6 ms·

What I can't seem to figure out (and the knee-jerk censorship of any discussion on the topic isn't helping...) is whether or not this is unusual, as vaccines go

What I can't seem to figure out (and the knee-jerk censorship of any discussion on the topic isn't helping...) is whether or not this is unusual, as vaccines go. Although I never thought much about it before, it seems like no vaccine could possibly be 100% safe, so, say the smallpox vaccine must produce occasional side effects. How does this vaccine compare with all the other ones? Smallpox will almost definitely kill you, so a small chance of a side effect is worth it. What is the real cost/benefit of getting this particular vaccine?

jjeaff 5y ago
I think the most important data point you should compare in this case is the rate of myopericarditis in young men who get COVID. It's somewhat irrelevant what the rate is in past vaccines. Two things seem pretty clear from the data. The first is that myocarditis rates are much higher in unvaccinated young men who get COVID than those who get the vaccine. And the second is that you almost certainly will get COVID eventually. One hypothesis is that the spike protein in the vaccine is what causes the myocarditis. If you are scared of that, then you should be really scared of how much more spike protein you are going to have in your body if you get COVID unvaccinated. The spike protein in the vaccine does not replicate. In COVID, it obviously does. If I had to guess, I would say that anyone who gets myocarditis from the vaccine probably would have had a very bad time with COVID.
- commandlinefan 5y ago
  Interesting, thanks, I had not heard/seen that before.
- merpnderp 5y ago
  "And the second is that you almost certainly will get COVID eventually" this wasn't true until Omicron. Social distancing, proper masking, and maintaining good ventilation were all ways to dramatically lower your chances of getting any of the previous strains. And Omicron is so much milder it would be shocking if myocarditis rates remain higher than in vaccinations. "The spike protein in the vaccine does not replicate. In COVID, it obviously does." This is misleading. The spike protein is created similarly in both cases, both from RNA being introduced into the cells. "If I had to guess, I would say that anyone who gets myocarditis from the vaccine probably would have had a very bad time with COVID." This very much is a guess as we don't know the mechanism for what is causing myocarditis. My guess is that we'll find much lower levels of vaccine myocarditis in countries which aspirate injections, dramatically lowering the rate of inadvertent intravenous injections. And we'll find that the cause of SARS-COV-2 myocarditis differs greatly from vaccine induced myocarditis.
  - glial 5y ago
    > Omicron is so much milder It's milder when measured by overall hospitalization rates (covering vaccinated + unvaccinated + past infection), but is there evidence that it is milder for unvaccinated individuals specifically? Genuine question, happy to learn.
    - merpnderp 5y ago
      I don't know that we know that. But given the UK death rates I'm guessing we'll be happy. I don't know anyone still unvaccinated, but I certainly hope omicron is milder for the people are aren't.
    - bsaul 5y ago
      unless omikron spread to vaccinated people preferably , or if vaccination rates increase a lot between delta and omikron, the fact that the increase in omikron cases doesn't produce an increase in hospital ICU prooves it's also not as lethal to non-vax
    - rsfern 5y ago
      Solid data is still hard to come by, but preliminary analyses from the week of Dec 20 have omicron as moderately less virulent than Delta, and on par (+/- 10-20%) with the original strain. Good discussion of various pieces of the picture here: https://thezvi.wordpress.com/2021/12/23/omicron-post-9/ https://thezvi.wordpress.com/2021/12/23/omicron-post-9/
  - qeternity 5y ago
    > this wasn't true until Omicron You don’t understand what people mean when they say that. The premise of everyone getting covid is based on the continued mutation and evolutionary pressure to more contagious and less deadly variants. The emergence of an Omicron-like variant is exactly what people meant when they said “everyone will get covid”.
    - nojokes 5y ago
      No, they did not. What they meant was that already Delta is so contagious that only very limited amount of people can avoid it - r0 ~ 6-8 will make sure of it that ~85-90% of people must be immune to stop its spread. Seasonal flu has r0 = 1.3. This means that it does not affect 75% of the population. The formula is p = 1 - (1/r0) to find out at what level of immunity the disease will die out. Original Sars2 had r0 = 3, this meant that about 60% immunity level is needed. This is from where to original need of 70% of vaccinated comes from - vaccines do not give 100% immunity so you have to account for that. Delta messed everything up. With p=85% and vaccine efficiency of 70% (because nobody, except Israelis dared to think about boosters first), you need more than 100% vaccinated - everyone gets is either vaccinated and lucky or vaccinated/unvaccinated and will get infected.
- bko 5y ago
