it in the next few years.

Keep in mind that boosters are now considered only good for 6 months, so depending on your definition of “the next few years”, you may be exposed to many times more spike protein load via the vaccine route.

Anyways, I have no horse in this race, but I did notice some unusual chest tightness after my 3rd shot very recently - nothing serious though. I’m completely stress-free in life, so it’s not anxiety. Things have been great for me.

What is the death rate from COVID-19 for those younger than 40 and healthy that is with no underlying health issues such as immunodeficiency or diabetes?

Seriously asking, its like the modern web has thrown such a question into a kakfaesque hole.

That depends on many factors. To answer this question you have to consider at least the country you are leaving in. It also depends on your environment and the timing, e.g. when hospitals are overwhelmed by Covid cases, they might discharge a younger person to early from the hospital or don't look deep enough.

If you want to answer this question for your country look at the official government numbers, I assume the CDC has those numbers for the US, the RKI publishes these numbers for Germany, etc. A generic Google search will find the most attention seeking site claiming stuff mildly related to your question.

CDC equivalent does not publish the numbers of deaths without health-issues, we only see total deaths per age group.

Below 40, the official stats say 43 males have died of which are 6 boys below 19 years old. The population is about 10 million. What if those dead had underlying genetic diseases or diabetes or hypertension?

My attempt at googling this produces an abundance of answers. They are not the best answers, but they do give some good indications. Here is an ABS article that appears in second place on DuckDuckGo Aust [0]. If you want really solid numbers I suggest you look for research papers. Here is one based on Melbourne’s first wave which we have basically complete information on [1].

In conclusion, its not particularly hard to find this data with a few searches on your favourite search engine.

0. https://www.abs.gov.au/articles/covid-19-mortality-1 1. https://bmcmedresmethodol.biomedcentral.com/articles/10.1186...

One still has to look through the numbers to see 74% of deaths have underlying issues and connect the dots to "per-age-group" and still interpolate some numbers from that instead of actual statistics on "per age group healthy deaths".

In the data you linked to, the age group 0-59 15 people died, lets say the 74% number which is from all ages, that makes 4 where healthy.

Death rate is very low for that age, but I believe "long COVID" rates could be 20% or more - which might severely restrict your life for many months.

Vaccines dont prevent long-covid either, my wife had 2 shots of Moderna and not even 4th month in she lost sense of smell and has still not recovered it 2 months later.

What is the percentage of people who fit that description? I'm concerned that the subtext here is that if Bruce Wayne would likely shrug off Covid, we shouldn't worry about it. But the vast majority of us aren't Bruce Wayne.

Fully a third of Americans are obese, for instance. And why is 40 the cutoff anyway? That's half the population right there. So already you've excluded two thirds of Americans, right from the get-go.

And what percentage of "underlying health issues" are undiagnosed and asymptomatic until a severe challenge comes along - like a heart murmur? It's all very well saying "well I don't have any underlying conditions", but do you really know that?

It's about 1 in 10000-30000.

That is 33-100 micromorts. You can use this unit to compare with other activities (higher value is more lethal).

Base jumping is 400 micromorts.

https://en.m.wikipedia.org/wiki/Micromort

> you're better off taking your chances on the vaccine

I hate this kind of advice. It is like nutritional advice. "eat less omega 6", etc. None of it applies to any one person. What if I don't interact with humans and live on an island? What if I am a certain age, etc.

If you live on an island in complete isolation chances are you wouldn’t care too much about general recommendations intended for the majority.

I'd say you're missing the forest for the trees. You'd be hard pressed to come up with a realistic scenario where I would advise you that your odds are indeed better without the vaccine.

I am genuinely curious, if you've had Covid, should you get vaccination? The official source says:

"Cases of reinfection with COVID-19 have been reported, but remain rare." https://www.cdc.gov/coronavirus/2019-ncov/your-health/reinfe...

So, why is there a need for boosters? And why is there a need for the vaccination if you already had it?

It seems that you should. Check out the chart at the last page of this PDF.

https://www.medrxiv.org/content/10.1101/2021.12.04.21267114v...

