3 ms·

I can't find much besides models for < 16 unfortunately. However, for 16-40, Patone, et al[1] estimates that myocarditis incidence is around 2/mil for AstraZen

by sfteus 5y ago

I can't find much besides models for < 16 unfortunately. However, for 16-40, Patone, et al[1] estimates that myocarditis incidence is around 2/mil for AstraZeneca, 1/mil for Pfizer per does, and 6/mil for Moderna first dose, 10/mil for the second, compared to 40/mil for an active infection. Singer, el al[2] (pre-print) states that males < 20 are roughly 6x less likely to develop myocarditis from vaccination compared to an infection. The AMA[3] also has some info on both myocarditis and MIS-C. 95% of those who developed MIS-C were unvaccinated, and up to 40% required some sort of respiratory or cardiovascular life support (compare to 0% of those vaccinated). Also states ages 12-15 appear less likely to develop myocarditis than the 16 - ~40 range. Everything I've read so far is that myocarditis from vaccination usually resolves fairly quickly. ----- [1]: https://www.nature.com/articles/s41591-021-01630-0.pdf https://www.nature.com/articles/s41591-021-01630-0.pdf [2]: https://www.medrxiv.org/content/10.1101/2021.07.23.21260998v1 https://www.medrxiv.org/content/10.1101/2021.07.23.21260998v... [3]: https://www.ama-assn.org/delivering-care/population-care/unvaccinated-kids-much-higher-risk-severe-mis-c-outcomes https://www.ama-assn.org/delivering-care/population-care/unv...

ALittleLight 5y ago
Do these papers differentiate infection with and without vaccination? Meaning, if an unvaxxed person has X myocarditis risk from the vaccine, and Y from infection, what is the myocarditis risk of infection after vaccination?
- sfteus 5y ago
  I haven't seen anything comparing the two yet, but I would be interested in seeing that. I'll note that in general, I have seen studies indicating that the risk of both MIS-C (linked in GP) and long-covid[1][2] are decreased when comparing vaccinated/unvaccinated post active infection. I've also seen reports that those unvaccinated who experience long-covid sometimes see reduced / cleared symptoms after subsequent vaccination.[3] We also know that antibody titer levels seem to be correlated with a reduction in infection, which is why when those begin to fall off we see more breakthrough infections. And finally we know that building long term T and B cells tends to see a quicker, more effective immune response, both of which should be created post-vaccination. Given that, I would speculate that vaccination is likely to reduce overall proliferation of cell infection (including directly infecting cardiac tissue via the ACE2 receptors) via having more free-floating antibodies in your system, and is likely to reduce the overall immune-mediated inflammatory response to the virus as it can respond more quickly before the virus has had a chance to proliferate as much. Both of these (reduced inflammation, reduced cell infection) should reduce the risk of myocarditis as a result of infection. And I would speculate that that tracks with other observed reduction of symptoms of infection (MIS-C, long-covid). Again, speculation on my part; I would definitely want to see studies to confirm or refute that. ----- [1]: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00460-6/fulltext#seccestitle10 https://www.thelancet.com/journals/laninf/article/PIIS1473-3... [2]: https://www.medrxiv.org/content/10.1101/2022.01.05.22268800v2 https://www.medrxiv.org/content/10.1101/2022.01.05.22268800v... [3]: https://www.yalemedicine.org/news/vaccines-long-covid https://www.yalemedicine.org/news/vaccines-long-covid
jamesblonde 5y ago
Myocarditis is extremely serious and potentially life-long. Please don't downplay it. I have a cardiomyopathy.
- sfteus 5y ago
  I'm saying this as someone who lost a family member to a combination of myocarditis and endocarditis resulting from a flu infection: I'm not attempting to downplay it. Myocarditis has the potential to be extremely serious, especially for those with pre-existing heart problems. However, _in my opinion_ with how infectious omicron is, it is likely inevitable that everyone will eventually be exposed. The literature (linked in my GP) currently seems to indicate that vaccines have a lower risk of myocarditis than an active SARS-CoV-2 infection. Most literature that I've seen (so far) indicates that occurrences of post-vaccination myocarditis tends to be rare, and not life-threatening, and the patients tend to recover quickly.[1] ----- [1]: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.056583 https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.0...
  - jamesblonde 5y ago
    We read different literature: https://vinayprasadmdmph.substack.com/p/uk-now-reports-myocarditis-stratified https://vinayprasadmdmph.substack.com/p/uk-now-reports-myoca... based on this Nature paper https://www.nature.com/articles/s41591-021-01630-0.pdf https://www.nature.com/articles/s41591-021-01630-0.pdf "Yes, sorry to break it to you, vaccines can have risks of myocarditis EXCEEDING risks of myocarditis from infection. Pls stop saying otherwise."
    - gilbetron 5y ago
      Only for Moderna, which is why a number of places stopped recommending it for "younger" adults. Pfizer has lower results of myocarditis.

