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Covid-19 vaccination-related myocarditis: A Korean nationwide study (academic.oup.com)
73 points by VagueMag 1108 days ago
5 comments

I skimmed through the study, but didn't read the whole thing. It appears that they called it vaccine related if it happened within 42 days of being vaccinated. What would the normal incidence be for unvaccinated people in a typical 42 day period? And what is the incidence for people who get infected with covid? Without those to compare with its hard to know what to think about these numbers.
I don't have numbers at hand at the moment, but the expectation is that its background rate is effectively zero in the absence of viral illness (COVID or otherwise), and presumably VRM is still lower compared to COVID-induced cardiac events.

However, the latter point doesn't make this finding trivial; there was considerable debate during the pandemic, whether people who had recently contracted COVID (and thus had natural immunity already) should have the vaccine as scheduled anyway, on account of it "being harmless", with early evidence of VRM dismissed as conspiracy theories and fearmongering. I recall many people who declined the vaccine on that premise and were still labelled "antivaxxers" on that basis (which I thought was rather sad at the time).

Furthermore, in many countries this policy was further enforced via "vaccine passports", meaning people with natural immunity still had to vaccinate regardless, in order to be able to go outside and conduct their business as normal, effectively putting people at unnecessary risk purely for the sake of administrative convenience.

Therefore this is a clinically significant finding in my view. Not sure why the article got flagged so quickly on HN...

Where did you draw the conclusion that vaccination after contacting the virus and getting some natural immunity would still incur a risk of heightened myocarditis?
That's what the linked paper is about. Risk of myocarditis post mRNA-specific vaccination.
Look at this user's submission history - nothing but inflammatory political posts, almost nothing related to technology.

This is one of the only aggregation websites yet to turn into the typical Twitter/Reddit screaming chamber, disappointing to see users actively try to push it in that direction.

> nothing but inflammatory political posts, almost nothing related to technology

Ironically HN almost seems like one of the better discussion venues for all of these incendiary (and possibly off-topic) posts, because:

> This is one of the only aggregation websites [that has] yet to turn into the typical Twitter/Reddit screaming chamber

HN occasionally has downvote wars, but overall it seems to have done pretty well, even while comment sections on other sites (Ars Technica...) devolved into screaming chambers.

Apart from whether this messenger specialises in "inflammatory political posts" the fact remains that this specific message potentially "gratifies one's intellectual curiosity", especially given the way potential side effects of SARS2 vaccination have been made close to impossible to discuss without being labelled and pushed to the sideline. Assuming that the "European Heart Journal" is immune to being labelled as "anti-vaxx" and other similar epithets their decision to publish this article should give pause to those who attempt to silence any discussion on this subject.
I for one would really prefer more tech content. On certain days I barely see any interesting one, and while the discussion on non-tech topics can at times still be interesting, it is often prone to the typical ego-disease of IT people (I’m also guilty of that), who overestimate their knowledge on foreign topics.

I still think that a tagging system would greatly benefit the site.

1.08 in 100,000 cases of vaccine related myocarditis (VRM), 2.16 deaths per 1,000,000.

Hard to take much meaning away from that without understanding the risk posed by not vaccinating.

If vaccines can prevent long COVID or "post viral syndrome," that's another potential cost benefit analysis. (which would make sense from a laymen perspective, killing k random cells seems bad, but killing N random cells seems strictly worse).

This is true, but misses an important exception: people who received vaccines despite demonstrating natural immunity at the time of vaccination.

Indeed I'd be interested to know of those episodes of VRM, how many of them had recent COVID, and whether these individuals had worse outcomes. I suspect you'd find these individuals were put at increased risk, for no clear increase in benefit.

> Hard to take much meaning away from that without understanding the risk posed by not vaccinating.

What's the benefit from vaccinating otherwise healthy young men against Covid? Not people in risk groups, but healthy young men.

It should be obvious that if your clinical trials cannot rule out major adverse events in 1 in N, you shouldn't vaccinate populations in which the benefit occurs in less than 1 in N.

> If vaccines can prevent long COVID or "post viral syndrome, that's another potential cost benefit analysis.

That's a big "If".

It looks like this is part of a growing body of evidence that suggests that the risks outweigh the benefits of vaccination for young people.

It's also worth noting that the incidence of post-vaccination myocarditis (from this study; 1.08 per 100k people) is significantly lower than the 2014 rate of myocarditis: 8.6 per 100k people [1]. Additionally, the risk of myocarditis from a covid infection is signfiicantly higher than the risk of myocarditis from the covid vaccine.

That being said, especially since the danger of covid is much less for young people, and the risk of the covid vaccine causing myocarditis is much higher for them, there's a growing push to stop vaccinating young people against covid. I think the CDC continues to quash its credibility by trying to sweep this under the rug, rather than presenting the facts--that there is risk, and there's a cost-benefit analysis.

[1]: https://www.nature.com/articles/s41598-022-05951-z [2]: https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.... [3]: https://openheart.bmj.com/content/9/1/e001957

> I think the CDC continues to quash its credibility by trying to sweep this under the rug, rather than presenting the facts--that there is risk, and there's a cost-benefit analysis.