  > Two things seem pretty clear from the data. The first is that myocarditis rates are much higher in unvaccinated young men who get COVID than those who get the vaccine. And the second is that you almost certainly will get COVID eventually. Wouldn't you need to look at the P(covid | no_vaccine) * covid_myocarditus_risk vs P(covid | vaccine) * covid_myocarditus_risk + vaccine_myocarditus_risk Also this should be during the vaccine covid prevention efficacy window
  - vipa123 5y ago
    Given that it is well documented that the vaccine reduces the severity of the disease I would also expect it to modify the risk of myocarditus in some way (I assume that it reduces the risk)... That further complicates the picture... P(covid | no_vaccine) * covid_myocarditus_risk(no_vaccine) vs P(covid | vaccine) * covid_myocarditus_risk(vaccine) + vaccine_myocarditus_risk
    - qeternity 5y ago
      There is data to suggest this isn’t the case.
      - vipa123 5y ago
        Can you point me to it?
- potatochup 5y ago
  Yeah, this is the logic and data that I used. I plan on engaging in fairly 'risky' behavior when I can (social dancing), so I'm assuming I'll catch Covid at some stage, so I'd rather catch it with a vaccine (as I think the risk of vaccine+covid is less than unvaccinated covid). At current rates of 20,000 cases/day, everyone in New South Wales will get Omicron in just over a year, so unless you totally isolate yourself from society, it's highly likely everyone will catch it at some point.
  - rastignack 5y ago
    And we do not know if omicron causes more heart issues than the vaccine.
- blindmute 5y ago
  > Two things seem pretty clear from the data. Not according to this data. Turns out that myocarditis rates are higher in vaccinated young men, the complete opposite of your clear data's claim! https://www.medrxiv.org/content/10.1101/2021.12.23.21268276v1.full.pdf https://www.medrxiv.org/content/10.1101/2021.12.23.21268276v...
  - nojokes 5y ago
    This study has multiple issues as did the original study it is accompanying but what got published in Nature Medicine https://www.nature.com/articles/s41591-021-01630-0 https://www.nature.com/articles/s41591-021-01630-0 First the original study did not stratify based on age and sex - a huge failure because potential issue among young men was well known problem. This preprint tries to fix this but as the original study compared also other cardiac adverse events like pericarditis and cardiac arrhythmias, the preprint does not. It is important because the rate of other complications was not elevated among vaccinated. This study uses self-controlled case series. This means that they compare against previous incidence rates in the study group (vaccinated, covid-19). This would be possibly more or less fine if they compared two treatments but even then there is big potential for selection bias (the choice of treatment is based on preexisting conditions) but is even higher when you compare treatment and disease - covid-19 is harder for people with comorbidities, when you make a comparison within this group, you can most likely expect higher preexisting prevalence of heart conditions and therefor lower IRR. This preprint and the orginal paper do not contain any mentioning of unvaccinated. It very likely means that the covid-19 group also contains patients who were vaccinated and had lower rate of AE. Finally, this study design includes people with previous incidence. Hearth problems are very often recurrent. While it is important to know if vaccination of covid-19 will reintroduce the condition, it is not very interesting for most of the people because incidence rate of these conditions is very low. What is real interest here is how prevalent it is among people who did not have it previously. Now I am really interested to find out the truth here. This preprint and the orginal study does not help me in this unfortunately.
    - nojokes 5y ago
      I wanted to specify that I find these attempts to but vaccination and covid-19 into perspective very important. This is first study that I know so far has truly attempted to do so. Now in current state they create more confusion and possible harm but they have the data so they should be able to fix these issues.
adamredwoods 5y ago
>> The incidence of myocarditis increased from 0.7 to 0.9 per 100,000 children (p <0.0001) over the study period. [edit: study was 2007-2016] https://www.sciencedirect.com/science/article/abs/pii/S0002914921002617 https://www.sciencedirect.com/science/article/abs/pii/S00029... referenced by this presentation: https://www.fda.gov/media/153514/download https://www.fda.gov/media/153514/download
zyemuzu 5y ago
Google searches by date range will help you, since most medical searches are now completely skewed towards Covid.
dqv 5y ago
I want to know about it too. I got the flu vaccine in ~2016 and the next day experienced heartburn like I had never experienced before. I had to lay down the rest of the day. I had and have never experienced heartburn like that since. I probably should’ve had it checked but just toughed it out. I had a suspicion it was the vaccine, but no one I knew in medicine had ever heard of it happening. I didn’t have any side effects with either SARS2 vaccines except for a sore arm, so who who knows what that was!

