Myocarditis Cases Reported After mRNA-Based Covid-19 Vaccination

https://jamanetwork.com/journals/jama/fullarticle/2788346

by drocer88 • 4 years ago

65 83 4 years ago

It's important to mention that catching COVID also causes myocarditis https://www.cdc.gov/mmwr/volumes/70/wr/mm7035e5.htm

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.

mgamache2• 4 years ago

It's also true that VAERS may be underreporting cases.

zenplant• 4 years ago

It's probably true that cases are under reported in both groups. Many people with myocarditis might just go along with their day because the symptoms aren't especially worrisome to them. You can imagine the cohort of people with political affiliations that say COVID isn't worth worrying about might not see a doctor even if the symptoms are worrisome.

alfor2• 4 years ago

I hear that a factor of a 100X is common. The system is made so that the least amount of effect are reported.

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)

pfisherman• 4 years ago

VAERS is only one data source and not a particularly good one. We have vaccination records linked to medical histories in electronic health record systems and insurance claims databases.

NikolaeVarius• 4 years ago

RAW VAERS data is a POS source of data. Plenty of Anti-Vaxxers submit false data to it and even non Anti-Vaxxers submit symptoms that correspond to anything within a month of taking the shot.

cameldrv• 4 years ago

Vaccine Safety Datalink is a much better source.

marcinostefano2• 4 years ago

It's not one or the other any more, as You can easily catch symptomatic Covid being fully vaccinated, question is; does risk multiply, sum or maybe the vaccine somehow protects against it.

alanfranz• 4 years ago

easily

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.

gkfasdfasdf4• 4 years ago

Sure there are breakthrough cases, but if you are unvaccinated the chances of catching covid are still much higher. And if you get myocarditis with the vaccine (which is rare) you will get it much worse with covid.

ed25519FUUU• 4 years ago

That is not true for every age group.

wusher• 4 years ago

I don't have the numbers to answer this but which groups are getting myocarditis also matters. If covid causes myocarditis in 1 out of 100 people in an age group prone to myocarditis, but mRNA causes myocarditis in 15 out of 1000 people in an age group that doesn't get myocarditis, then then we should be very concerned about the mRNA myocarditis and adjust our policies accordingly.

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"

drocer88• 4 years ago

"Conclusions Men are significantly more susceptible to myocarditis than women. Young men are especially at risk for acquiring myocarditis, while women are affected most commonly at the postmenopausal age. The proportion of hospital admissions caused by myocarditis has an inverse, logarithmic association with age."

from : https://heart.bmj.com/content/99/22/1681

assbuttbuttass2• 4 years ago

I don't disagree with that nuance, I was just trying to get ahead of the inevitable anti-vaccine propagandists that will use this study out of context for their own narrative.

lern_too_spel5• 4 years ago

They're very likely to be causing myocarditis through the same mechanism involving the spike protein, which means your scenario is unlikely. Myocarditis prevalence among college athletes who have recovered from a COVID-19 infection (even asymptomatic) is so high that some conferences require comprehensive cardiac testing before they can return to play. https://www.thecardiologyadvisor.com/general-cardiology/hear...

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-...

disambiguation4• 4 years ago

Prior reports have done this examination

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.

Jansen312• 4 years ago

Currently, worldwide is still at "promoting vaccines at all cost because Covid is worse than Black Death". So doubt these research results would be freely allowed to get published or supported. China now only doing trials on mRNA (many countries stopped using their non-mRNA vaccines). India hasn't fully vaccinated their people yet. Large part of Africa is even worst situation. So at least 2-3 billions people havn't exposed fully to mRNA benefits or negative effects. Take dengue vaccine that was shelved in Philipines which requires multi years to see its side effects. We are now just entering year 2 or mRNA. Give it 10 years to know "acceptably" mRNA vaccine increases unnecessary risks of heart-related problems. If you know personally doctors working in vaccines research field you probably will know the negatives better. Many doctors scared to even mentioned these negatives for fear of retaliations (this is worlwide phenomena right now). There is a reason FDA needs 75 years to disclose mRNA vaccine related papers. There is also a reason why all statistics on negatives effect of vaccines is so few. Try mention any of those on Youtube or Facebook now and you'll almost instantly get retaliation as anti-vaxxers.

eminence32• 4 years ago

If I'm reading both summaries correctly:

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.

Arnt• 4 years ago

The numbers are so different that it doesn't matter very much how you compare. It would be different if only 5% of unvaccinated people contract the disease, or if the vaccine reduced the likelihood of infection by only 5%.

cuspy2• 4 years ago

These numbers are not even remotely comparable. The CDC number includes ages groups that are much more likely to have severe infections. The CDC number you cited is also based on hospitalized cases, which select for severity

Bancakes• 4 years ago

You will get the jab but for being symptomatic with covid, that's already a small chance. 5% * 0.146% ~~ 0.007

dazilcher• 4 years ago

I am fully vaccinated and, as I'm typing this, recovering from COVID.

Do tell me more about this vaccine/disease exclusivity. I must be doing something wrong.

josephcsible• 4 years ago

You can't just compare the overall myocarditis rate from the vaccine with the one from COVID like that. Doing so makes the incorrect assumptions that you definitely will get COVID if you're unvaccinated, and that you definitely won't if you are. Let w=the chance the vaccine gives you myocarditis, x=the chance COVID gives you myocarditis, y=the chance you get COVID if you're unvaccinated, and z=the chance you get COVID if you're vaccinated. The proper comparison is then between w and x*(y-z), not just between w and x.

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?

tchalla• 4 years ago

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.

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.

nicoburns• 4 years ago

That’s why we don’t see myocarditis from non-MRNA vaccines like Astra Zeneca.

