I love the discussion that we've stimulated.
Isn't it great when we discuss science transparently instead of trying to cancel one another?
I'm going to respond to the more substantive critiques.🧵
#1. "Diagnosis codes for cardiac-related deaths are imperfect."
Yes! But that is true for every subgroup we examined. Only in young men was the risk extremely high, and it was also increased in older men.
#2. "COVID test information was only available on death certificates."
No!
We used all of our data resources-test results, vaccine records, death records-to exclude individuals who had documented COVID-19 infection, as we write in the Methods section.
#3. "The sample size is too small."
3a. Elevated cardiac risk was also found in older men, and there were thousands of deaths in this group.
3b. The total cardiac deaths meeting inclusion criteria among young men was 77, not 20, as has been going around the web.
3c. Read the references about the method!
Self-controlled case series tell us whether events (death) are occurring unusually close to an exposure (mRNA Covid vaccine), or whether their timing is due to chance.
3c cont.
Even if the sample size was half of what it is, if events cluster after an exposure, that is valuable information about causation.
Finally, is it really that hard to imagine that mRNA COVID-19 vaccines that increase myocarditis in young men by 10x, 20x, or 30x (see Karlstad et al,
JAMA Cardiology, 2022) also increase the risk of cardiac death in that age group?
Of course it's not, and we all know that. 😉
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