7 ms·

Wow, I just got the Pfizer booster a few days ago and I'm an under-40 male who has previously had pericarditis... I was worried about the risk being greater tha

Wow, I just got the Pfizer booster a few days ago and I'm an under-40 male who has previously had pericarditis... I was worried about the risk being greater than the reward for my age group but didn't have the age-stratified data to prove it. Kind of regretting it now, especially since I only got it at the urging of my wife. I just needlessly increased the odds of a giving myself a heart issue for absolutely no reason. Edit: somebody else pointed out that the significantly elevated risk was only observed for Moderna (mRNA-1273). Pfizer (BNT162b2) only has a slightly elevated risk after the 2nd and 3rd doses. Looks like I'll be okay after all :)

kuhewa 5y ago
No, not unless Pfizer was a typo and you meant Moderna.
- TehShrike 5y ago
  After only looking at the charts at the end of the PDF, they seem to indicate that the 3rd dose (booster) of the Pfizer vaccine raises your myocarditis risk about as much as the 2nd dose of Moderna's.
  - sudosysgen 5y ago
    No. 3rd dose Pfizer is not statistically significantly worse than infection for myocarditis.
    - TehShrike 5y ago
      Am I missing something obvious? Am I reading too much from the error bars in the Incidence Rate Ratio charts? Or did I misinterpret the charts some other way?
      - sudosysgen 5y ago
        In the chart, the IRR from infection is 2.02, 95% CI 1.13-3.61. The IRR for 3rd dose Pfizer is 7.6, 95% CI 1.92-30.15. Because the confidence interval of the Pfizer 3rd dose contains the datapoint for infection, there is a pretty good chance that the 3rd dose is not anymore likely to lead to myocarditis than COVID, and the result isn't statistically significant at p<=0.05. We can't say for sure.
  - kuhewa 5y ago
    There are large CIs around the mean increase with Pfizer booster, but the mean doesn't fall into the confidence interval for second dose Moderna. Does not appear to be tracking as commensurate.
    - TehShrike 5y ago
      ah sure, I don't think I would have called them "commensurate" – but was I wrong to think of both rates as "elevated"?
      - TehShrike 5y ago
        heh, re-read my comment and I totally said "about as much", so never mind. Sloppy on my part.
unityByFreedom 5y ago
Your overall odds of death from covid went down. And as I understand it, myocarditis often goes away on its own or can be treated at home.
- boppo1 5y ago
  > myocarditis often goes away on its own I was under the impression myocarditis was when some heart tissue died and doesn't recover.
  - unityByFreedom 5y ago
    It's inflammation of the heart muscle. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/myocarditis.html https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/my... There is a wealth of info about this known condition on the web including symptoms and treatment. If you have concerns, ask your GP, they're there to help you.
  - inglor_cz 5y ago
    Myocarditis is an inflammation that can, and often does, heal fully. You are confusing it with ischemia (heart attack basically), where cells are no longer supplied with oxygen and die.
- aulin 5y ago
  It largely depends on the affected area... It can kill you instantly if it takes conduction centers, kill you years later if it damages the muscle or it can leave no consequences at all. It can go unnoticed and still leave you with long term damages.
  - davnn 5y ago
    > It can go unnoticed and still leave you with long term damages. That‘s the scary part imho, it appears that the long-term adverse cardiac risk is pretty much unknown.
rTX5CMRXIfFG 5y ago
Legit question--would you have higher chances of surviving COVID-19 had you gotten it without the vaccine?
- hnuser847 5y ago
  I don't think that's the right question to ask. Obviously my chances of surviving COVID would be higher with the vaccine than without. The real question is, which has an overall higher risk for someone of my age, sex, and health status, a COVID infection or the vaccine? I honestly don't know the answer to that question.
  - justin66 5y ago
    - hnuser847 5y ago
      A doctor can't provide me with data that doesn't exist. I actually did ask a friend who's an ER doc about whether or not I should get one of the mRNA boosters, given that I have a history of pericarditis. He said that, based on the available studies, the risk of getting pericarditis/myocarditis from COVID is far greater than the risk of getting it from the vaccine, but he also conceded that he didn't know of any studies that specifically examined the risk for someone who has a history of pericarditis. Also, the study that we're all discussing here is a preprint that was posted on December 25th, so this age-stratified data obviously wasn't available when I decided to get the booster on the 17th.
      - justin66 5y ago
        My point was that you're going to get terrible advice here, so what the hell are you even doing? The overall level of intellect displayed in Hacker News COVID threads is of the holy shit, there goes my faith in humanity level of quality. Just my opinion but you are barking up the wrong tree here. (these are important questions for a person who has been treated for a heart condition to bring up with their doctor)
blip54321 5y ago
To be fair, we're still talking about 1:10,000 odds. You're much more likely to, for example, be hit by a car in the next year, even if you're in a high-risk category. I tend to run numbers here and compare to events I'm worried or not worried about. I can live with 1:10,000 risks.
- mrhands556 5y ago
  CDC best guess mortality risk for his age group is 500/1000000 if he gets an infection. I would say risk probably not outweighing the benefit if it doesn’t prevent infection outright. Source: https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scenarios.html https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...
  - sudosysgen 5y ago
    That is a laughable analysis. You are comparing the risk of death to the risk of a serious side effect. Why not compare apples to apples and compare the risk of heart complications requiring hospitalization (a fraction of the myocraditis and pericarditis cases caused by the vaccine) to the hospitalization rate of infection? You can normalize that by the 75% efficacy against Omicron if you want.
    - mrhands556 5y ago
      Who says the vaccine prevents heart complications from infection? All the statistics I’ve seen compare mainly mortality. From a pure risk vs reward of vaccine vs no vaccine, measuring mortality seems reasonable. When in history have we vaccinated to prevent side effects?
      - kuhewa 5y ago
        You are asking when in history we vaccinated to prevent infectious disease induced morbidity?
        5y ago
Aurelius3 5y ago
nojokes 5y ago
If you got Pfizer, your risk is lower than Moderna for myocarditis. Fairly similar to COVID-19 itself according to this paper. There is also pericarditis and cardiac arrhythmia that they covered in their original paper https://www.nature.com/articles/s41591-021-01630-0#Sec30 https://www.nature.com/articles/s41591-021-01630-0#Sec30 Unfortunately not stratified by age and sex there (what a shame when it is obviously greatest interest here, what were they thinking, like actually, what were they thinking?) but the risk should be clearly higher for COVID-19 as it is non-existent for vaccines. As such, the original paper was bad as they did not stratify by important parameters but this paper might be even worse as they do not include other complications that would significantly change the picture. I also feel wary about the method they are using - perhaps somebody could share thoughts about this? They used self controlled case series (SCCS) for IRR. I am not fully confident that this kind of analysis can be used for such data in this setting.

