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Patricia Bruijning

10 Jun, 14 tweets, 4 min read

Over the last weeks, several reports came out on the rare occurrence of myocarditis in young people following mRNA COVID-19 vaccination. What do we know so far? 1/

Myocarditis is an inflammatory condition of the heart muscle. It can occur spontaneously in –mostly- young people following a (viral) infection or spontaneously without any apparent etiology. It is more common in males. 2/

The condition generally resolves within a couple of weeks, but can sometimes linger for months. Exercise should be limited during this period, because of the risk of heart attack or chronic thickening of the heart muscles. 3/

Israel, Italy and the US first reported on cases of myocarditis in young males following mRNA COVID-19 vaccination. Most were < 30 years. Clustering of cases occurred particularly in the first week after the 2nd dose. 4/
pubmed.ncbi.nlm.nih.gov/34077949/
; sciencedirect.com/science/articl…

More recently, the US also reported on 7 cases in adolescents 14-19 years, following the 2nd dose of mRNA vaccination. All cases were mild. 5/
pediatrics.aappublications.org/content/early/…

No causal link has been established yet. One hypothesis is that it is linked to the systemic reactogenicity seen more frequently after the 2nd dose of vaccination and in particular in young people. 6/

Alternatively, immune mediated cardiac injury could be induced by COVID-19 antibodies. Cardiac involvement, including myocarditis, is also (rarely) seen in COVID-19 itself. 7/

Both the Israel’s Health Ministry and CDC recognize increased cases are reported following vaccination in adolescents and young adults, but the condition remains extremely rare. 8/ cdc.gov/vaccines/acip/…
;
sciencemag.org/news/2021/06/i…

They conclude the risk-benefit ratio of COVID-19 vaccination remains well in favor of vaccination. 9/

It is no surprise that these early observations came from Israel, as they were the first to vaccinate large numbers of younger adults. In the US, the link was first observed among early vaccinated military recruits. 10/
military.com/daily-news/202…

As vaccination programs in young adults/adolescents are being rolled out in many countries, we will learn more about the condition.This is why pharmacovigilance is so important; to help us find side effects too rare to be picked up in Phase 3 trials or in certain risk groups. 11/

@VACCELERATE

The findings also illustrate the need for continued research on optimal dosing regimens of mRNA vaccines in young people that minimize risk of side effects, but maintain effectiveness against disease, one of the key priorities of @VACCELERATE trials. 12/
vaccelerate.eu

Note; myocarditis or pericarditis are the terms for diagnosis of both myocardial and pericardial inflammation, they often occur together and may also be referred to as myopericarditis. The described patients had both myocardial and pericardial involvement. END/

#myocarditis update FDA; June 10th;

fda.gov/media/150054/d…

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More from @P_Bruijning

Patricia Bruijning

@P_Bruijning

5 Jan

De opkomst van de ‘Britse variant’ zorgt voor veel onrust. Wat moet er straks met de scholen gebeuren?

Een draadje;

1/16

De Britse variant van het coronavirus, ook wel bekend onder de naam Variant of Concern (VOC) 202012/01 werd voor het eerst gesignaleerd in het VK in Sept 2020 en heeft in de afgelopen maanden snel terrein gewonnen in het VK.

2/16

De toename van de nieuwe variant werd als eerste opgemerkt onder 0-19 jarigen. Dit wekte de suggestie dat deze variant mogelijk juist onder kinderen meer besmettelijk is.

Biologisch gezien is dat niet zo aannemelijk.

3/16

Read 16 tweets

Patricia Bruijning

@P_Bruijning

12 Dec 20

Eurosurveillance | Secondary transmission of COVID-19 in preschool and school settings in northern Italy after their reopening in September 2020: a population-based study eurosurveillance.org/content/10.280…

This is a very nice study because they tested all school contacts of index cases irrespective of symptoms.

There were multiple measures implemented in schools to reduce crowding and maintain physical distance between students

Read 10 tweets

Patricia Bruijning

@P_Bruijning

11 Dec 20

Our model-based analysis; Potential effects of school-based measures to reduce contacts between children, including school closures, markedly depends on the reduction in the effective reproduction number achieved
by other measures. medrxiv.org/content/10.110…

Let me try to explain what our new modelling study does and does not suggest. First, this is a model and it is currently being peer reviewed. Ganna Rozhnova did this work, and if you thinks it’s good all credits go to her (and the other co-authors). (1/10)

Results based on 2 aspects: (1) contact rates in different age groups. For children (<20yr) we distinguish school-based & non-school-based contacts; (2) what is the susceptibility of age groups to be infected with SARS-CoV2 after being contacted by an infectious person. (2/10)

Read 11 tweets

Patricia Bruijning

@P_Bruijning

20 Nov 20

Zo snel al een veilig vaccin, hoe kan dat?

Ik bemerk in mijn omgeving nogal eens twijfel over de veiligheid van coronavaccins. Een proces dat normaal gesproken jaren duurt, kan dat in zo’n korte tijd een veilig en werkzaam vaccin opleveren. Gaan we niet te kort door de bocht?1/

Nee, is het antwoord, maar het is goed om uit te leggen waarom het dan wél zo snel kon;

1)Het SARS-CoV-2 virus is een relatief makkelijk doelwit om een vaccin tegen te ontwikkelen. 2/

Er was al veel voorwerk verricht op vaccins tegen het SARS en het MERS coronavirus, broertjes die veel op het huidige virus lijken. Zo wisten wetenschappers vrijwel direct op welk eiwit van het virus ze zich moesten richten. Dat scheelt jaren laboratoriumonderzoek.
3/

Read 18 tweets

Patricia Bruijning

@P_Bruijning

21 May 20

1/8 We moeten het eens hebben over buitensporten en coronavirus; #COVID19
Er zijn inmiddels tientallen studies beschreven van bron-en-contact onderzoek van vóór de lockdown. wellcomeopenresearch.org/articles/5-83/…
Dit is het beeld;

2/8 De meeste besmettingen vinden plaats in gezinnen. Daarna volgt
gezamenlijk reizen (OV), in winkels en winkelcentra, restaurants en andere
uitgaansgelegenheden, kantoren, kerkdiensten of andere bijeenkomsten, vooral wanneer daarbij ook intensief gesport of gezongen wordt.

3/8 Opvallend; de locaties zijn allemaal binnen, de onderlinge afstand tussen mensen is er klein, en men verblijft er doorgaans langere tijd. medrxiv.org/content/10.110…

Read 8 tweets

Patricia Bruijning

@P_Bruijning

2 May 20

Some important findings from this contact tracing study in Taiwan of 100 index cases; ja.ma/3d4M29S
* 22 secondary cases among 2761 close contacts=secondary attack rate (SAR) 0,8%

* SAR highest among household contacts (4.6%) and non-household family members (5.4%)
* Very few secondary cases in other settings. What is different in Taiwanese people? No hand shaking? Face masks? Keeping more distance? /2

* Of 9 asymptomatic cases, none transmitted to any of 91 close contacts.
* SAR increased with disease severity
* None transmission occurred beyond day 6 of symptom onset.
* Transmission occurred as early as 5 days prior to symptom onset. /3

Read 6 tweets

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