When I look at that paper and compute for the age group 40-59 I come up with these normalized values:

         infection   severe covid

rec 0.614 0.007

boost 0.253 0.002

vacc 2.272 0.014

rec+vacc 0.271 0.006

(No idea how to do a pretty table)

Those are normalized values per person-month-at-risk according to whatever definition they use. I don't know if those numbers are high or low in an absolute sense but they should be comparable across rows. They separate the categories of recovered then vaxxed and vaxxed then recovered but I've combined them in sum here because vaxxed then recovered is quite a low statistics. Perhaps this shouldn't be done but the low statistics also would only impact the conclusion in more of a positive direction. That conclusion is, in the case of a recovered person they were 2-3x less likely to get infected if they went to get a shot after recovery than if they didn't. But protection against severe covid didn't really get impacted.

An animal study indicated that most cases of myocarditis associated with COVID-19 vaccination could be caused by incorrect injection technique. So the issue is not with the vaccine per se, but with injecting it into a vein instead of a muscle. This research hasn't been reproduced in humans though, so there could be something else going on.

https://www.10news.com/news/in-depth/in-depth-can-a-simple-t...

Finally, some real information.. Three points of note:

1) The number of Covid infections is likely either over-reported or under-reported. That could push the results in either direction.

2) The end results are an average of men and women; if separated they would show men are more susceptible to myocarditis (higher than 15 per million for <40 in Moderna's case).

3) We don't know how boosters will affect these rates.

How can COVID infections be over reported? They are obviously underreported in the total population due to the limitations of testing. Is the over-reporting risk a matter of how they adjusted their data in this study?

I could see it happening if your data source works of raw test result statistics, since you don't know how often the same person was tested. But that doesn't sound like it is the case here, since they reference a specific database they use "at individual patient level".

I think its a mute point anyway, excess deaths are hard to argue statistic. Also hard to explain with any other means than Covid.

Interesting point you're making about excess deaths being hard to argue. Have you looked at the data? Because some countries don't show any significant excess (some even record negative excess during the pandemic) while in some other places we're only seeing access deaths since mass vaccination started. Conveniently, many who want to argue that covid vaccines help only pick places where the data seems to show what they want to see, ignoring all the opposite examples and that correlation doesn't imply causation.

Age group 30-39 has higher risk from pfizer than positive covid-19 test, if Im reading this table correctly, https://www.nature.com/articles/s41591-021-01630-0/tables/1 ouch.

And with moderna, 16-29 agegroup risk is 41.4 with vaccine vs 24.4 covid. Wow.

But the TL;DR says "take the vaccine its better than covid". Statistics and damn lies.

Edit: See comment below, I put the wrong column in. It's still dozens of deaths per case of myocarditis (just not as many dozens).

Prior to vaccination being widespread, in the UK, deaths among 30-39 year olds were 185 per 100,000.

So dozens of deaths for each case of vaccine induced myocarditis.

https://www.gov.uk/government/publications/covid-19-reported...

That's total deaths, not the death rate, which was 28.9 per 100,000.

See the sister comment; it seems you (and others) are not reading this chart correctly: https://news.ycombinator.com/item?id=29564488

Table 1, which your comment currently links, does not show any information about risks, it is the baseline characteristics of the study population.

The percents are the portion of the demographic that the row represents.

So for example, when first dose of Pfizer is broken down by age, 36.4% of the participants were 30-39.

How do they know how many cases of myocarditis should be in unvaccinated people that didn't contract covid? They don't measure that themselves.

1) There was a hypothesis (reddit comment, not medical) that a degree of myocarditis might be due to people not resting for the few days after vaccination - especially young men and kids, ignoring very mild fatigue/symptoms to play sport or do physical labouring the next day - overly stressing the heart.

2) I'm surprised the dosage for moderna hasn't been reduced to 50 mcg for first and second doses (especially for young men) since it seems to provide similar protection to the full 100mcg doses: https://www.sciencedirect.com/science/article/pii/S0264410X2...

3) I'd wager we end up with more frequent, smaller doses as this goes on. Moderna at 25 mcg was shown to have some protective effect, note however pfizer didn't reach marginal gains in antibody response, with dosages instead being limited by side-effects, but still had some effect at even 1 mcg (standard dose 30 mcg) https://www.nature.com/articles/s41586-020-2814-7

4) A longer series of smaller doses might be preferable for the vaccine hesitant also - if you start getting noteworthy side-effects then you can terminate the programme.

tl;dr: " Subgroup analyses by age showed that the increased risk of events associated with the two mRNA vaccines was present only in those aged under 40 years. For this age group, we estimated 2 (95% CI 1, 3) and 8 (95%CI 4, 9) excess cases of myocarditis per 1 million people receiving a first dose of BNT162b2 and mRNA-1273, respectively, and 3 (95% CI 2, 4) and 15 (95%CI 12, 16) excess cases of myocarditis per 1 million people receiving a second dose of BNT162b2 and mRNA-1273, respectively. This compares with ten (95% CI 7, 11) extra cases of myocarditis following a SARS-CoV-2 positive test in those aged under 40 years."

