What I would like to know is, for young males (i.e. those who are most at risk of myocarditis after the vaccine), does the vaccine lessen cardiac risks in a subsequent infection or not?
I am 31 and got a heart attack caused by a blood clot last year. Had to undergo double bypass surgery. This happened two months after my second shot so every doctor dismissed the fact of it being related to the vaccine.
I was fit and healthy, no smoking, no drinking, no drugs, and exercising regularly with no family history.
I never had symptoms but maybe at some point I caught covid without knowing despite going out very rarely and always observing precautions.
My brother passed away at 35 from an undiagnosed heart condition. He was in incredible physical shape and had run a half-marathon a few weeks earlier. He had never smoked, he drank moderately and he was a vegetarian. He had no history of any kind of heart problems (or any serious medical problems, in fact), but one day he felt dizzy and had trouble staying upright, so he took a sick day from work, took a nap and never woke up. This was in 2017.
It's certainly rare, but young fit people do have heart problems. You can't conclude that this had anything to do with the vaccine, this is not how science works. Certainly the long-term health effects of the vaccines should be studied, but bandying about these kinds of anecdotes is dangerous: it's the same kind of thing that has (wrongly!) convinced so many people that vaccines cause autism.
By the way, this is not to minimize what you went through, I cannot imagine how scary or painful it must've been. I hope you will have a strong path to recovery, and I wish you all the best.
That's terrible, I hope you're recovering to the best possible.
Do you happen to know what was your blood pressure prior to the heart attack, and/or your apob level?
At least you should have it checked now (I assume that's what have been prescribe by your doctors).
It is my understanding that it is more statistically sound to point the cause of a heart attack at your age to genetic/epigenetic factors instead of a potential coronavirus infection with no symptoms.
"It is my understanding that it is more statistically sound to point the cause of a heart attack at your age to genetic/epigenetic factors instead of a potential coronavirus infection with no symptoms."
He's saying that he has an effect 2 months after the vaccine. Is that not also worthy of consideration, or do you include it as an epigenetic factor?
Well, in my mind `epigenetic = biological age * food intake`, where `food intake` is 'is he eating a consistent healthy diet, given that a typical person not eating healthy will surely says that she's eating healthy'. It's (unfortunately) enough to be >30yo, having bad genes around cholesterol handling pathways and eating a standard american diet (even without significant overweight) to be in the danger zone in terms of cardiovascular risks.
ApoB in the golden (and recent) blood test here. OP: given that you have experienced chest pains, and if it's not the case already, go have your ApoB checked and ask for statins if needed: your 60yo you will thank you.
And, in my own and non-important opinion: don't waste your time even thinking about potential link between your condition and covid/vaccine, this is a path that leads nowhere in terms of prevention of futures attacks.
My cholesterol level are OK and I am Italian, so I surely don't follow an average American diet xD My gf and I love cooking and baking and all our food is freshly, with plenty of fruit and veggies, low salt in favour of spices, low sugar and plant based alternatives for butter and such :)
Sorry I should point out I had pains even before the first dose but every doctor or specialist I consulted thought they were muscular pains (right chest and shoulder area). So it's likely a vaccine is not the cause but there are so many factors and cofactors to consider it's very hard to make a diagnosis. Other blood tests in March will hopefully clear some of this out --
Consider the billions of shots being taken. Consider the time frame of 2 months. Consider the fact that it was the second shot. Meaning it could have happened within 2 months of the first shot, and then there's a 4 month window of consideration.
What do you think is the prevalence of something happening to someone in a pool of, let's say, 4 billion people in 4 months.
I'm sure 2 separate people had a potted plant land on their head. Is it worth considering its relation to the vaccine?
I'm not saying it can't be related to vaccines, but as an anecdote it's useless until it's shown in statistics, or proven causality by his doctors.
