10 ms·

The study only checks for myocarditis diagnosis codes 1-7 days after vaccination. That's a very short timeframe... We have multiple months worth of data at this

The study only checks for myocarditis diagnosis codes 1-7 days after vaccination. That's a very short timeframe... We have multiple months worth of data at this point, I wonder what happens to the incidence rate at longer timelines.

elcritch 4y ago
I’m not a doctor but fairly well versed in inflammatory conditions for personal medical reasons. Myocarditis is primarily an acute condition. According to Google its onset is quick, and most people don’t suffer chronic forms. That’d imply that if myocarditis doesn’t happen in the first 1-7 days it seems very u likely it’d occur after that period. https://www.myocarditisfoundation.org/research-and-grants/faqs/chronic-myocarditis/ https://www.myocarditisfoundation.org/research-and-grants/fa...
- busymom0 4y ago
  Check out this Kaiser Permanente Northwest study which points out the flaw in the "first 1-7 days" logic: https://onlinelibrary.wiley.com/doi/10.1002/pds.5439 https://onlinelibrary.wiley.com/doi/10.1002/pds.5439 > The encounter methodology identified 14 distinct patients who met the confirmed or probable CDC case definition for acute myocarditis or pericarditis with an onset within 21 days of receipt of COVID-19 vaccination. When we extended the search for relevant diagnoses to 30 days since vaccination, we identified two additional patients (for a total of 16 patients) who met the case definition for acute myocarditis or pericarditis, but those patients had been misdiagnosed at the time of their original presentation. Three of these patients had an ICD-10-CM code of I51.4 “Myocarditis, Unspecified;” that code was omitted by the VSD algorithm (in the late fall of 2021). The VSD methodology identified 11 patients who met the CDC case definition for acute myocarditis or pericarditis. Seven (64%) of the 11 patients had initial care for myopericarditis outside of a KPNW facility and their diagnosis could not be ascertained by the VSD methodology until claims were submitted (median delay of 33 days; range of 12–195 days). Among those who received a second dose of vaccine (n = 146 785), we estimated a risk as 95.4 cases of myopericarditis per million second doses administered (95% CI, 52.1–160.0). One of the author also did a podcast where she pointed out how the way some insurance claims (especially those from outside facility) works is that it takes a few weeks to receive the claim and it to get registered correctly. So they often get missed in short period windows. When they took into account the correct numbers, they found rates of 537.1 per million for MALES aged 18-24. Here in Ontario, our government reports rates of 200.2 per million in males aged 18-24. Note that Ontario stopped giving Moderna to under 30 year olds and also made the dosing interval to be 8 weeks but our rates of myocarditis continued to climb. > most people don’t suffer chronic forms This is misleading. There is no such thing as mild myocarditis. Inflammation of your heart muscle has to be taken seriously, even if you end up in the hospital for a couple days, that's not the end of inflammation because it leads to scarring and permanent damage. Heart is the only organ that's going to keep you alive the longest and any damage to the heart has to be taken seriously especially if you are balancing it with a condition that in itself is very low risk to youth. Around 88% of the cases occur in males and up to 96% of the cases are hospitalized. Requires no exercise for 6 months and 6 month follow up Cardiac MRI still shows damage: https://www.jpeds.com/article/S0022-3476(22)00282-7/fulltext https://www.jpeds.com/article/S0022-3476(22)00282-7/fulltext And since the COVID vaccine doesn't prevent infection, you may end up compounding the risk if you get myocarditis first from the vaccine and then again from infection. The largest study on this topic has been of 23.1 million residents across four Scandinavian countries — Denmark, Finland, Norway, and Sweden. They found that: > in young men 16 to 24 years of age, the risk for myocarditis after vaccination with either the Pfizer or Moderna vaccine is higher than the risk for myocarditis after COVID-19 infection. > "We show that the risk of myocarditis after COVID infection is lower in younger people and higher in older people, but the opposite is true after COVID vaccination, where the risk of myocarditis is higher in younger people and lower in older people" > "In the group at highest risk of myocarditis after COVID vaccination — young men aged 16 to 24 — the Pfizer vaccine shows a five times higher risk of myocarditis versus the unvaccinated cohort, while the Moderna vaccine shows a 15 times higher risk" https://www.medscape.com/viewarticle/972453 https://www.medscape.com/viewarticle/972453 Actual study: https://jamanetwork.com/journals/jamacardiology/fullarticle/2791253 https://jamanetwork.com/journals/jamacardiology/fullarticle/... This finding from Scandinavian countries also seems to match the update to the Nature study which found the risk of myocarditis in under-40 males to be greater from the vaccine than from COVID. Discussed here few months ago: https://news.ycombinator.com/item?id=29697780 https://news.ycombinator.com/item?id=29697780
  - justinjlynn 4y ago
    I'm impressed by the number of specific studies and writings you've gathered which happen support your conclusion. Tell me, what evidence and studies have you collected and evaluated which do not support it?
    - suture 4y ago