"Vaccination for SARS-CoV-2 in adults was associated with a small increase in the risk of myocarditis within a week of receiving the first dose of both adenovirus and mRNA vaccines, and after the second dose of both mRNA vaccines. By contrast, SARS-CoV-2 infection was associated with a substantial increase in the risk of hospitalization or death from myocarditis, pericarditis and cardiac arrhythmia."

tl;dr hospital cases of myocarditis per million 28 days after:

Astra 2

Pfizer 1

Moderna 6

Covid 40

Now be a good sport and post the numbers per age group for males

Doesn't the COVID number contain people who vaccinated (only) once?

Aren't most responses not addressing the point of that study? I understand the abstract to say that the likelyhood of heart conditions due to contracting Covid is higher than due to vaccination?

Something else to consider which hasn't been addresses in any studies so far is does the risk of myocarditis change depending on the variant of covid - it's possible omicron is more or less likely to cause it dues to wide range of mutations.

This will obviously impact the risk/reward in younger cohorts

I can't figure out what the study found. Is the vaccinated group more likely to develop heart problems?

How did they calculate that? What do they take as a baseline for myocarditis?

I cant find anywhere any information that they measured how many myocarditis occurences were in people who were not vaccinated and didn't contract covid.

The study was “self-controlled”. That is, individuals before being exposed to vaccine/covid were their own controls. This is a fairly robust technique if done right. You automatically avoid issues of your controls having different attributes to your test group. But obviously if your whole cohort is a year older after being exposed then the risk of myocarditis is higher purely based on the risk factor of age.

Interesting technique.

I'm still not very convinced by this research.

That myocarditis is so rare and the increase is so small. People might have changed their behavior in 28 days after getting the vaccine. Younger people especially. They might have started to expose themselves to other people more which might lead to them getting in contact with myriad of other mild viruses that might carry unknown risk of myocarditis.

On the, er, spicier ends of Telegram people have been keeping logs of football (soccer) players that have been having heart issues recently. There have also been stories about people having heart issues due to "post-pandemic stress disorder" [1]

I'm not saying that I think the vaccine causes heart issues, but I definitely think governments wouldn't tell you the truth if it did.

[1] https://www.standard.co.uk/news/health/post-pandemic-stress-...

I'd be super interested in the data on this - breaking down these pro athlete issues by

- who's vaccinated and hasn't had a positive PCR test

- who's vaccinated and has had a positive PCR test

- who's unvaccinated

Until that is clear, all these stories are basically clickbait. These issues could be caused by covid, the vaccines, or both. We just don't know.

> but I definitely think governments wouldn't tell you the truth if it did

Think a bit more about this. How many countries, how many people, how many hospitals you would have to silence to make that happen.

Also with respect to the football player. As far as I can tell it's been going around quite long and people are just noticing it more due to some highly televised event.

You don’t really need to silence them. Just ignore them and relegate them to the fringes. “What? More and more people are having heart issues after vaccination? Hogwash! It’s post pandemic stress, nothing special, you’re just being a conspiracy theorist! And we all know conspiracy theorist is just one step away from far right and we don’t listen to nazis here”.

Sounds familiar?

They can say all that. The old adage about how to tell if a politician is lying - if their lips are moving - applies.

But the data cannot simply be hand-waved away by politicians, nor easily controlled in the West. Look at what medical experts say when they publish analysis about the data - and you get as near to the truth as you can reasonably hope.

I could imagine a world where no respectable journal would publish a conspiracy theory like 'the vaccine is worse than covid for under-25 males', and no respectable academic would touch the question because it's too radioactive. Academia is politicized. We've already had plenty of cases of medical academics getting hounded off e.g. twitter for supporting non-mainstream positions, questioning vaccine rollout timelines, or entertaining the lab leak.

This happens, it happened with the lab leak hypothesis. It's believable.

