COVID-19 Vaccine Myocarditis Update From Thailand
by Anish Koka, The Pulse:
First some background for 1st time readers. Readers who are regular followers can skip this section and go straight to the Thailand study section.
Background:
It has long ago been established that the messenger RNA vaccines cause myocarditis, the controversial question now relates to what the actual rate of myocarditis is. The CDC chart below notes a peak myocarditis rate (all boxes shaded in orange are myocarditis rates that are higher than what is expected in the population) in 16-17 year old boy of 75.9 / million (or 1/13,157) after dose 2 of the mrna COVID vaccine.
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Unfortunately, because of the heavy reliance in the United States on passive reporting, which entails clinicians/ patients voluntarily reporting myocarditis cases, this number is likely an undercount.
Multiple datasets from around the globe from countries with much smaller budgets than our CDC have suggested higher rates than what the CDC reports. A nice comprehensive review from Hoeg, Stevenson & Krug last year demonstrates the discrepancy well.
Troublingly, the more carefully you look for myocarditis after vaccines, the more you find. Hong Kong (Chua et. al. ) has a robust surveillance system , and reported rates of myocarditis of 1/2700 in 12-17 year old boys after the 2nd dose of the Pfizer COVID vaccine. Given the Moderna vaccine has 3 times the dose of Pfizer, it is not particularly surprising that countries with access to both vaccines have noted rates of myocarditis that are 3-4x higher with Moderna than Pfizer. (French Study / Nordic Study) . This suggests that the peak rates of myocarditis with Moderna in young men could be around 1326 per million vs. the 76 per million currently reported by the CDC.
The randomized control trials were blind to this particular adverse event because there weren’t enough young men in the trial, and no one was specifically looking for this particular side effect. There are potentially a number of cases of children with chest pain that are never brought to the attention of the health care system , and are thus never captured. There is also the issues of myocardial damage that may occur without any overt, severe symptoms. The young baseball player with an ache in his left shoulder for a few days that is shrugged off. Even more concerning given the marked cardiac injury demonstrated in some vaccine myocarditis cases that presented to the hospital, it is entirely possible that there are severe cases of myocarditis that result in out of hospital death that are never labeled as myocarditis.
And it’s not just random cardiologists concerned about this. The FDA became concerned enough about myocarditis that they approved the Pfizer vaccine contingent on the performance of a number of trials specifically designed to assess the true frequency of myocarditis after administration of their vaccine. (They are supposed to report on their progress in a few weeks). One of the studies was specifically supposed to look for the “incidence of subclinical myocarditis”.