jjeaff 5y ago

I think the most important data point you should compare in this case is the rate of myopericarditis in young men who get COVID. It's somewhat irrelevant what the rate is in past vaccines. Two things seem pretty clear from the data. The first is that myocarditis rates are much higher in unvaccinated young men who get COVID than those who get the vaccine. And the second is that you almost certainly will get COVID eventually. One hypothesis is that the spike protein in the vaccine is what causes the myocarditis. If you are scared of that, then you should be really scared of how much more spike protein you are going to have in your body if you get COVID unvaccinated. The spike protein in the vaccine does not replicate. In COVID, it obviously does. If I had to guess, I would say that anyone who gets myocarditis from the vaccine probably would have had a very bad time with COVID.

commandlinefan 5y ago
Interesting, thanks, I had not heard/seen that before.
merpnderp 5y ago
"And the second is that you almost certainly will get COVID eventually" this wasn't true until Omicron. Social distancing, proper masking, and maintaining good ventilation were all ways to dramatically lower your chances of getting any of the previous strains. And Omicron is so much milder it would be shocking if myocarditis rates remain higher than in vaccinations. "The spike protein in the vaccine does not replicate. In COVID, it obviously does." This is misleading. The spike protein is created similarly in both cases, both from RNA being introduced into the cells. "If I had to guess, I would say that anyone who gets myocarditis from the vaccine probably would have had a very bad time with COVID." This very much is a guess as we don't know the mechanism for what is causing myocarditis. My guess is that we'll find much lower levels of vaccine myocarditis in countries which aspirate injections, dramatically lowering the rate of inadvertent intravenous injections. And we'll find that the cause of SARS-COV-2 myocarditis differs greatly from vaccine induced myocarditis.
- glial 5y ago
  > Omicron is so much milder It's milder when measured by overall hospitalization rates (covering vaccinated + unvaccinated + past infection), but is there evidence that it is milder for unvaccinated individuals specifically? Genuine question, happy to learn.
  - merpnderp 5y ago
    I don't know that we know that. But given the UK death rates I'm guessing we'll be happy. I don't know anyone still unvaccinated, but I certainly hope omicron is milder for the people are aren't.
  - bsaul 5y ago
    unless omikron spread to vaccinated people preferably , or if vaccination rates increase a lot between delta and omikron, the fact that the increase in omikron cases doesn't produce an increase in hospital ICU prooves it's also not as lethal to non-vax
  - rsfern 5y ago
    Solid data is still hard to come by, but preliminary analyses from the week of Dec 20 have omicron as moderately less virulent than Delta, and on par (+/- 10-20%) with the original strain. Good discussion of various pieces of the picture here: https://thezvi.wordpress.com/2021/12/23/omicron-post-9/ https://thezvi.wordpress.com/2021/12/23/omicron-post-9/
- qeternity 5y ago
  > this wasn't true until Omicron You don’t understand what people mean when they say that. The premise of everyone getting covid is based on the continued mutation and evolutionary pressure to more contagious and less deadly variants. The emergence of an Omicron-like variant is exactly what people meant when they said “everyone will get covid”.
  - nojokes 5y ago
    No, they did not. What they meant was that already Delta is so contagious that only very limited amount of people can avoid it - r0 ~ 6-8 will make sure of it that ~85-90% of people must be immune to stop its spread. Seasonal flu has r0 = 1.3. This means that it does not affect 75% of the population. The formula is p = 1 - (1/r0) to find out at what level of immunity the disease will die out. Original Sars2 had r0 = 3, this meant that about 60% immunity level is needed. This is from where to original need of 70% of vaccinated comes from - vaccines do not give 100% immunity so you have to account for that. Delta messed everything up. With p=85% and vaccine efficiency of 70% (because nobody, except Israelis dared to think about boosters first), you need more than 100% vaccinated - everyone gets is either vaccinated and lucky or vaccinated/unvaccinated and will get infected.
bko 5y ago
> Two things seem pretty clear from the data. The first is that myocarditis rates are much higher in unvaccinated young men who get COVID than those who get the vaccine. And the second is that you almost certainly will get COVID eventually. Wouldn't you need to look at the P(covid | no_vaccine) * covid_myocarditus_risk vs P(covid | vaccine) * covid_myocarditus_risk + vaccine_myocarditus_risk Also this should be during the vaccine covid prevention efficacy window