kuhewa 5y ago

No, not unless Pfizer was a typo and you meant Moderna.

TehShrike 5y ago
After only looking at the charts at the end of the PDF, they seem to indicate that the 3rd dose (booster) of the Pfizer vaccine raises your myocarditis risk about as much as the 2nd dose of Moderna's.
- sudosysgen 5y ago
  No. 3rd dose Pfizer is not statistically significantly worse than infection for myocarditis.
  - TehShrike 5y ago
    Am I missing something obvious? Am I reading too much from the error bars in the Incidence Rate Ratio charts? Or did I misinterpret the charts some other way?
    - sudosysgen 5y ago
      In the chart, the IRR from infection is 2.02, 95% CI 1.13-3.61. The IRR for 3rd dose Pfizer is 7.6, 95% CI 1.92-30.15. Because the confidence interval of the Pfizer 3rd dose contains the datapoint for infection, there is a pretty good chance that the 3rd dose is not anymore likely to lead to myocarditis than COVID, and the result isn't statistically significant at p<=0.05. We can't say for sure.
- kuhewa 5y ago
  There are large CIs around the mean increase with Pfizer booster, but the mean doesn't fall into the confidence interval for second dose Moderna. Does not appear to be tracking as commensurate.
  - TehShrike 5y ago
    ah sure, I don't think I would have called them "commensurate" – but was I wrong to think of both rates as "elevated"?
    - TehShrike 5y ago
      heh, re-read my comment and I totally said "about as much", so never mind. Sloppy on my part.

unityByFreedom 5y ago

Your overall odds of death from covid went down. And as I understand it, myocarditis often goes away on its own or can be treated at home.

