Bozkurt, B., [et al.] Myocarditis With Covid-19 mRNA Vaccines (2021) | Hacker News Reader

Bozkurt, B., [et al.] Myocarditis With Covid-19 mRNA Vaccines (2021)

pubmed.ncbi.nlm.nih.gov

25 pointskfrzcode56 comments

I'm one of the people who've experienced this (exceptionally rare) side effect personally. I was hospitalized twice after my second Pfizer dose (in Australia). I'm still recovering. It sucked. It still sucks.

And I'm still very happy to be vaccinated. I do not at all regret my vaccination. The EV of a covid vaccine was, and is, hugely positive. I drive to work, I've run two marathons, and I've been scuba diving dozens of times. All are riskier, overall, than the vaccine.

Even if 100% of the ~12.6 in a million cases of myocarditis from the vaccine had resulted in death --- which, let's be very clear, they absolutely have not --- it would still be a risk worth taking. Your per year chances of dying from homicide in the US are 3-4 times as high.

If that side effect has 12.6 in a million odds, what are the odds of an active HN user experiencing it?

(153,057 active HN users * 12.6 events per million)/1,000,000 = 1.4*10^-8

This leads to a P value of approximately 0.0014, which is well below the 5% threshold.

This is a very crude calculation, but it does give an idea of what we can expect. Given the small P value, there’s a good chance that the HN community has experienced a similar event to the one described in the article.

Hold on, 2 million divided by 1 million equals 2, not 0.000000014. What am I missing?

0.153M * 12.6/1M = 1.9E-5

Your change of dying from the vaccine is very low, indeed.

But, if you have no comorbidity, your chance of dying from the covid is extremely low too...

You must also take this into account in your comparison

It looks likely that everyone who lives ten more years is going to encounter this virus at least once and there is a frequency of comorbidities first discovered at the morgue that needs to be considered by a "healthy" person.

Isn’t the risk of myocarditis an order of magnitude or two higher when contracting the virus?

Isn’t it then a matter of 12.6 in a million with the vaccine or 126 in a million when getting the virus?

Depends heavily on age/sex.

"Previously having covid" (which happens more than you'd think, and will undoubtedly continue to happen as time passes) counts as a comorbidity.

Consider that your risk of adverse reaction was higher than advertised: https://vinayprasadmdmph.substack.com/p/uk-now-reports-myoca...

(Depending on age/sex)

I don’t wanna sound mean at all but honestly, a this point I’m just sick of this trend of bragging about numbers and statistics ignoring completely that behind that “small percentage of people” there are guys like me who have been having a rough time with post vaccine heart related issues.

I get your point from a pure “analytical-cognitive-satisfaction” perspective. But in my case, I’ve been vaccinated with Moderna and I’ve been struggling with my heart for the last two months: Arrhythmia, pain in my chest, excessive strong beating even being sitting down in my sofa, short breath, tiredness even for the most simple physical efforts. I ignored all the symptoms assuming that was something psychosomatic due stress or what not (I even quit caffeine just in case). Two nights ago I woke up at 5 am because my heart was beating so strong and the pain in my chest was massive. I ran to the hospital.

I am a very healthy person: no smoke, sport all my life, take care of nutrition, 0 family related heart issues, took all the precautions for not getting covid nor spread it in case of being asymptomatic , take antigen tests twice per week etc And here I am, freaking praying for the results to be ok, knowing that if not, I’m on my own with the possibility of ending up with a faulty heart that worked like a charm before having to be vaccinated due to extorsion-like strategies from the government and gaslighting and half-truths from media.

So yes, I am sick of being treated like a number.

PS: Please, don’t take this as an attack by any means.

Lest I be labeled a plague rat of misinformation; I'm trying to ready proper studies on some of the supposed "vaccine injuries" that have been popping up. After the smear campaign that muffled Dr. Robert Malone, I discovered his website and substack which led me to this page:

https://www.rwmalonemd.com/references

That is a lot of NIH papers citing a lot of suspicious things!

In contrast I'm not able to find much to compare with other vaccines (this is because I don't have a nicely curated list to start from; nor are my journal-searching skills up to snuff).