If true, I don’t blame them. One thing they have learned this pandemic is the modern public doesn’t process nuance - see the usage of masks. If they broadcast this, a huge chunk of the population will think they should not vaccinate, COVID deaths will surge and more people died from COVID than vaccines induced myocarditis. Best to keep their mouths shut until more studies are completed and they have enough data.

> see the usage of masks

The modern public doesn't have patience for lies. The messaging around the masks was explicitly untruthful, as we now know. Once the public picked up on that, the CDC etc. lost the benefit of the doubt, and that got us to where we are now. What you're referencing is the effect, not the cause.

See ...

At the beginning it was "don't hog masks" because there was a shortage, it's effectiveness vs COVID was unknown, and healthcare workers needed them to do their job - it would be a problem if Nurse Nancy breathed additional germs onto Little Timmy who is already weaken because he is sick.

Later it's confirm that masks are effective vs COVID and the shortage has ceased so you should definitely wear them.

But to a good chunk of the public, context and nuance is completely lost on them.

>At the beginning it was "don't hog masks"

As gfodor said, this is an utter lie. The Powers that Be explicitly told us that masks did not help against COVID-19, then completely reversed itself and told us that everyone should wear masks while claiming either a) "We never said masks did not help against COVID-19", or b) "We said 'masks don't help' to avoid a shortage for medical personnel". Now, as geekybear and the_third_wave said, it seems like TPTB was right at the start, albeit for completely the wrong reason, but that doesn't take away the seriousness of the initial lie that led to more.

Just before COVID-19 became widespread in the US, I discussed with my dentist brother the advice media was giving about how masks wouldn't help. Hearing his skepticism about said advice was my first clue about how the media was being used to spread falsities about the epidemic.

No, they didn't just say that, that was the problem. They said that there was no evidence to support the idea that masks were effective against COVID-19. This is the usual weasel word approach of saying "there is no evidence" to support something to lead people to thinking there is counterevidence, which there wasn't. Once they started lying to people this way, it was over.

The proper messaging was: "we need to keep the mask supply up for medical workers if it turns out masks are effective in helping reduce their exposure. we don't know yet if masks are effective, they might be, and we are researching this right now as fast as we can. in the meantime, it seems prudent to assume they may help, and we ask the public to avoid buying masks for the time being while we increase the supply so our medical workers can have them."

> Later it's confirm that masks are effective vs COVID

This has never been proven in any real sense, certainly not enough to justify mandatory masking. Now that the smoke is starting to clear a bit it is becoming clear that "There is not enough evidence to suggest medical-grade face masks protect vulnerable people from Covid" [1] and that "There is just no evidence that they — masks — make any difference ... There’s no evidence that many of these things make any difference” [2]. A similar conclusion was reached earlier by an oft-cited Danish study [3] from 2020 so it can not be said that these are new insights. This also makes it clear that forcing people to wear masks was not based on scientific data and as such can not be justified as "following science".

[1] https://www.telegraph.co.uk/news/2023/04/12/face-masks-prote...

[2] https://www.nytimes.com/2023/02/21/opinion/do-mask-mandates-...

[3] https://www.acpjournals.org/doi/10.7326/M20-6817

It's fact that masks help prevent the transmission of diseases that spread from the nose and mouth (and to my knowledge COVID is one of those) - that's why healthcare workers wear them; they have worn them for decades.

> certainly not enough to justify mandatory masking

This is the part that I don't get. People like you act like wearing a breathable fabric over your nose and mouth is some kind of huge sacrifice. Healthcare workers wear them everyday. The Japanese wear them whenever they are out and are sick with the flu/cold - some Japanese women even just wear them because they were too lazy to put on makeup that day. It's such a dumb thing to kick up a fuss over.

Ah, yes. Account created 43 minutes ago.
20% of myocarditis ended up in deaths and heart transplantation. Young males 12-17 seems to be more affected.
I think you misread the numbers:

> 21 deaths (4.4%), and 1 heart transplantation (0.2%).

Yes, with 5.29 cases of myocarditis for males aged 12-17 per 100,000 people. I think that number is good to include for context
Given the 20% incidence rate at 5.29/100k, the population of the US in that age bracket, and the last update cdc vaccination rate (71%) for that age bracket, that means you could expect roughly 200 males 12-17 died from a covid vaccine in the US, assuming no confounding factors in the study (such as other cause myocarditis).

The known death count for this age range, males, for covid in the US is roughly 1000, or 5:1. There’s not good estimates on severe long term impact of covid (long covid) in these ages, but the studies I found estimate 4-10%. Further, when considering the value of vaccination at any age, you need to consider the “firewall” effect in not further transmitting to more vulnerable people. Young children in multi generational homes can pose a non trivial risk to the elderly in their home. A child killing their grandparents isn’t an outcome to be discounted. Overall even with these results it seems like good public health advice to vaccinate everyone, while not downplaying the tragedy of any premature death for any reason.

The study seems to say 1.08 cases of myocarditis per 100,000
That’s for all age groups
Ah the nuthingbargar that inevitably follows the evidence of being wrong. Does the entire population have BPD?