boppo1 5y ago
> myocarditis often goes away on its own I was under the impression myocarditis was when some heart tissue died and doesn't recover.
- unityByFreedom 5y ago
  It's inflammation of the heart muscle. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/myocarditis.html https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/my... There is a wealth of info about this known condition on the web including symptoms and treatment. If you have concerns, ask your GP, they're there to help you.
- inglor_cz 5y ago
  Myocarditis is an inflammation that can, and often does, heal fully. You are confusing it with ischemia (heart attack basically), where cells are no longer supplied with oxygen and die.
aulin 5y ago
It largely depends on the affected area... It can kill you instantly if it takes conduction centers, kill you years later if it damages the muscle or it can leave no consequences at all. It can go unnoticed and still leave you with long term damages.
- davnn 5y ago
  > It can go unnoticed and still leave you with long term damages. That‘s the scary part imho, it appears that the long-term adverse cardiac risk is pretty much unknown.

rTX5CMRXIfFG 5y ago

Legit question--would you have higher chances of surviving COVID-19 had you gotten it without the vaccine?

hnuser847 5y ago
I don't think that's the right question to ask. Obviously my chances of surviving COVID would be higher with the vaccine than without. The real question is, which has an overall higher risk for someone of my age, sex, and health status, a COVID infection or the vaccine? I honestly don't know the answer to that question.
- justin66 5y ago
  - hnuser847 5y ago
    A doctor can't provide me with data that doesn't exist. I actually did ask a friend who's an ER doc about whether or not I should get one of the mRNA boosters, given that I have a history of pericarditis. He said that, based on the available studies, the risk of getting pericarditis/myocarditis from COVID is far greater than the risk of getting it from the vaccine, but he also conceded that he didn't know of any studies that specifically examined the risk for someone who has a history of pericarditis. Also, the study that we're all discussing here is a preprint that was posted on December 25th, so this age-stratified data obviously wasn't available when I decided to get the booster on the 17th.
    - justin66 5y ago
      My point was that you're going to get terrible advice here, so what the hell are you even doing? The overall level of intellect displayed in Hacker News COVID threads is of the holy shit, there goes my faith in humanity level of quality. Just my opinion but you are barking up the wrong tree here. (these are important questions for a person who has been treated for a heart condition to bring up with their doctor)

blip54321 5y ago

To be fair, we're still talking about 1:10,000 odds. You're much more likely to, for example, be hit by a car in the next year, even if you're in a high-risk category. I tend to run numbers here and compare to events I'm worried or not worried about. I can live with 1:10,000 risks.

mrhands556 5y ago
CDC best guess mortality risk for his age group is 500/1000000 if he gets an infection. I would say risk probably not outweighing the benefit if it doesn’t prevent infection outright. Source: https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scenarios.html https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...
- sudosysgen 5y ago
  That is a laughable analysis. You are comparing the risk of death to the risk of a serious side effect. Why not compare apples to apples and compare the risk of heart complications requiring hospitalization (a fraction of the myocraditis and pericarditis cases caused by the vaccine) to the hospitalization rate of infection? You can normalize that by the 75% efficacy against Omicron if you want.
  - mrhands556 5y ago
    Who says the vaccine prevents heart complications from infection? All the statistics I’ve seen compare mainly mortality. From a pure risk vs reward of vaccine vs no vaccine, measuring mortality seems reasonable. When in history have we vaccinated to prevent side effects?
    - kuhewa 5y ago
      You are asking when in history we vaccinated to prevent infectious disease induced morbidity?
      - 5y ago

Aurelius3 5y ago

nojokes 5y ago

If you got Pfizer, your risk is lower than Moderna for myocarditis. Fairly similar to COVID-19 itself according to this paper. There is also pericarditis and cardiac arrhythmia that they covered in their original paper https://www.nature.com/articles/s41591-021-01630-0#Sec30 https://www.nature.com/articles/s41591-021-01630-0#Sec30 Unfortunately not stratified by age and sex there (what a shame when it is obviously greatest interest here, what were they thinking, like actually, what were they thinking?) but the risk should be clearly higher for COVID-19 as it is non-existent for vaccines. As such, the original paper was bad as they did not stratify by important parameters but this paper might be even worse as they do not include other complications that would significantly change the picture. I also feel wary about the method they are using - perhaps somebody could share thoughts about this? They used self controlled case series (SCCS) for IRR. I am not fully confident that this kind of analysis can be used for such data in this setting.