Thank you, I recovered well and am now able to walk more than one hour each day. I don't know what my pressure was prior to heart attack but now it's kept on the lower side by medications (115/60)
The rate of myocarditis is much higher if you get Covid than if you get the vaccine . So indirectly getting vaccine will lower your risk since of heart disease as everyone will eventually get covid.
Unfortunately this study's message is quite obfuscating, probably intentionally. They mean exactly what they say though: covid-induced myocarditis rate is higher than vaccine-induced myocarditis rate, but it says nothing about covid-induced myocarditis rate in relation to vaccination status.
> The rate of myocarditis is much higher if you get Covid than if you get the vaccine .
What are you basing this on? There was a recent UK study (preprint, last I checked) of 40 million people that showed that the risk of myocarditis was definitively higher compared to Covid in the Moderna sample and higher (albeit statistically insignificant) in the Pfizer sampler for young men.
> So indirectly getting vaccine will lower your risk since of heart disease as everyone will eventually get covid.
This is a separate claim about the conditional probability, which I haven't seen data on. The unconditional probability does not inform the conditional probability.
As I read the text of the study (https://www.medrxiv.org/content/10.1101/2021.12.23.21268276v...) it directly says:
"First, we confirm and extend our previous findings in more than 42 million persons that the risk of hospitalization or death from myocarditis following COVID-19 infection is higher than the risk associated with vaccination in the overall population." Is it another study you have where the risk [] is higher after Moderna/Pfizer than after COVID?
Only % risk is misleading. From the conclusion of the PDF linked:
> In summary, the risk of hospital admission or death from myocarditis is greater following COVID-19 infection than following vaccination and remains modest following sequential doses of mRNA vaccine including a third booster dose of BNT162b in the overall population. However, the risk of myocarditis following vaccination is consistently higher in younger males, particularly following a second dose of RNA mRNA-1273 vaccine
This concurs with what OP is saying, but the statement is in effect misleading. The vaccine induced myocarditis risk is higher in young males. The numbers also indicate this is even higher than the risk from COVID-19 infection in that group. However, in the population in aggregate the vaccine is less likely to cause this side effect than infection.
My pet hypothesis: people who are into one of the many athletic pastimes, particularly those with a competitive component, will all do exactly one thing when faced with an appointment that comes with an attached "take a rest from exercising afterwards": they will schedule a particularly intensive workout the day before so that those rest days "don't go to waste". (source: I'm one of those and very few in my social circle don't match that pattern)
But the risk association might very well be not so much the exercise happening while under immune stress but the processes that happen during recovery doing their thing while under immune stress. Usually immune stress means infection and we don't get to schedule our infections, so this distinction (exercise time vs recovery time) will be very much unexplored.
Young males tend to be more into performance-oriented training (competitive, or focused on metrics, or both) than other population groups, and with an actual infection it might even be that the relevant immune stress does not really start before more direct symptoms suggest taking a break. Could be as simple as shifting the "no sports" instruction that comes with the jab a few days backwards.
The point is that it is misleading (or at least, premature) to say that myocarditis is more likely with the virus than with the vaccine, given that the context of this discussion is usually around young men and there is recent data that suggests the opposite for this cohort under Moderna (and perhaps Pfizer).
Also, what you say is not the case in every country. Many countries are jabbing young men with Moderna.
You keep quoting this research like it is something special. The EMA has know this for quite some time to be in the 1-10 in 100000 and more prevailant in males aging 12-35. It either goes away by itself or with medication though you are advised to seek medical attention if you feel anything strange. At least where I live no cases are known of death due this in stark contrast to the actual desease.
From the paper, 3rd paragraph from the end in the "Main" section:
> "First, we confirm and extend our previous findings in more than 42 million persons that the risk of hospitalization or death from myocarditis following COVID-19 infection is higher than the risk associated with vaccination in the overall population."
Quick edit: while I was skimming the paper someone else commented exactly this excerpt, hehe.
