Myocarditis and COVID Vaccine Risk

 Vinay Prasad analyzes a 2021 published paper about COVID vaccines and myocarditis. Even my relatives who discounted the vaccines as a health hazard have noticed on an anecdotal level, acquaintances with sometimes fatal results from heart problems. Prasad is not some antivaxxer of questionable scientific credentials:

Vinay Prasad MD MPH is a hematologist-oncologist and Professor in the Department of Epidemiology and Biostatistics at the University of California San Francisco. He was the Chief Medical and Scientific Officer and Director of CBER at the US FDA. He runs the VKPrasad lab at UCSF, which studies cancer drugs, health policy, clinical trials and better decision making. He is author of over 500 academic articles, and the books Ending Medical Reversal, and Malignant. He hosts the oncology podcast Plenary Session, the general medicine podcast the VPZD show is active on Substack and runs a YouTube Channel VinayPrasadMDMPH. He runs The Drug Development Letter, a must read for industry insights. He tweets @VPrasadMDMPH.

He observes:

This was the key figure in a Nature Medicine paper published on Dec 14, 2021. It showed clearly that myocarditis after vaccination (in this case, Moderna dose 2) was higher! than myocarditis after sars-cov-2 infection for people <40. 

There were a few remaining issues. While the denominator for vaccines is known with precision, the true number of infections is unknown. Many people don’t seek testing or medical care. So the red bar above will be shorter if you used a sero-prevalence (aka the correct) denominator. The authors needed to fix this.

The other problem is that this analysis lumps together men & women, while men have the greatest risk. Well, the authors are back with a new pre-print to fix this point, and here is what they find.

1. It is now clear for men <40, dose 2 and dose 3 of Pfizer have more myocarditis than sars-cov-2 infection, and this is true for dose 1 and dose 2 of Moderna.

2. Pfizer boosters (Dose 3) have more myocarditis for men <40 than infection.

3. Myocarditis post infection is more common as you get older, in contrast with myocarditis post vaccination, which is more common as you are younger (reverse gradients).