      This comes across a bit disingenuous. Do you have evidence to the contrary? If so why not state what it is or that such evidence exists? I believe the Earth is spheroidal in shape and also haven’t collected evidence that supports it being flat. It’s not reasonable, in general, to look up the pros/cons of each belief. In the present case are you suggesting that people are cherry picking the studies to conform to a preconceived belief?
      - justinjlynn 4y ago
        Yes, to your questions; however, do note that I am not the one publishing this unsatisfactory metastudy. As such the burden is on the publisher to produce something of value by looking up the pros and cons and comparing the two. Otherwise, anyone could just punch up google, print out the results for "flat earth" and claim to have done research which says you should believe it. Obviously, that's not the case.
        suture 4y ago
        This is not an academic forum and so the standards are a bit relaxed. Typically people post their beliefs along with a snippet of the reasons for said beliefs. Then others who disagree sometime respond by presenting contrary evidence. No one has a burden as such. We are not academicians beholden to standards of thoroughness. My suggestion is that had you responded by stating that there are contrary studies and that those studies are better then your post would have been a lot clearer. At least it would have put the idea that the evidence presented was suspect into my mind. As it is it came across as unclear who has the stronger position objectively speaking.
- lamontcg 4y ago
  I had viral pericarditis after a cold one time, but it appeared about 2 months after I had recovered. That's pretty common with autoimmune conditions triggered by IgG autoimmunity response. But we understand autoimmunity in response to individual exposure to antigens pretty well and while 1-7 days is probably too short to see a lot of responses, over 3 months is highly unlikely. There can be a long tail of certain individuals having autoimmune responses up until 2 years later, but in a population study if you capture nearly all the responses after 3 months. If you don't see anything 3 months later then there's no hidden long-term effects waiting to happen years later. And there's nothing fundamentally unique about the mRNA vaccinations that would cause anything different. It is just a dose of mRNA that looks like any other mRNA payload from a virus which is wrapped in a lipid package that fuses with the lipids in your cell wall (and we understand the allergy to PEG that some people have against the lipid nanoparticle itself). All of the 200 years of understanding of vaccinations and hundreds of years of autoimmune conditions subsequent to viruses still apply to the mRNA vaccines. The "no we don't understand anything about these new things and the clock starts from zero" is just a fantastically ignorant argument based on no understanding of what the vaccines are built from and what vaccines and viruses are and how they interact with the immune system. So both of you are kind of wrong. 7 days is too short, but 90 days is all you need.
  - elcritch 4y ago
    Thanks, good to know about pericarditis. I’m not well versed on that or myocarditis and in particular the IgG or T-Cell response mechanism. Though the little I’ve read seems to indicate myocarditis is still primarily due to an acute immune response, but can re-occur or turn into a more autoimmune condition (chromic myocarditis or perhaps pericarditis). That said I would normally give the benefit of doubt that the authors of a paper in the Lancet are more well versed on myocarditis and it’s behavior. It looks like they do adjust all their comparisons to odds ‘per 100,000 person-days’. If done properly that would adjust from an event basis to per-time basis or rate which could account for long tail reactions. Using 90 days would risk including non-vaccine related myocarditis risks as well, which is perhaps why the lancet paper uses the time rate basis. If someone got a normal cold after a month and got pericarditis that'd skew the results as an example. Though I was disappointed to not see statistical analysis or comparison to normal occurrence rates of myocarditis without vaccine exposure, etc. though I didn’t thoroughly check their references, etc.
nabla9 4y ago
Chronic inflammation is not a symptom of Covid-19.
- philjohn 4y ago
  Turns out that myocarditis is though https://pubmed.ncbi.nlm.nih.gov/34341797/ https://pubmed.ncbi.nlm.nih.gov/34341797/
  - lamontcg 4y ago
    myocarditis isn't generally chronic, particularly in kids. and that study concludes that the risk of the vaccine in 12-19 year olds outweighs the risk of the virus if you bother to read it.
    - philjohn 4y ago
      No, if you read the article it's from 12 up the benefits outweigh the risks, quoth: The ACIP report projected that mRNA vaccination in 12-17-year-old males would result in 215 fewer hospitalizations and 71 fewer intensive care unit stays. Benefits of the vaccine outweighed the risk of myocarditis from vaccination in all age groups, 12 years-old and up. Our results suggest that the risk of myocarditis from COVID-19 infection itself exceeds the known risk from vaccination by a considerable margin. In light of more infectious variants, the new school year nearing and many colleges now requiring COVID-19 vaccination (either for all students or just those living on campus), these results are especially timely. Whether considering all the risks and benefits of COVID-19 vaccination or just myocarditis, vaccination appears to be the safer choice for 12-19-year-old males and females.
      - lamontcg 4y ago
        Yeah I accidentally typed the exact opposite of what I meant.

