Myocarditis Cases Reported After mRNA-Based Covid-19 Vaccination
jamanetwork.com
jamanetwork.com
Edit: this article says out of 192 405 448 people, 1626 had myocarditis, or about 0.0008%.
In contrast, the CDC estimates COVID has a 0.146% chance to give you myocarditis.
Personally I know someone who had a heart attack 3 day after second dose (60yo female) The doctor dismissed the possibility of a causation by the vaccine, this case is not reported even if the person almost died.
Is covid still worse than the vaccine with Omicron, I don’t know, probable. But I know that most side effect are not reported.
A crazy thing is that the Myocardis rate can be reduce 3X by a 2 second procedure at vaccination (verifying that the injection is not in a vein)
I'd remove that word. It's more uncommon to get symptomatic covid in vaccinated vs unvaccinated.
We still need to investigate whether myocarditis risks exceeds vaccine benefits in very young people.
Unvaccinated is two groups that are wildly different:
Those who've had Covid and those who haven't. Depending on where you are, unvaccinated may be majority share recovered, in which case this is an incorrect statement:
> It's more uncommon to get symptomatic covid in vaccinated vs unvaccinated.
"rates among unvaccinated persons with a previous COVID-19 diagnosis were 29-fold lower (95% CI = 25.0–33.1) than rates among unvaccinated persons without a previous COVID-19 diagnosis in California and 14.7-fold lower (95% CI = 12.6–16.9) in New York. Rates among vaccinated persons who had had COVID-19 were 32.5-fold lower (95% CI = 27.5–37.6) than rates among unvaccinated persons without a previous COVID-19 diagnosis in California and 19.8-fold lower (95% CI = 16.2–23.5) in New York."
Asking for a "significant" difference is just using weasel words to note that each individual post-Delta study is not powered to detect a difference with those very small slices and no metanalysis having been completed yet. Every single study has shown a point estimate difference that is consistent with vaccination conferring additional protection on those who have previously recovered.
> it would just reduce the error bars.
Significance is about the error bars. You are not using the term correctly.
The statement that you originally claimed to be incorrect remains true. It did not make any value judgments about whether a group is immune enough. It only made a factual claim that one group is less likely to get a symptomatic infection than another.
People need to understand COVID is not one thing. Delta was very different from alpha, omicron wildly different from Delta, etc… They all have spike proteins sure, but so does the vaxxx.
https://www.medrxiv.org/content/10.1101/2022.01.07.22268919v...
What this study does show is that with a booster shot you are offered significant immunity against COVID, including omicron. I'll take 50 or 60% over 0% any day of the week.
I am incredibly grateful for the vaccines, which have done (and continue to do) a tremendous amount of heavy lifting as far as global health and reducing severe illness and hospitalization is concerned, despite those who like to pretend that they are pretty much useless.
The confidence interval is between 10%-60% for the booster, oddly selective of you to pick the highest number. The FDA standard is to have at least 50% VE, with lower bound CI >30% for EUA.
What this study does show is that immunity is trending down and will likely hit 0 within a few months once the antibody response wanes. So yes, omicron does spread easily which is the original point I was contesting.
In addition to this it is well known now that for men under 40 the risk of myocarditis from the vaccine outweighs the risk from the virus: https://vinayprasadmdmph.substack.com/p/uk-now-reports-myoca...
“We esti- mated 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.”
Vaccine = +2-10 myocarditis events
COVID infection = +40 myocarditis events
And…
“the increased risk of myocarditis associated with the two mRNA vaccines was present only in those younger than 40.”
I don’t see how you justify saying that the vaccine risk outweighs the risk form infection. That increase in myocarditis from vaccines was only present in men under 40 but the increase was still less than the increase from the virus.
Incorrect, you can clearly see from figure 2 on page 11 that the second dose of Moderna had a higher risk than the virus. Is there a reason you omit this?
That increase in myocarditis from vaccines was only present in men under 40
The paper doesn’t contain a breakdown in the sex difference. This was for men and women.
The authors have an updated pre-print that breaks it down by sex and both Pfizer and Moderna had higher rates than the virus for men(page 13): https://www.medrxiv.org/content/10.1101/2021.12.23.21268276v...
If the authors fixed the denominator for viral infection (i.e. used sero-prevalance), it would look even worse.
Absolutely false as noted by the other reply to this comment.
Don’t just blindly trust someone else’s comment.
You can clearly see from figure 2 on page 11 that the second dose of Moderna has a higher risk than the virus. The updated preprint also shows this for Pfizer.
https://www.nature.com/articles/s41591-021-01630-0.pdf
https://www.medrxiv.org/content/10.1101/2021.12.23.21268276v... (page 13)
My other point on vaccine effectiveness against omicron stands as well.