Everyone will eventually be exposed to covid (probably repeatedly). It's possible with vaccinations that not everyone will be infected with covid however, as even against omicron it appears 3 doses of vaccine (especially a mix of pfizer and moderna) provide efficacy of 60%+ for at least 15 weeks. Omicron-specific versions of the mRNA vaccines are also already in testing, so I would hope those will be available for future boosters. (Of course there will be future variants as well, but it seems likely those would branch off of Omicron, so an updated vaccine would likely still prove more effective than the current ones would.)
I suppose for some version of "eventually" then everyone would likely expect to get a breakthrough case eventually, but even so the vaccines should drastically reduce the number of times one expects to be infected, so still risk would be reduced, even if it wasn't for breakthrough cases (although it appears that vaccines reduce the risk there as well).
Related to your "exposed to" vs "infected" point, I've been wanting to check my understanding on something, and hopefully someone here can provide a more informed opinion. Immunity can be boosted through exposure, right?
For instance, if someone was vaccinated, but then exposed and was lucky enough not to develop an infection from their exposure, are they immunologically better off as a result of that exposure? I think they probably are, because my understanding is that's how the earliest vaccines worked (exposure on a small enough innoculum to avoid infection) but I'm not an expert, so would love to hear more about this & whether there's a name for such an immune effect when it happens in the wild.
Immunity can be boosted through exposure (indeed, this is one of the reasons why we may be seeing higher rates of shingles in young people, or why we see occasional outbreaks of pertussis in people who were vaccinated awhile back).
But for that, you are, at most, looking for the occasional transient exposure - not the bombardment that one is getting right now.
I saw a blurb about tests of a two part vaccine on mine. First dose an mRNA vaccine injection. Second dose is intranasal naked spike protein. Provided good protection when the mice were challenged. The spike protein isn't infectious. Part of the motivation behind intranasal vaccines is the hope that mucosal immunity provides better protection.
Also read a summary of influenza challenge studies. People exposed to low doses often seroconverted asymptomatically.
I feel it's plausible small exposures after vaccination would build more protection.
It also depends on how many particles it takes to get you sick. Norovirus is only 7, which is insane and also why it spreads so easily. Hard to have just an exposure to that!
China can't stay locked down to the extent they are forever. Hopefully they will have a chance to get their population substantially vaccinated before most there are exposed though.
As I read the text of the study (https://www.medrxiv.org/content/10.1101/2021.12.23.21268276v...) it directly says: "First, we confirm and extend our previous findings in more than 42 million persons that the risk of hospitalization or death from myocarditis following COVID-19 infection is higher than the risk associated with vaccination in the overall population." Is it another study you have where the risk [] is higher after Moderna/Pfizer than after COVID?
"in the overall population" does a lot of heavy lifting there. Young males are both more vulnerable to vaccine-induced myocarditis and far less vulnerable to severe covid than the general population.
While there are several problems with that paper, it should be noted, as an epidemiologist, that the publication timelines for COVID-19 papers have gone well and truly pear shaped.
Are there any problems with that paper that would invalidate their conclusion that myocarditis is more likely in young men who get Moderna than young men who get Covid?
My biggest concern is the studies that have been comparing myocarditis induced by the vaccine vs. those with MIS-C from COVID-19 that show that they're not necessarily directly comparable - the vaccine-induced version is also milder.
It is elevated, but the implications of that depend wildly on things like case rates, as events/vaccine doses is static, and events/cases is dynamic. A conclusion reached in Sept., 2021 misses a huge upswing in cases in young men from Omicron, which while milder on a per-case bases has also caused a lot more cases (to use a gaming analogy, making better saving throws, but making a lot of them).
Do you have a source on the vaccine-induced myocarditis being milder? If that's true then it is indeed a crucial thing to keep in mind when interpreting these results.
It was posted less than two months ago, that’s a pretty normal time frame for a paper to stay in review depending on the field and journal. Often there are two rounds of review even if the reviews only call for minor revisions
Honest question: is myocarditis and "heart disease" exactly equivalent for purposes of that assertion? In any case, you would have to subtract the percentage of people who get myocarditis from the vaccine itself, before deciding on the net benefit.