I don't believe it to be happening here though. I've not seen any evidence for that. There are plenty of papers examining everything from vaccine rollout strategy, mixing vaccines, dose spacing, side effects for all age groups, etc.

Currently, I am only aware of one football player with unusual health problems: Kimmich, a German national player with Bayern München. He said on TV he has doubts about possible long term effects of the vaccines against. He contracted Sars-COV II. He tests negative now, but still has lung problems and cannot play. [1] Hmm, perhaps he should have considered the risks of an infection as well.

[1]: https://www.sueddeutsche.de/sport/fc-bayern-kimmich-corona-l...

Funny enough, I was just reading about Aguero:

https://www.bbc.co.uk/sport/football/59660727

Christian Eriksen, Sergio Aguero, John Fleck, Charlie Wyke, Adam Traore have all had heart issues (and vaccine reasons discounted apparently).

>> Think a bit more about this. How many countries, how many people, how many hospitals you would have to silence to make that happen.

I'm generally with you on this point - governments just generally aren't that competent to EG fake the moon landings. However, I do look at how the narrative over the COVID 19 lab leak theory has changed from "You are racist and cancelled for even saying it" to "This sounds at least possible, if not probable."

So I don't think (if it were the case vaccines had harmful side effects) that it would stay secret forever, but it might stay secret long enough for people to take the vaccines.

///edit// Also this doesn't encourage confidence:

Wait what? FDA wants 55 years to process FOIA request over vaccine data

https://www.reuters.com/legal/government/wait-what-fda-wants...

There doesn't even have to be a big government conspiracy, the whole thing is politicized enough that most people are either scared to speak up and/or convinced of things no matter the data. For example I personally know of two serious cases of completely healthy people falling ill days after the vaccination. One died and one was in hospital for over 2 weeks with heart inflammation. Both did not get investigated for the possible vaccine connection.

In my extended circle of acquaintances, below the age of 40, there have been so far 0 covid deaths (no hospitalizations either, some claim it was a very unpleasant disease).

One died shortly after his vaccination. He developed high fever and after a few days his aorta bursted.

It’s just anecdotal data, I know.

Actually the article tells us the vaccins are probably causing heart issues. It's easy to take this line and shove it into a tweet but then you would ignore this part:

We found increased risks of myocarditis associated with the first dose of ChAdOx1 and BNT162b2 vaccines and the first and second doses of the mRNA-1273 vaccine over the 1–28 days postvaccination period, and after a SARS-CoV-2 positive test. We estimated an extra two (95% confidence interval (CI) 0, 3), one (95% CI 0, 2) and six (95% CI 2, 8) myocarditis events per 1 million people vaccinated with ChAdOx1, BNT162b2 and mRNA-1273, respectively, in the 28 days following a first dose and an extra ten (95% CI 7, 11) myocarditis events per 1 million vaccinated in the 28 days after a second dose of mRNA-1273. This compares with an extra 40 (95% CI 38, 41) myocarditis events per 1 million patients in the 28 days following a SARS-CoV-2 positive test. We also observed increased risks of pericarditis and cardiac arrhythmias following a positive SARS-CoV-2 test. Similar associations were not observed with any of the COVID-19 vaccines, apart from an increased risk of arrhythmia following a second dose of mRNA-1273. Subgroup analyses by age showed the increased risk of myocarditis associated with the two mRNA vaccines was present only in those younger than 40.

Which is a tough read and far more subtle. The downsides of the vaccines need to be constantly weighed against the downsides of contracting Covid19 un-vaccinated. And this is different for different age groups (and very probably ethnicity, BMI, etc).

I bet people will take single lines from this article and shove them into tweets which shows exactly how harmful that can be, it does only one thing: Polarize. The truth is complex and you can't tell people to please refrain from commenting if you don't understand the concept of confidence intervals, for example.

I've been trying to stress this to friends on both sides, some (the minority) are angry that the government and (former) friends feel that they are obliged to inject themselves with a substance they don't understand, and some are angry that you can be so selfish that you don't want to join everyone in the only collective effort we have to beat that damn Covid19. Both want to die thinking "I did it my way". Both are primarily angry these days. What a shame.

I like this admission from the scientists, I think we can all get behind that:

By the end of September 2021, more than 6.3 billion doses of COVID-19 vaccination had been administered worldwide1. Clinical trials of COVID-19 vaccines were underpowered to detect the rare adverse events that are important for risk–benefit evaluations and to inform clinical practice postvaccination. Therefore, identifying such rare adverse events is now a global scientific priority.