Again, I made up those numbers and I'm not saying mRNA is worse. My point is that we should take a more nuanced and honest view than "they both cause it" or even "X has a great rate; therefore Y is better"
Exercising while infected is known to increase risk. If you get the vaccine, you will be told not to exert yourself for some time after. If you get infected, you might have no idea that you should stop exercising unless and until you're symptomatic. https://www.bvhealthsystem.org/expert-health-articles/covid-...
https://www.nature.com/articles/s41591-021-01630-0
> the increased risk of myocarditis after vaccination was higher in persons aged under 40 years. 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.
https://www.medrxiv.org/content/10.1101/2021.12.23.21268276v...
> Despite more myocarditis events occurring in older persons, the risk following COVID-19 vaccination was largely restricted to younger males aged less than 40 years, where the risks of myocarditis following vaccination and infection were similar. However, the notable exception was that in younger males receiving a second dose of mRNA-1273 vaccine, the risk of myocarditis was higher following vaccination than infection, with an additional 101 events estimated following a second dose of mRNA-1273 vaccine compared to 7 events following a positive SARS-CoV-2 test.
Rates of myocarditis after 2nd shot for males 16 to 17 years of age: 105.9 per million doses of the BNT162b2 vaccine
Rates of myocarditis from COVID-19: 1500 per million cases
I rewrote both stats to be in the form of "x per 1 million" but I don't think that's a fair thing to do. Not everyone is going to get both a vaccine and get covid.
What's a better comparison? Rates of myocarditis for a unvaccinated person (roughly rate of getting covid multiplied by rate of myocarditis if getting covid) versus rates of myocarditis if vaccinated?
stats are hard, explaining stats are even harder. I'm already screwing this up.
Do tell me more about this vaccine/disease exclusivity. I must be doing something wrong.
Also, are you only counting the number of reported and confirmed vaccine-caused cases, but then comparing that to an estimate of the total number of COVID-caused cases?
https://twitter.com/joshzepps/status/1486213480823017472?s=2...
Edit : Consider readied the entire Twitter thread.
https://www.abc.net.au/radio/sydney/programs/afternoons/myoc...
> It's hard to sift through the mass of information and misinformation that exists about COVID-19. Recently there’s been increased focus on myocarditis and whether COVID-19 vaccines increase the risk of this condition and, if so, is that risk greater or less than the risk if you contract COVID.
> To clarify exactly what the situation is Josh Szeps spoke to an expert, Associate Professor Raj Puranik who’s a consultant cardiologist with the Royal Prince Alfred Hospital in Camperdown and board member and clinical practice advisor with the Cardiac Society of Australia and New Zealand.
Does the AstraZeneca vaccine not include the spike protein? I thought it included the whole virus including the spike protein.
So I'm not sure what this guy is on about.
In both the mrna and viral vector vaccines, the mrna and virus are the DELIVERY mechanism of the payload.
https://www.mayoclinic.org/diseases-conditions/coronavirus/i...
"In this type of vaccine, genetic material from the COVID-19 virus is placed in a modified version of a different virus (viral vector). When the viral vector gets into your cells, it delivers genetic material from the COVID-19 virus that gives your cells instructions to make copies of the S protein. Once your cells display the S proteins on their surfaces, your immune system responds by creating antibodies and defensive white blood cells."
https://www.gavi.org/vaccineswork/there-are-four-types-covid...
"Viral vector vaccines also work by giving cells genetic instructions to produce antigens. But they differ from nucleic acid vaccines in that they use a harmless virus, different from the one the vaccine is targeting, to deliver these instructions into the cell. One type of virus that has often been used as a vector is adenovirus, which causes the common cold. As with nucleic acid vaccines, our own cellular machinery is hijacked to produce the antigen from those instructions, in order to trigger an immune response."
https://www.science.org/content/blog-post/how-you-make-adeno...
"The adenovirus goes in and does its normal infection route; all that machinery is intact.. But in this case, the DNA payload that's delivered into your cells is not a big set of instructions for making more adenoviruses, it's a much shorter sequence that codes for the coronavirus spike protein instead. So the modified DNA gets transcribed to messenger RNA in your cells (and that's the exact step that the mRNA vaccines jump in at if you take them), and this mRNA is taken up by ribosomes and translated into the Spike protein itself."
https://www.science.org/content/blog-post/coronavirus-vaccin...