Does the AstraZeneca vaccine not include the spike protein? I thought it included the whole virus including the spike protein.

cloutchaser• 4 years ago

It should also produce the spike protein I believe, it's just that the triggers for cells to produce it are within an adenovirus, not mrna inside lipids.

So I'm not sure what this guy is on about.

mattzito2• 4 years ago

I posted a similar comment, but it's not the same - AZ uses a modified non-Covid virus that has been engineered to model the spike protein. I'm not sure why that spike protein is different than the MRNA, other than being attached to a virus.

nojokes2• 4 years ago

If it was just reaction to the spike protein then why is myocarditis more likely on the second vaccination?

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).

goalieca• 4 years ago

Well his blue check says he’s a journalist. I do wonder if the delivery is different. Wild covid is caught in the respiratory tract while vaccine is injected in the muscle. Any medically savvy people can comment on this pseudoscientific drivel?

mattzito2• 4 years ago

I'm confused by this - the AZ vaccine also expresses the spike protein, just in a different delivery mechanism, right? That was my understanding when I got the AZ vaccine in a trial.

licnep• 4 years ago

In viral vector vaccines (AstraZeneca, Sputnik, Johnson & Johnson) the gene for the spike protein is introduced into an adenovirus. Following vaccination, the modified adenovirus will infect cells of the host, which will subsequently start to produce the spike protein

So if there is a difference in the incidence of myocarditis, it must be for a different reason.

https://pubmed.ncbi.nlm.nih.gov/34228411/

cuspy2• 4 years ago

To be clear: this is an overconfident assumption, not an evidence-based claim. It's not even plausible on the surface. Why would we assume these proteins would be distributed similarly in the infection case and the vaccination case? We know that very different physiological processes will be taking place, so why assume the inflammatory responses must be the same?

mizzack• 4 years ago

The issue arises from the spike protein itself. That’s why we don’t see myocarditis from non-MRNA vaccines like Astra Zeneca.

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.

yucky• 4 years ago

Correct me if I'm wrong, but I believe the FDA still has not approved Moderna beyond emergency use, due to the myocarditis issues. This, in addition to a number of EU countries that have now stopped giving Moderna to males under 30 for the same reason.

legitster• 4 years ago

We're likely not seeing myocarditis in AZ shots because it's a very long tail event and the AZ represent an order of magnitude smaller sample size.

gkfasdfasdf4• 4 years ago

Re: question of why the spike protein from mRNA vaccines shows increased risk of heart inflammation vs AZ vaccine, I listened to the entire interview with Raj Puranik [0], and it's still not clear to me why. He said comparing side-effect profiles of different vaccines is challenging because the dosage and delivery are so different. I.e. mRNA is given over 3 weeks while AZ is given over months.

[0] https://abcmedia.akamaized.net/radio/local_sydney/audio/2022...

nojokes2• 4 years ago

If it was just reaction to the spike protein then why is myocarditis more likely on the second vaccination?

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.

This is in correlation with the amount of antibodies produced by these vaccines.

This is the not contradicting with the observation so far.

There are few ways to find how what is most likely happening.

draw_down• 4 years ago

This risk should be considered in the context of the benefits of COVID-19 vaccination.

Whoa now, easy on the antivaxxer rhetoric!

JohnHaugeland4• 4 years ago

That's not an antivax thing to say, or rhetoric at all.

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"

castrodd• 4 years ago

I think he was using a rhetorical device called sarcasm.

scotty79• 4 years ago

Number of registered cases of myocarditits after vaccination is not very different from baseline, while covid infection increses risk of miocarditis 16 times.

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.

gkfasdfasdf4• 4 years ago

Great twitter thread on this subject [0]:

"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...

marcinostefano2• 4 years ago

Yes, but how about breakthrough infections as You can easily get symptomatic Covid nowadays especially with Omicron, do You have any data on this?

gkfasdfasdf4• 4 years ago

Breakthrough infections are much milder. There is mountains of data on this. Look at hospitalization and death rates of vaccinated vs unvaccinated.

peteradio4• 4 years ago

How much of the spike proteins from virus are free floating after being injected near capillaries? Spike is supposed to be attached to the virus and break off on entry into cell. It doesn't seem like they are apples to apples in how you'd expect to see them in the body. It doesn't seem like a very rigorous argument at least.

disambiguation4• 4 years ago

Results Among 192 405 448 persons receiving a total of 354 100 845 mRNA-based COVID-19 vaccines during the study period, there were 1991 reports of myocarditis to VAERS and 1626 of these reports met the case definition of myocarditis.

So.. we're using VAERS now?

JohnHaugeland4• 4 years ago

You aren't using anything.

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."

disambiguation4• 4 years ago

Sure, I don't mind leaving it to the scientists. I'm just wondering "out loud" for 2 reasons:

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.

alfor2• 4 years ago

Sun exposure to reduce severity of covid (not vitamin D, infrared radiation)

https://www.youtube.com/watch?v=2Zzo4SJopcY&t=1003s

newbamboo4• 4 years ago

Now we need to see if it’s lower in one of the many nations that train their nurses, correctly, to aspirate the injection.

0x500x79• 4 years ago

I know this might be a bad analogy, but it was one of the things that went through my mind during all of this as a software engineer:

"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.

stjohnswarts• 4 years ago

Good I'm glad they were able to share the risk was minimal and line with previous discussions on the matter. I'm sure that Fox News will turn this into a complete fail for medical science and NOT report the comparitive death rate of people who are completely unvaxxed.

Myocarditis Cases Reported After mRNA-Based Covid-19 Vaccination

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