One note: Pubmed is a public archive hosted by the National Library of Medicine. It doesn’t imply endorsement by NIH.

Thank you! ++

I had never heard of myocarditis until recently, but now I know three people with the condition, all recently vaccinated. I know that is anecdotal, but I am more afraid of heart problems than I am of covid at this point, so I will remain unvaccinated.

You're more likely to develop myocarditis from COVID than from the vaccine. So if you're more worried about heart problems than COVID, it still makes sense to get vaccinated. Pretend it's a vaccine against heart problems, and try not to think too much about where the heart problems came from.

> You're more likely to develop myocarditis from COVID than from the vaccine

Do we know this yet for omicron?

Nobody can make statements like that with any confidence, and I feel it's misleading and possibly dangerously misleading to claim that.

COVID and any/all possible symptoms are being searched for with the largest dragnet disease surveillance system in history. Millions of people are subject to essentially "random" COVID testing per day, and if any of them become positive, that triggers a chain of events that leads to huge quantities of research effort being directed towards them.

Myocarditis cases are being investigated only when people turn up at hospital saying "my heart hurts", and even then, there is enormous pressure on medics to not ascribe these cases to vaccination. There is no systematic survey of the population being done to detect these cases.

Thus it's not really possible to say how often myocarditis is being created by COVID vaccines in the general population. All the numbers being thrown around in this thread, like the top voted post, are ridiculous because they're assuming that both sides of the ratio are being discovered in equal proportions, which clearly cannot be true.

One of my own best friends took Moderna, which has a much higher risk of triggering myocarditis than COVID according to British data, even though nobody is looking for. Sure enough a couple of months later he experienced some sort of "heart event". I'm not sure it was quite a heart attack exactly but he experienced sudden extreme fatigue in which he had to lie down, a squeezing sensation in his chest and racing heart with skipped/irregular heartbeats. Whatever it was, he didn't report it or get it looked at.

That sounds like you described a heart attack. They aren't always fatal and many people have a heart attack without realizing that's what it was.

I was hoping nobody would say that :( I guess I should tell him.

Dying of Covid seems to be pretty brutal

If you're in the US, look into the J&J vaccine. It isn't an mRNA vaccine, and doesn't seem to have the myocarditis risk.

It also is quite a bit less effective.

You know 3 people that have confirmed, physician diagnosed myocarditis following vaccination? Or do you know 3 people who have "heart feel kinda weird, is this myocarditis"?

Hospital confirmed in two cases, physician confirmed in the other. Really scary stuff.

The important sentence:

> Despite rare cases of myocarditis, the benefit-risk assessment for COVID-19 vaccination shows a favorable balance for all age and sex groups; therefore, COVID-19 vaccination is recommended for everyone ≥12 years of age.

Except I get to make the risk assessment for myself not someone I've never met.

Legally speaking, that isn't true (at least not in the US).

Vaccine mandates (in general, regardless of today's SCOTUS decision) remain constitutional: https://en.wikipedia.org/wiki/Jacobson_v._Massachusetts

In fact, you are perfectly within your rights to elect a state government that requires vaccination for all citizens.

That case is only in reference to state government not federal. No where in the constitution does the federal government receive any kind of power remotely close to that. If my state enacted a mandate, I would move immediately. While I may agree that in some cases that the state has the right to do force one, it would only be in an extremely rare, last resort, literally everyone will die case. The government should always err on the side of liberty.

I won't presume your qualifications, but I'll just state my opinion: the people who are qualified to perform benefit risk assessments are the people writing papers saying that the benefit risk assessment is favourable.

You might be qualified to make that assessment. But you'd be in disagreement with most of your peers.

This statement should give you pause when the FDA has rejected the risk benefit assessments of the qualified advisory committees.

https://www.nbcnews.com/news/amp/rcna2074

https://www.rollcall.com/2021/11/17/fda-to-sidestep-advisers...

That was a narrow rejection based on incomplete evidence, as explained in the article. They were relying only on old U.S. data and still believed that the original 2 shots were adequate protection. This was in question at the time and subsequently there’s been a clear consensus that a booster is necessary at least until the original short timing is fixed, and, of course, that was before Omicron greatly increased the risk of exposure.