"This class uses some other infectious virus, but with its original genetic material removed. In its place goes genetic instructions to make coronavirus proteins, and when your infected cells do that, these proteins will set off an immune response. Note that this is different than being infected with a “real” virus, whose instructions are (naturally enough) to produce more virus, which go off and infect more cells. No, in this case each viral particle that you’re injected with will be able to infect one cell, and that’s it. "
The virus pollutes the body with spike protein recipes. There are absolutely not spike proteins on the surface of the vector virus.
I think it is therefore more likely that adaptive immune system is involved because it has ability to remember.
Now is it possible that spike protein itself or lipid shell is causing this based on incidence rate differences between 3 vaccines?
Hard to say.
The amount of spike protein produced is in correlation with amount of mRNA entering cells. The amount of mRNA entering cells is 3x higher with Moderna vaccine than with Pfizer vaccine and it appears that it is similar on both shots (first and second). But the amount of mRNA (converted from adenovirus DNA) entering cells with the second AZ shot is probably lower than on the first shot because there is also some immunity against the adenovirus and the dose size is the same.
This is in correlation with the amount of antibodies produced by these vaccines.
This is the not contradicting with the observation so far.
But it could be also lipid cell that has been found to cause inflammation. Considering the high amount of antibodies generated on the second vaccination, it is plausible that the lipid shells are not attacked by the immune system directly. But it might be possible that the cells are attacked after lipid shells have merged with their membranes.
There are few ways to find how what is most likely happening.
First is to hope that protein based vaccine from Novavax will be used by meaningful amount to detect proper incidence rates. When it is spike protein itself then we should see also high incidence rate on second vaccination.
The second option is to analyze mixed vaccinations where first vaccination was done with adenovirus vaccine and the second one with mRNA vaccine. It is not perfect setup but it might provide some additional information.
Third option is to use a mouse model similar to one in previous study where mouse were intravenously injected with mRNA vaccines. Repeat the study with mRNA vaccine, placebo (saline solution), dummy lipid shells and protein vaccines (might be necessary to do the study without and with the adjuvant).
So if there is a difference in the incidence of myocarditis, it must be for a different reason.
AZ also uses spike, so he's undermining his own argument.
Of course the spike is pathogenic. In this case, though, it could be something else like the mRNA strands themselves or the structure of the lipid envelope causing inflammation. There isn't enough evidence either way for this journalist to confidently assert a single cause.
[0]: https://abcmedia.akamaized.net/radio/local_sydney/audio/2022...
I think it is therefore more likely that adaptive immune system is involved because it has ability to remember.
Now is it possible that spike protein itself or lipid shell is causing this based on indicence rate differences between 3 vaccines?
Hard to say.
The amount of spike protein produced is in correlation with amount of mRNA entering cells. The amount of mRNA entering cells is 3x higher with Moderna vaccine than with Pfizer vaccine and it appears that it is similar on both shots (first and second). But the amount of mRNA (converted from adenovirus DNA) entering cells with the second AZ shot is probably lower than on the first shot because there is also some immunity against the adenovirus and the dose size is the same.
This is in correlation with the amount of antibodies produced by these vaccines.
This is the not contradicting with the observation so far.
But it could be also lipid cell that has been found to cause inflammation. Considering the high amount of antibodies generated on the second vaccination, it is plausible that the lipid shells are not attacked by the immune system directly. But it might be possible that the cells are attacked after lipid shells have merged with their membranes.
There are few ways to find how what is most likely happening.
First is to hope that protein based vaccine from Novavax will be used by meaningful amount to detect proper incidence rates. When it is spike protein itself then we should see also high incidence rate on second vaccination.
The second option is to analyze mixed vaccinations where first vaccination was done with adenovirus vaccine and the second one with mRNA vaccine. It is not perfect setup but it might provide some additional information.
Third option is to use a mouse model similar to one in previous study where mouse were intravenously injected with mRNA vaccines. Repeat the study with mRNA vaccine, placebo (saline solution), dummy lipid shells and protein vaccines (might be necessary to do the study without and with the adjuvant).
"We have this bug in production which is a Sev-1. We have a possible fix that won't make things worse we can rollout that should make things better."
Yes, we have all been here where someone did this and it made things worse, but we also have thousands of people looking at this change and been in situations where this was required.
I guess what I'm saying is: The spike protein is in the vaccine and the virus - injecting ourselves with a spike protein to build immunity is likely less impactful than getting the entire virus. If it is truly the spike protein that causes myocarditis, then it causing issues in vaccination is a non-issue. There is a (in my mind high, but we need controlled studies on it) chance that the same people would have gotten myocarditis from Covid. If we can limit the number of other side-effects that people have during the myocarditis then it seems like a win.
I am by no means a virologist or an expert in vaccines, just my thought process.
So.. we're using VAERS now?