You're commenting on a government sponsored study about the vaccine causing heart issues. Are you sure you want to repeat that conspiracy theory?

Summary.

>We estimated extra myocarditis events to be between 1 and 10 per million persons in the month following vaccination, which was substantially lower than the 40 extra events per million persons observed following SARS-CoV-2 infection.

Vaccination reduces the risk of myocarditis relative to not getting vaccine.

(risk increased only among those younger than 40).

> Vaccination increases the risk of myocarditis.

Relative to the base-level in a pre-covid world?

adjusted for calendar time from 1 December 2020 to 24 August 2021

Yes. According to this same study covid-19 has a 4x higher incidence of myocarditis than the "worst" of the mRNA vaccines. So the smart bet is still get the vaccine. That's not even accounting for all the other effects of a covid illness, including death.

I think there's a misunderstanding. funklute was asking about the pre-covid world, but your answer is about people who have covid.

>Vaccination reduces the risk of myocarditis relative to not getting vaccine.

only when covid gets to 25% of population. Until that the vaccine results in higher risk of myocarditis than covid. And if we use cut-off of 40 years age, then the risk is even more worse with vaccine.

Covid-19 will get to 25% of the population. It’s nearly there in many countries. The UK had 11 million confirmed cases for a 66 million population. Germany is comparatively good with 6 million confirmed on an 80 million population. Both is severely undercounting, as it doesn’t include asymptomatic cases and people that did not get tested.

Covid will sooner or later infect everyone, likely even people that are vaccinated. The entire goal of the vaccination campaign is to slow and manage the spread and to reduce the severity of the infection.

>The entire goal of the vaccination campaign is to slow and manage the spread

Looks like you're repeating some politicians' talking point without bothering to check it yourself - the existing vaccines have no noticeable effect on the spread:

https://www.nature.com/articles/d41586-021-02689-y

"Unfortunately, the vaccine’s beneficial effect on Delta transmission waned to almost negligible levels over time. In people infected 2 weeks after receiving the vaccine developed by the University of Oxford and AstraZeneca, both in the UK, the chance that an unvaccinated close contact would test positive was 57%, but 3 months later, that chance rose to 67%. The latter figure is on par with the likelihood that an unvaccinated person will spread the virus."

>In people infected

That's measure people who got the vaccine and then got infected. It's not factoring in how the vaccine reduces infections.

>It's not factoring in how the vaccine reduces infections.

The existing covid vaccines don't really reduce infections. Vaccinated chances of getting infected is about 1/3rd that of unvaccinated if one looks at the official numbers of infections at those places where such numbers are available. Giving that vaccine decreases the symptoms it is natural to expect that all those hordes of asymptomatic vaccinated virus spreaders aren't accounted for (CDC wouldn't count breakthrough until it is a hospitalization). The precise estimates of those unaccounted breakthrough is a wild guess, yet ballpark estimation (based on asymptomatic to symptomatic ratio for vaccinated which is much higher that that ratio for unvaccinated) brings vaccinated infection rate on par to that of unvaccinated.

Empirical proof seems to indicate that your theory is wrong. Look at the infection numbers in Israel for example how they track pretty well with their vaccination campaign.

yep, Israel is one of the data point i used:

https://www.science.org/content/article/grim-warning-israel-...

" Israel has among the world’s highest levels of vaccination for COVID-19, with 78% of those 12 and older fully vaccinated, the vast majority with the Pfizer vaccine. Yet the country is now logging one of the world’s highest infection rates, with nearly 650 new cases daily per million people. More than half are in fully vaccinated people"

more-than-half. Say 55%. 22% gets 45%, 78% gets 55%. I.e. the 1/3rd as i said.

Current incidence is about 50. Israel has been the first country to experience that the immunity from vaccination wanes after 6 month and had a severe peak. If you look at the development of the caseload over time, it tracks the initial vaccination campaign, rises after 6 month, falls after the booster campaign.

The vaccine loosing effectiveness and the occurrence of partially vaccine-evading variants have been predicted from the outset. The open question was always where and when that would happen.

Edit: references for the Israeli case load and development over time https://graphics.reuters.com/world-coronavirus-tracker-and-m... You can clearly identify the two peaks, about 6 month apart.