- vipa123 5y ago
  Given that it is well documented that the vaccine reduces the severity of the disease I would also expect it to modify the risk of myocarditus in some way (I assume that it reduces the risk)... That further complicates the picture... P(covid | no_vaccine) * covid_myocarditus_risk(no_vaccine) vs P(covid | vaccine) * covid_myocarditus_risk(vaccine) + vaccine_myocarditus_risk
  - qeternity 5y ago
    There is data to suggest this isn’t the case.
    - vipa123 5y ago
      Can you point me to it?
potatochup 5y ago
Yeah, this is the logic and data that I used. I plan on engaging in fairly 'risky' behavior when I can (social dancing), so I'm assuming I'll catch Covid at some stage, so I'd rather catch it with a vaccine (as I think the risk of vaccine+covid is less than unvaccinated covid). At current rates of 20,000 cases/day, everyone in New South Wales will get Omicron in just over a year, so unless you totally isolate yourself from society, it's highly likely everyone will catch it at some point.
- rastignack 5y ago
  And we do not know if omicron causes more heart issues than the vaccine.
blindmute 5y ago
> Two things seem pretty clear from the data. Not according to this data. Turns out that myocarditis rates are higher in vaccinated young men, the complete opposite of your clear data's claim! https://www.medrxiv.org/content/10.1101/2021.12.23.21268276v1.full.pdf https://www.medrxiv.org/content/10.1101/2021.12.23.21268276v...
- nojokes 5y ago
  This study has multiple issues as did the original study it is accompanying but what got published in Nature Medicine https://www.nature.com/articles/s41591-021-01630-0 https://www.nature.com/articles/s41591-021-01630-0 First the original study did not stratify based on age and sex - a huge failure because potential issue among young men was well known problem. This preprint tries to fix this but as the original study compared also other cardiac adverse events like pericarditis and cardiac arrhythmias, the preprint does not. It is important because the rate of other complications was not elevated among vaccinated. This study uses self-controlled case series. This means that they compare against previous incidence rates in the study group (vaccinated, covid-19). This would be possibly more or less fine if they compared two treatments but even then there is big potential for selection bias (the choice of treatment is based on preexisting conditions) but is even higher when you compare treatment and disease - covid-19 is harder for people with comorbidities, when you make a comparison within this group, you can most likely expect higher preexisting prevalence of heart conditions and therefor lower IRR. This preprint and the orginal paper do not contain any mentioning of unvaccinated. It very likely means that the covid-19 group also contains patients who were vaccinated and had lower rate of AE. Finally, this study design includes people with previous incidence. Hearth problems are very often recurrent. While it is important to know if vaccination of covid-19 will reintroduce the condition, it is not very interesting for most of the people because incidence rate of these conditions is very low. What is real interest here is how prevalent it is among people who did not have it previously. Now I am really interested to find out the truth here. This preprint and the orginal study does not help me in this unfortunately.
  - nojokes 5y ago
    I wanted to specify that I find these attempts to but vaccination and covid-19 into perspective very important. This is first study that I know so far has truly attempted to do so. Now in current state they create more confusion and possible harm but they have the data so they should be able to fix these issues.

adamredwoods 5y ago

>> The incidence of myocarditis increased from 0.7 to 0.9 per 100,000 children (p <0.0001) over the study period. [edit: study was 2007-2016] https://www.sciencedirect.com/science/article/abs/pii/S0002914921002617 https://www.sciencedirect.com/science/article/abs/pii/S00029... referenced by this presentation: https://www.fda.gov/media/153514/download https://www.fda.gov/media/153514/download

zyemuzu 5y ago

Google searches by date range will help you, since most medical searches are now completely skewed towards Covid.

dqv 5y ago

I want to know about it too. I got the flu vaccine in ~2016 and the next day experienced heartburn like I had never experienced before. I had to lay down the rest of the day. I had and have never experienced heartburn like that since. I probably should’ve had it checked but just toughed it out. I had a suspicion it was the vaccine, but no one I knew in medicine had ever heard of it happening. I didn’t have any side effects with either SARS2 vaccines except for a sore arm, so who who knows what that was!