> Because severe disease increased the risk of complications much more than mild disease, Ardehali wrote, “it is important that those who are not vaccinated get their vaccine immediately”.
We're trying to isolate just one single claim. A claim about myocarditis alone. An article saying that the vaccine reduces complications overall, and is therefore a good choice, does not address the question of myocarditis in particular, and if it is reduced in the vaccinated population.
You've found the only sentence in the entire article about vaccination and attached you own meaning to it. If Ardheli wished to convey that severe disease increased the risk of complications much more than mild disease Ardheli could have and should have stated so.
I'm not saying your point is invalid, I'm just saying it's not addressed in the article in question. Please be more careful. It's OK to just admit you we're wrong. It's not OK to twist quotations to support your position not matter how valid or righteous you believe it to be.
That's the point. You're still going to get Covid, so the question is, does having the vaccine reduce the prevalence of myocarditis in Covid patients? If it's the same as in the unvaccinated population, then (ignoring other actual benefits for a moment) taking the vaccine may actually increase your risk of myocarditis, since there is the risk with the vaccine itself, plus the risk once you get Covid.
It makes no sense to only look at the risk of myocarditis. What you really want to know is how likely people in your age group and with similar predispositions are going to have serious health problems or die (i) if they are vaccinated and boostered and are exposed to SARS-CoV-2 and (ii) if they are not vaccinated and are exposed to SARRS-CoV-2. The tricky part is the "exposed to" - if you interpret this as a symptomatic breakthrough infection, then you'll bias the study a little bit against vaccination because it seems likely that fully vaccinated people who get breakthrough cases of Covid have previously undiscovered health deficiencies in contrast to those who are vaccinated, exposed to the virus and do not show any symptoms. (I'm talking about a statistical tendency, of course, not all of those people.)
So in the end the most interesting data is still how many vaccinated get serious health problems or die versus how many unvaccinated get serious health problems or die in a time and place where both groups are likely to be exposed to the virus. If the group is large enough and randomly selected, then this should be fairly indicative. Of course, the meaning of "serious" needs to be defined and quantified.
AFAIK, myocarditis can be treated very well when its diagnosed, that alone makes the focus on it strange. Maybe the lesson to draw from the debate is that patients should be informed better so they can identify symptoms of myocarditis and seek medical help early. Just an idea...
I don't see anywhere in that article where it states that myocarditis is less prevalent in patients who subsequently get Covid. Would you mind quoting the relevant bit?
> Based on a study out of Israel, the risk of post-vaccine myocarditis is 2.13 cases per 100,000 vaccinated, which is within the range usually seen in the general population
Because the vaccinated are not immune to the virus, some of them must have gotten covid. The overall risk of this sample still falls with-in the normal range for myocarditis.
Epidemiologically, endemic is that the rates of disease are within expectation - for example, there's a statistical threshold for flu every year. There can still be swings - seasonal diseases for example.
There is no sane universe where COVID-19 is endemic from an epidemiological standpoint.
It also doesn't imply that we should stop doing things.
The change in conditional probability though likely flips when considering the third dose - the third dose is most likely to cause myocarditis, and least likely to protect against severe covid causing myocarditis (because the first two doses are already providing a high level of protection).
Nope. For the control group to be valid, it must be drawn from the same reference class as the treatment.
You could of course argue that in all respects that matter for the risk of heart disease, people who take vaccines are the same as people who don't. I would disagree, and only a bet could settle the difference.
> "This is the figure, and it shows really clearly, that when you look at myocarditis just in this group, men under the age of 40, it is crystal clear, pfizer dose 2, pfizer dose 3, moderna dose 1, moderna dose 2, have rates of myocarditis greater than the rate of myocarditis post SARS-CoV-2 infection"