Total number of cases changes, yet for Delta the 1/3rd has been pretty much the same over time and over space (UK, Israel, Singapore, MA in US (they have good data)). For Omicron it seems much higher than the 1/3rd.

>The vaccine loosing effectiveness

it never been effective at controlling the spread. It was developed for Alpha and was obsoleted almost immediately by Delta.

>The precise estimates of those unaccounted breakthrough is a wild guess

Do you really need to wild guess? Couldn't you randomly test both vaccinated and unvaccinated people and see which group gets infected more often?

> Looks like you're repeating some politicians' talking point without bothering to check it yourself - the existing vaccines have no noticeable effect on the spread:

If you assume that everyone except you just repeats something some other party has said then I don’t think there’s much to discuss here.

I admit that I haven’t run studies myself, but I have read up what experts in virology and epidemiology have to say and I do have a bit of an understanding about how statics work. The studies you cite show the risk of spreading an infection once a person is infected and that’s the same or at least similar to what for both vaccinated and unvaccinated people. There was hope that vaccines would also reduce that risk, but they do not significantly, at least from what we know today. However, this only is one very small piece of the puzzle. To spread, the virus needs to infect a person in the first place - and that risk is significantly reduced, even for the latest variants that partially escape the vaccine. So getting vaccinated significantly reduces both your personal risk and the risk of becoming a spreader.

Over what time period? It seems pretty clear that covid is not going anywhere. Eventually almost everyone will get it. The only real question is do you want to be vaccinated when that happens to you. The answer is a no- brainer no matter how you look at the data. Which is why I'm surprised and saddened by how many people can't see that for one reason or another. As a programmer who lives and breathes logic, so often I find myself unable to relate to or understand how many people live their lives largely devoid of good logical reasoning. So much emotion and tribalism.

Family has died or almost died from this disease, and it was entirely preventable. Whenever you depart from the basis of reality, by being wrong about some aspect of it, there is always a price to be paid. At times I have paid this price and I really value careful and rational challenging of all my beliefs.

> Eventually almost everyone will get it.

Do you mean symptomatic Covid or just a positive PCR test?

Neither. An infection, which may or may not be symptomatic.

> The only real question is do you want to be vaccinated when that happens to you.

I don't really care. I haven't even had the flu yet and I am in my 40s. The question is also what state the virus will be in by the time it reaches any particular person (Omicron seems likely to be less severe than delta). and what that person's vaccination status will be at that time in terms of time since last booster etc. Also, vaccines seem to decrease in effectiveness with each booster shot over a certain number.

I had heart issues, still have shortness of breath and headaches after second dose. I have not reported it but I was close to calling ambulance one night. I lost faith in doctors here. They are laser focused on jabbing everything that moves and apparently they get £15 for each jabbed person. It's disgusting.

You should report it.

You can find the exact billing per vaccine from NHS, (was £12.57 end of last year) but keep in mind that goes to the doctor, nurse, admin staff handling bookings, disposables budget, and all costs related to running the clinic. Doctors see a small percentage of that. The same thing happens for most of GP services. You don't expect them to work for free, do you? For the NHS itself is still likely cheaper than what a meltdown of hospital services would cost.

I thought they are paid salary. Isn't giving jabs part of their job?

A lot are salaried, some aren't, there's a number of models active at the same time. But NHS still has the ability to give incentives for things that are a benefit to everyone, like paying extra for vaccinations, screening for preventable diseases, etc. to give them priority. Also extra pay allows some clinics to run out of hours / weekend vaccination.

"We found increased risks of myocarditis associated with the first dose of ChAdOx1 and BNT162b2 vaccines and the first and second doses of the mRNA-1273 vaccine over the 1–28 days postvaccination period, and after a SARS-CoV-2 positive test."

So the Pfizer gave me increased risk of heart inflammation. Thank you very much.

Read the summary again. Even the vaccine with the highest risk only had 1/4 of the risk of proper SARS-CoV-2.

Decreased* risk of heart inflammation compared to catching Covid without the vaccine.

It seems that the study doesn’t have a control group and everyone studied is _vaccinated_. I don’t know where you found your numbers about the unvaccinated.

This is incorrect. Most of the SARS-CoV-2 positive persons in the study (2,315,669/3,028,867) were unvaccinated at the time of infection.

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