by sfteus 5y ago

ALittleLight 5y ago

Do these papers differentiate infection with and without vaccination? Meaning, if an unvaxxed person has X myocarditis risk from the vaccine, and Y from infection, what is the myocarditis risk of infection after vaccination?

sfteus 5y ago
I haven't seen anything comparing the two yet, but I would be interested in seeing that. I'll note that in general, I have seen studies indicating that the risk of both MIS-C (linked in GP) and long-covid[1][2] are decreased when comparing vaccinated/unvaccinated post active infection. I've also seen reports that those unvaccinated who experience long-covid sometimes see reduced / cleared symptoms after subsequent vaccination.[3] We also know that antibody titer levels seem to be correlated with a reduction in infection, which is why when those begin to fall off we see more breakthrough infections. And finally we know that building long term T and B cells tends to see a quicker, more effective immune response, both of which should be created post-vaccination. Given that, I would speculate that vaccination is likely to reduce overall proliferation of cell infection (including directly infecting cardiac tissue via the ACE2 receptors) via having more free-floating antibodies in your system, and is likely to reduce the overall immune-mediated inflammatory response to the virus as it can respond more quickly before the virus has had a chance to proliferate as much. Both of these (reduced inflammation, reduced cell infection) should reduce the risk of myocarditis as a result of infection. And I would speculate that that tracks with other observed reduction of symptoms of infection (MIS-C, long-covid). Again, speculation on my part; I would definitely want to see studies to confirm or refute that. ----- [1]: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00460-6/fulltext#seccestitle10 https://www.thelancet.com/journals/laninf/article/PIIS1473-3... [2]: https://www.medrxiv.org/content/10.1101/2022.01.05.22268800v2 https://www.medrxiv.org/content/10.1101/2022.01.05.22268800v... [3]: https://www.yalemedicine.org/news/vaccines-long-covid https://www.yalemedicine.org/news/vaccines-long-covid

jamesblonde 5y ago

Myocarditis is extremely serious and potentially life-long. Please don't downplay it. I have a cardiomyopathy.

sfteus 5y ago
I'm saying this as someone who lost a family member to a combination of myocarditis and endocarditis resulting from a flu infection: I'm not attempting to downplay it. Myocarditis has the potential to be extremely serious, especially for those with pre-existing heart problems. However, _in my opinion_ with how infectious omicron is, it is likely inevitable that everyone will eventually be exposed. The literature (linked in my GP) currently seems to indicate that vaccines have a lower risk of myocarditis than an active SARS-CoV-2 infection. Most literature that I've seen (so far) indicates that occurrences of post-vaccination myocarditis tends to be rare, and not life-threatening, and the patients tend to recover quickly.[1] ----- [1]: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.056583 https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.0...
- jamesblonde 5y ago
  We read different literature: https://vinayprasadmdmph.substack.com/p/uk-now-reports-myocarditis-stratified https://vinayprasadmdmph.substack.com/p/uk-now-reports-myoca... based on this Nature paper https://www.nature.com/articles/s41591-021-01630-0.pdf https://www.nature.com/articles/s41591-021-01630-0.pdf "Yes, sorry to break it to you, vaccines can have risks of myocarditis EXCEEDING risks of myocarditis from infection. Pls stop saying otherwise."
  - gilbetron 5y ago
    Only for Moderna, which is why a number of places stopped recommending it for "younger" adults. Pfizer has lower results of myocarditis.