I genuinely wish I knew what to make of this study (PDF):
We estimated the number of excess myocarditis events per million persons in the 1-28 days following each exposure for the main analysis and by age and sex (Supplemental Table 5 and
Figure 1). Following the first dose of the ChAdOx1 and BNT162b2 vaccines an additional 1 (95%CI 0, 2) and 2 (95%CI 1, 2) myocarditis events per million persons exposed would be anticipated, respectively. Following the second dose of BNT162b2 and mRNA-1273 an additional 2 (95%CI 2, 3) and 36 (95%CI 34, 37) myocarditis events would be anticipated, respectively. Following a third dose of BNT162b2 an additional 2 (95%CI 1, 2) myocarditis events per million persons would be anticipated. These estimates compare to an additional 30 (95%CI 29, 31) myocarditis events per million in the 1-28 days following a SARS-CoV-2 positive test.
If the findings prove out it would suggest to me that the model of getting a booster against COVID-19 every few months may not be workable.
Nothing is risk-free and the assessment of risk varies by individual based both on personal circumstances as well as individual tolerance for risk. I haven’t done the math but it would seem to me that there would be a “sweet spot” somewhere at which the risk of myocarditis was so much lower than the risks from contracting COVID-19 it was barely worth considering. It does make one wonder about the 20th or 50th booster shot.
I’m not getting another booster shot. One booster shot made sense given that the optimal time between first and second doses was not used in an emergency. The paper points to young males under 40 being most at risk, but they probably don’t need boosters in any event.
On the flip side to the risks repeated “booster” doses; the risk of repeated COVID-19 infections (and possibly myocarditis from that) is much higher than previously thought.
The usual caveats apply. This is a pre-print. The fine details of the statistics and methods have not been reviewed. (If you read the paper they note a lot of problems, among them that their numbers are too small to reach many conclusions.) We dont know how severe the myocarditis. (By report they tend to be mild. Post vaccine myocarditis behaves differently than myocarditis from other causes.) It is very rare. In every group except maybe one Myocarditis is more frequent with covid.
So the take home is that we dont learn a lot from this. But, lets take it as a real confirmed study. What you learn is that if myocarditis is your one and only concern you might think twice about vaccination. If you can somehow avoid covid w/o getting vaccinated you would be better off. But, if you are worried about your total well being there are lots of other bad things that happen with covid and not much with the vaccines. If you are concerned about cardiac complications then you should know about Post Covid tachycardia, a more common problem.
The incidence of Post covid syndrome varies by study but if you use the 10% number in this study and if their 25%-50% number is correct, then 2-5% of covid pts have this tachycardia for a while. Compare that with 2 in a million. 9% of those with this tachycardia have it persist over 6 months, or about 0.2%-0.5% of covid pts. The impact? 2 of my guys have spouses who have this. One since October. She has been unable to go back to work (nurse) and the in laws still need to help with child care.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8356730/
The following is from a CHOP info site. The cardiologist cited has done some evals for us.
““Though children and teens are fortunately less likely to experience significant heart disease as a result of COVID-19, they can absolutely still develop severe illness, including heart failure and more severe forms of myocarditis,†says Dr. Elias, noting that the biggest concern for children with COVID-19 is the development of multi-system inflammatory syndrome in children (MIS-C), a rare but very serious condition in which different parts of the body — including the heart — become inflamed. “Approximately 50% of patients with MIS-C have decreased heart function,†he says.
Recent data provided by the CDC suggests that among 100,000 vaccinated adolescent males, only about four to seven would be expected to develop post-vaccine myocarditis. If this group was not vaccinated, however, more than 5,500 would be likely to become infected with COVID-19 over a period of three months, with infections resulting in 500 hospitalizations, potential MIS-C, myocarditis and possible death. Recent surges in infections would only increase these risks in unvaccinated individuals.
The numbers are clear: in children and teens, the risk of getting COVID-19, and developing severe illness that could seriously impact the heart, are far greater than the risk of experiencing post-vaccine myocarditis.
Common myocarditis myths busted
Still not convinced? Below, Dr. Elias addresses the most frequent concerns he hears from patient families, and busts common myths about myocarditis and the COVID-19 vaccine.
Myth: The COVID-19 vaccine will cause a child to develop heart disease.
Fact: “Children are much more likely to develop heart issues after COVID-19 infection than after the vaccine. When children develop myocarditis after COVID-19 infection, it’s typically much more severe than when it occurs post-vaccine.â€
Myth: Kids don’t get that sick from COVID-19, so they don’t need the vaccine.
Fact: “While kids are less likely to develop severe illness from COVID-19, they can get COVID-19, they can transmit COVID-19 and they can die from COVID-19. Even if they initially have no symptoms with infection, they can still develop MIS-C, which many families haven’t ever heard of.â€
Myth: Children with congenital heart disease are at a higher risk of developing post-vaccine myocarditis.
Fact: “Congenital heart disease is not a risk factor for developing post-vaccine myocarditis. However, it has been identified by the CDC as a risk factor for severe infection for COVID-19.â€
Steve
That sounds like good advice to me. However, I would think the concern would be that if the negative risk of myocarditis with repeated vaccinations increases faster than the positive risk of avoiding COVID-19 with repeated vaccinations.
Totally unnoticed here is that our surveillance efforts picked up a complication that happens about 2 in one million times. The anti-vaxxers claim that we are missing stuff much more common that that and at the extreme end they claim the vaccines kill more than the virus. Somehow we dont notice that.
Steve