[amanaplanacanal]

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.

[tpoacher]

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...

[kaba0]

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?

[tpoacher]

That's what the linked paper is about. Risk of myocarditis post mRNA-specific vaccination.