elcritch 4y ago

I’m not a doctor but fairly well versed in inflammatory conditions for personal medical reasons. Myocarditis is primarily an acute condition. According to Google its onset is quick, and most people don’t suffer chronic forms. That’d imply that if myocarditis doesn’t happen in the first 1-7 days it seems very u likely it’d occur after that period. https://www.myocarditisfoundation.org/research-and-grants/faqs/chronic-myocarditis/ https://www.myocarditisfoundation.org/research-and-grants/fa...

busymom0 4y ago
Check out this Kaiser Permanente Northwest study which points out the flaw in the "first 1-7 days" logic: https://onlinelibrary.wiley.com/doi/10.1002/pds.5439 https://onlinelibrary.wiley.com/doi/10.1002/pds.5439 > The encounter methodology identified 14 distinct patients who met the confirmed or probable CDC case definition for acute myocarditis or pericarditis with an onset within 21 days of receipt of COVID-19 vaccination. When we extended the search for relevant diagnoses to 30 days since vaccination, we identified two additional patients (for a total of 16 patients) who met the case definition for acute myocarditis or pericarditis, but those patients had been misdiagnosed at the time of their original presentation. Three of these patients had an ICD-10-CM code of I51.4 “Myocarditis, Unspecified;” that code was omitted by the VSD algorithm (in the late fall of 2021). The VSD methodology identified 11 patients who met the CDC case definition for acute myocarditis or pericarditis. Seven (64%) of the 11 patients had initial care for myopericarditis outside of a KPNW facility and their diagnosis could not be ascertained by the VSD methodology until claims were submitted (median delay of 33 days; range of 12–195 days). Among those who received a second dose of vaccine (n = 146 785), we estimated a risk as 95.4 cases of myopericarditis per million second doses administered (95% CI, 52.1–160.0). One of the author also did a podcast where she pointed out how the way some insurance claims (especially those from outside facility) works is that it takes a few weeks to receive the claim and it to get registered correctly. So they often get missed in short period windows. When they took into account the correct numbers, they found rates of 537.1 per million for MALES aged 18-24. Here in Ontario, our government reports rates of 200.2 per million in males aged 18-24. Note that Ontario stopped giving Moderna to under 30 year olds and also made the dosing interval to be 8 weeks but our rates of myocarditis continued to climb. > most people don’t suffer chronic forms This is misleading. There is no such thing as mild myocarditis. Inflammation of your heart muscle has to be taken seriously, even if you end up in the hospital for a couple days, that's not the end of inflammation because it leads to scarring and permanent damage. Heart is the only organ that's going to keep you alive the longest and any damage to the heart has to be taken seriously especially if you are balancing it with a condition that in itself is very low risk to youth. Around 88% of the cases occur in males and up to 96% of the cases are hospitalized. Requires no exercise for 6 months and 6 month follow up Cardiac MRI still shows damage: https://www.jpeds.com/article/S0022-3476(22)00282-7/fulltext https://www.jpeds.com/article/S0022-3476(22)00282-7/fulltext And since the COVID vaccine doesn't prevent infection, you may end up compounding the risk if you get myocarditis first from the vaccine and then again from infection. The largest study on this topic has been of 23.1 million residents across four Scandinavian countries — Denmark, Finland, Norway, and Sweden. They found that: > in young men 16 to 24 years of age, the risk for myocarditis after vaccination with either the Pfizer or Moderna vaccine is higher than the risk for myocarditis after COVID-19 infection. > "We show that the risk of myocarditis after COVID infection is lower in younger people and higher in older people, but the opposite is true after COVID vaccination, where the risk of myocarditis is higher in younger people and lower in older people" > "In the group at highest risk of myocarditis after COVID vaccination — young men aged 16 to 24 — the Pfizer vaccine shows a five times higher risk of myocarditis versus the unvaccinated cohort, while the Moderna vaccine shows a 15 times higher risk" https://www.medscape.com/viewarticle/972453 https://www.medscape.com/viewarticle/972453 Actual study: https://jamanetwork.com/journals/jamacardiology/fullarticle/2791253 https://jamanetwork.com/journals/jamacardiology/fullarticle/... This finding from Scandinavian countries also seems to match the update to the Nature study which found the risk of myocarditis in under-40 males to be greater from the vaccine than from COVID. Discussed here few months ago: https://news.ycombinator.com/item?id=29697780 https://news.ycombinator.com/item?id=29697780
- justinjlynn 4y ago
  I'm impressed by the number of specific studies and writings you've gathered which happen support your conclusion. Tell me, what evidence and studies have you collected and evaluated which do not support it?
  - suture 4y ago
    This comes across a bit disingenuous. Do you have evidence to the contrary? If so why not state what it is or that such evidence exists? I believe the Earth is spheroidal in shape and also haven’t collected evidence that supports it being flat. It’s not reasonable, in general, to look up the pros/cons of each belief. In the present case are you suggesting that people are cherry picking the studies to conform to a preconceived belief?
    - justinjlynn 4y ago
      Yes, to your questions; however, do note that I am not the one publishing this unsatisfactory metastudy. As such the burden is on the publisher to produce something of value by looking up the pros and cons and comparing the two. Otherwise, anyone could just punch up google, print out the results for "flat earth" and claim to have done research which says you should believe it. Obviously, that's not the case.
      - suture 4y ago
        This is not an academic forum and so the standards are a bit relaxed. Typically people post their beliefs along with a snippet of the reasons for said beliefs. Then others who disagree sometime respond by presenting contrary evidence. No one has a burden as such. We are not academicians beholden to standards of thoroughness. My suggestion is that had you responded by stating that there are contrary studies and that those studies are better then your post would have been a lot clearer. At least it would have put the idea that the evidence presented was suspect into my mind. As it is it came across as unclear who has the stronger position objectively speaking.
lamontcg 4y ago
I had viral pericarditis after a cold one time, but it appeared about 2 months after I had recovered. That's pretty common with autoimmune conditions triggered by IgG autoimmunity response. But we understand autoimmunity in response to individual exposure to antigens pretty well and while 1-7 days is probably too short to see a lot of responses, over 3 months is highly unlikely. There can be a long tail of certain individuals having autoimmune responses up until 2 years later, but in a population study if you capture nearly all the responses after 3 months. If you don't see anything 3 months later then there's no hidden long-term effects waiting to happen years later. And there's nothing fundamentally unique about the mRNA vaccinations that would cause anything different. It is just a dose of mRNA that looks like any other mRNA payload from a virus which is wrapped in a lipid package that fuses with the lipids in your cell wall (and we understand the allergy to PEG that some people have against the lipid nanoparticle itself). All of the 200 years of understanding of vaccinations and hundreds of years of autoimmune conditions subsequent to viruses still apply to the mRNA vaccines. The "no we don't understand anything about these new things and the clock starts from zero" is just a fantastically ignorant argument based on no understanding of what the vaccines are built from and what vaccines and viruses are and how they interact with the immune system. So both of you are kind of wrong. 7 days is too short, but 90 days is all you need.
- elcritch 4y ago
  Thanks, good to know about pericarditis. I’m not well versed on that or myocarditis and in particular the IgG or T-Cell response mechanism. Though the little I’ve read seems to indicate myocarditis is still primarily due to an acute immune response, but can re-occur or turn into a more autoimmune condition (chromic myocarditis or perhaps pericarditis). That said I would normally give the benefit of doubt that the authors of a paper in the Lancet are more well versed on myocarditis and it’s behavior. It looks like they do adjust all their comparisons to odds ‘per 100,000 person-days’. If done properly that would adjust from an event basis to per-time basis or rate which could account for long tail reactions. Using 90 days would risk including non-vaccine related myocarditis risks as well, which is perhaps why the lancet paper uses the time rate basis. If someone got a normal cold after a month and got pericarditis that'd skew the results as an example. Though I was disappointed to not see statistical analysis or comparison to normal occurrence rates of myocarditis without vaccine exposure, etc. though I didn’t thoroughly check their references, etc.

