Thread by @MonicaGandhi9

MYOCARDITIS after 2nd dose of COVID vaccine after 2nd dose mainly among 12-17 year olds in US. Data from Vaccine Adverse Events Reporting System (VAERS). Remember, vaccines can cause myocarditis. The rate of myocarditis from smallpox vaccine was 1/12,000: jamanetwork.com/journals/jama/…

Mechanism unclear (handwaving paper says "antibodies & T cells"). Now remember, only Pfizer is approved for 12-17 year olds and the dose of the vaccine (30 micrograms) is the same dose used for adults (the trials among kids 6 months-11 years uses lower dose, 10). Publicly

available data from VAERS up to 5/28/21 shows myocarditis rate post vax for16-17 yo is 0.0016% (so comparable to smallpox). In fact, hospitalization for myocarditis post-vax among 12-17 year olds is currently 12x greater than hospitalization for COVID with low cases among

kids now (was 4x more common at end March). Here is data from VAERS on a spreadsheet, 49 total cases across US of young people hospitalized for myocarditis (46 in 16-17 yo; 3 in 14-15 yo). Only 6 in females so more prevalent in males 16-17 year old & more common after 1-4 days

following 2nd dose. Spreadsheet here comparing hospitalization rates for COVID vs for myocarditis in 12-17 year olds currently. So, what are next steps? ACIP compiling data- possibilities are 1) close monitoring in young & making parents aware of symptoms
urldefense.com/v3/__https:/do…$

2) If child has had COVID or has antibodies to COVID, decide whether dose necessary right now; 3) Consider 1 dose strategy like Israel considering; 4) Talk to pharm companies about reduced strategy for adolescents; 5) Delay 2nd dose to later. CDC closely evaluating

but wanted to update the numbers from the publicly-available database of VAERS since CDC website not updated. Not seen with J&J. Pediatricians aware & monitoring. Look forward to more CDC updates soon. Follow here
cdc.gov/vaccines/covid…

This is the spreadsheet of the 49 cases of hospitalized myocarditis seen so far in US among 12-17 year olds (mainly 16-17, male, after 2nd dose)
docs.google.com/spreadsheets/d…

Also, Israel likely to adopt a 1 dose strategy for younger individuals (12-17) based on their data of myocarditis summarized in this Science Mag article.
sciencemag.org/news/2021/06/i…

A few more clarifying points to this thread and the spreadsheet- VAERS is a bit behind since this doesn't include the 17 cases reported from CT. I don't know what true rate is - say 46+17/(2,813,832) 16-17 yo vaxed so far (2.2/100K). CDC will update/report
portal.ct.gov/Coronavirus/Co…

Not just #myocarditis but #pericarditis & #myopericarditis. All ok so far/days of hospitalization in spreadsheet. Variety of ways to deal with this (would certainly delay if child has had previous covid). Myocarditis seen with smallpox vax- good read:
sciencedirect.com/science/articl…

Oh, wanted to add 1 more thing on this (and why I am electing for a longer interval between doses for my 13 year old son): Please notice reports on this rare myocarditis event coming out of Israel/US which uses 3 week between doses, not UK which elected 12 weeks between doses.

By the FDA TODAY are having their meeting on vaccinations in children; so all of the myocarditis cases we know of being discussed today (Germany delayed 12-17 child vaccinations) - I will discuss what happened at FDA today once I see all minutes/talks

Okay, here is the updated data from FDA meeting today- CDC has had 475 reports and 226 meet working class definition of myocarditis/pericarditis; 41 still having symptoms; 15 still hospitalized; 3 in ICU.

Here is the comparison to observed versus expected cases of myocarditis in young people so higher than expected, thereby thought to link to vaccine. Higher rate after the 2nd dose. ACIP to meet June 18 "emergency meeting" to make recommendations

The entire FDA report is here - male predominance & after 2nd dose: my recommendation on males 17 and younger after seeing data today? Let's wait on that 2nd dose until ACIP meets to make recs. May come with a warning; watch for chest pain.
fda.gov/media/150054/d…