The scientists are, in a controlled way. That doesn't mean that it's a regular source.
Yes, it's appropriate to use a no-validation report system to search for signal.
Vaers is crap, but crap is actually what you want when you're saying "look how ridiculously wide I cast my net looking for examples."
1. "experts" have been relentlessly debunking vaers the past 2 years. This is even discussed in the limitations: "Given the high verification rate of reports of myocarditis to VAERS after mRNA-based COVID-19 vaccination, underreporting is more likely."
2. This isn't the first analysis of this kind, yet prior reports have emphasized an important distinction not found in the OP:
https://www.nature.com/articles/s41591-021-01630-0
> the increased risk of myocarditis after vaccination was higher in persons aged under 40 years. 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.
because it feels like you're being a valuable skeptic, even though you aren't?
because you think "just asking questions," the way scare political news commentators, delivers something positive?
because you think the work of scientists should be judged based on the debunking of a source that has nothing to do with the science you're openly questioning?
because you've become so comfortable explaining your behavior to people who are openly telling you to your face that it's not appropriate that you don't even hear them saying "this isn't appropriate" anymore?
.
> prior reports have emphasized an important distinction
I took a look at your new link, and I don't see any important distinction being emphasized.
THIS IS NOT AN INVITATION FOR YOU TO EXPLAIN.
This is me saying "nothing is being emphasized to the point that someone who, unlike you, has domain specific training can even notice it."
In reality, you've hyper-focused on some irrelevant detail, and now you're desperately trying to figure out why that irrelevant detail isn't present other places.
"Well yes, don't you see? Sure, this paper is about fuel efficiency, but this one doesn't cover kerosene cars, and the other one emphasized an important distinction about kerosene cars"
In reality it's likely to be some detail the paper put in to silence a different walrus.
Yes, I see that you quoted a random statistical detail about age groups and likelihoods.
You want to know why this doesn't matter?
Every vaccine you've ever taken has this risk. All of them.
We just don't talk about it for the same reason that we don't talk about a seatbelt's risk of causing a broken rib, which can puncture your lung, and kill you. Happens twice a year in this country.
Why?
Because twice a year is nothing, and we don't want to spend the rest of our lives talking to people who really want to deeply study that twice a year number, as if there's something valuable there.
The real issue is you have no statistical intuition, so you don't recognize that you're wasting everyone's time chasing ghosts.
The downside, of course, is that STUPID PEOPLE CAN SEE YOU.
And they think you're challenging whether the vaccine is a good idea.
And no, it really doesn't matter if you say you aren't doing that. Stupid people see scary numbers and they remember what Fox News said, and they end up not taking the vaccine, because with five billion people worldwide having a dose in their arm, their dumb ass is so scared by people like you that they're still going to wait and see.
And you, desperate to feel intelligent, will not stop trying to ply these bullshit nonsense numbers, to show everyone else how much you get it.
Please stop doing this soon.
You're killing stupid people.
"Stupid people should shut-up and listen to the smart people!" is that it?
Am I leading the "stupid" astray? Am I the villain to your hero? This is cute, really.
May I ask how many lives have you saved today? Donated any blood lately? Perhaps you volunteer at your local fire department? Anything at all?
"Oh look the self anointed arbiter of the intellectual elite is here to rescue us from the very bad, no good, misinformation brigade!"
How many dragons have you vanquished on the internet today? Do you pat yourself on the back every time you blow your load?
Guess what else? Smart and stupid people can see you too. They can all see just "how much you get it".
Take a deep breath, look in the mirror, and try to do better next time.
Thanks for the laugh.
Whoa now, easy on the antivaxxer rhetoric!
They're saying "sure, seat belts occasionally break ribs, but consider that in the context of all the windshields you didn't get thrown through"
If you feel the need to make a joke like that, which is unfunny and makes you look like you don't understand things, you should expect some inbound explanations.
I wouldn't be surprised if incresed risk of miocarditis after second dose is completely explained by changes in behavior of people who finally got vaccinated after many monthes of lockdowns.
They probably started going out more and exposing themselves to coronavirus which vaccine provides partial protection against.
Researchers don't even exclude from this research people who got full blown covid before their miocarditis.
"Data out of Israel ... suggests that vaccine-induced myocarditis is caused by the spike protein. In that case, Covid would cause the same condition in the same person -- but more severely, attached to a fully-fledged living virus.
To be clear: whoever gets heart inflammation from Moderna would’ve almost certainly got it worse from Covid. The issue arises from the spike protein itself. That’s why we don’t see myocarditis from non-MRNA vaccines like Astra Zeneca."
[0]: https://twitter.com/joshzepps/status/1486213462816866304?t=P...