nabla9 4y ago

Chronic inflammation is not a symptom of Covid-19.

philjohn 4y ago
Turns out that myocarditis is though https://pubmed.ncbi.nlm.nih.gov/34341797/ https://pubmed.ncbi.nlm.nih.gov/34341797/
- lamontcg 4y ago
  myocarditis isn't generally chronic, particularly in kids. and that study concludes that the risk of the vaccine in 12-19 year olds outweighs the risk of the virus if you bother to read it.
  - philjohn 4y ago
    No, if you read the article it's from 12 up the benefits outweigh the risks, quoth: The ACIP report projected that mRNA vaccination in 12-17-year-old males would result in 215 fewer hospitalizations and 71 fewer intensive care unit stays. Benefits of the vaccine outweighed the risk of myocarditis from vaccination in all age groups, 12 years-old and up. Our results suggest that the risk of myocarditis from COVID-19 infection itself exceeds the known risk from vaccination by a considerable margin. In light of more infectious variants, the new school year nearing and many colleges now requiring COVID-19 vaccination (either for all students or just those living on campus), these results are especially timely. Whether considering all the risks and benefits of COVID-19 vaccination or just myocarditis, vaccination appears to be the safer choice for 12-19-year-old males and females.
    - lamontcg 4y ago
      Yeah I accidentally typed the exact opposite of what I meant.