I don't think that a post-hoc justification is sufficient here. Policy makers didn't have advance knowledge that the scientific experts didn't. It may have worked out in this case, but what about the next? In particular, I am concerned about the risk assessments for the <5 population. Or perhaps the next drug\therapy. Looking abroad, you will also find cases where expert panels found questionable risk/benefit for some groups and were overruled.

Most of what I said was available at the time (not Omicron, of course). The US agencies chose not to take non-US data seriously, similarly to when the CDC acted like Delta would magically stop at the border after it was causing huge problems in the UK & India.

The original 2 shots still provide good protection. Whether that's "adequate" or not is entirely subjective and arbitrary.

I assume this is to peer pressure and other dynamics at this point. The benefit for young people is nearly not quantifiable.

Spoken like a true individual.

Vaccines optimally work if we don't, and instead think as a community.

Surely you must agree that there is some point where individual trumps community benefits?

The hard part is deciding when. It is extremely easy to postulate hypotheticals if utilitarianism has no limitations.

Yes sure, but you need to factor in the fact that you might be wrong and that the risk of being wrong can be disastrous for you and your family.

Let's put this another relatable way.

Despite rare cases of aircraft disasters, the benefit-risk assessment for air travel shows a favourable balance for all age and sex groups; therefore, air travel is recommended for everyone ≥12 years of age

When this comes to travel by car/road, the risk just shoots up many fold, yet nobody bats an eyelid to use cars, sometimes multiple times a day.

Right, but if we had an injection which fixed the car death rate, we damn well would take it.

I mean, we _do_; not traveling by car. And yet people who could take a bus/train, or just _walk_, feasibly, often do take a car. The risk of death from any given car journey vs the inconvenience just isn't high enough that this is a significant factor for most people.

(Though, people who take cars where they could walk are missing a trick here; in the long run the risks of this sort of sedentary lifestyle are much more of a risk than that of car accidents.)

If cars killed 800,000 people over the past few years and getting a shot vastly reduced the death people would get that shot without all the irrational resistance this shot has generated.

There is some preliminary evidence from an animal study that the myocarditis side effects aren't being caused by the vaccine per se but rather by bad injection technique.

https://pubmed.ncbi.nlm.nih.gov/34406358/

this is the "aspiration technique" thats being argued? ie inserting the needle, drawing back to see if there is blood and if there is finding a new location because finding blood indicates you have found a vein ?

This is standard procedure in many communities, I wonder why they seem to be pushing back on this. It seems like a good and harmless argument to me.

It is more painful, takes longer and needs trained personell. The risk when injecting a muscle is very low.

Some argued it would increase acceptance and reduce stress if aspiration wasn't used. I dislike this line of reasoning but can understand the overall decision.

Why is myocarditis more prevalent after the second mRNA vaccine dosage?

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

If this was merely application error, ought we expect this reaction to be equally probable after the first and second dosages, this isn't what the data suggests.

Why would the level of reaction from tissue exposed to a higher than intended dose of a novel protein be the same as its reaction to a higher dose of a protein it has been primed to react to?

myocarditis isn't instant, and while it typically presents within a week, given that there is a long tail, you would expect to see it more likely after the second dose. Furthermore, it could be that in some cases the first jab causes the myocarditis, but the second dose symptoms causes the myocarditis to become evident.

“You are not holding it right” kind of thing?

This possibility freaked me out a little:

> "molecular mimicry between the spike protein ... and self-antigens"

If a virus were to better mimic a self-antigen, does that imply that vaccines are unlikely to work without introducing some other harm?

Our ability to quickly engineer vaccines may have lulled us into a false sense of security. Imagine a replay of the last two years without an vaccines.

Off target autoimmune response has been discussed somewhat in the fringe literature, but is hard to find information on. We probably won't have an answer for many more years.

We do know that covid causes some pretty nasty autoimmune stuff.

Totally agree

It implies vaccines could cause auto-immune diseases. There was a paper with many case studies of this happening in real world patients discussed here a few days ago, so it's not theoretical.

https://news.ycombinator.com/item?id=29872308

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