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Tracy Høeg, MD, PhD Profile picture
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10 Sep, 4 tweets, 3 min read
It's important to note, it's the CDC's estimates of myocarditis in boys & young men that have been the outliers. Israel & Canada reporting similar rates of post-vax myo to the 1/6,000 from our study. TY @_lewisy for the Israeli data ⬇️ medrxiv.org/content/10.110…
And rates from Moderna may be significantly higher:

And those Moderna rates are predicted to be even higher in the 12-17 year old boys:

I highly recommend this discussion of childhood COVID-19 vaccination arranged by the @bmj_latest yesterday. There are numerous considerations being weighed in the UK & Europe which are laid out nicely here w/the best interests of the child at the center.

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More from @TracyBethHoeg

Tracy Høeg, MD, PhD Profile picture
12 Sep
I want to answer 2 questions we are frequently receiving about our study (which are excellent questions!):
1. Why did you use 120-day COVID hospitalization risk rather than overall COVID hospitalization risk?
2. But isn't post COVID myo *more* common than post-vax myo? 1/
2/ The US infection-hospitalization risk in the peds population is too uncertain bc we don't have reliable seroprevalence numbers. Based on a v recent analysis of UK data there is about a 1/750 chance for a child to be hospitalized/infection. TY @apsmunro
3/ We used 120-day hospitalization/population (just as the CDC did in their analysis) because there was less uncertainty about its accuracy. It also allowed us to include multiple rates in our model & incl. recent delta rates, as shown below from COVID-NET gis.cdc.gov/grasp/covidnet…
Read 12 tweets
Tracy Høeg, MD, PhD Profile picture
9 Sep
Our group's analysis of pediatric post-vax myocarditis rates stratified by age, sex & dose. An extensive harm-benefit analysis is included w/consideration of presence or absence of comorbidities

Thanks @drjohnm @KrugAlli & @ifihadastick for the teamwork
medrxiv.org/content/10.110…
"For boys 12-17 without medical comorbidities, the likelihood of post vax dose 2 CAE is 162.2 & 94.0/million respectively. This... exceeds their expected 120-day COVID-19 hospitalization rate at both moderate (August 21, 2021 rates) & high COVID-19 hospitalization incidence"
I agree with @DrJBhattacharya highlighting @adamhfinn of JCVI here stating how cautious we need to be with our vaccination recommenations in this low risk group

Personal bias: I am a mom of 10 and 13 year old boys & want the best for them & all kids

Read 6 tweets
Tracy Høeg, MD, PhD Profile picture
2 Sep
Nice depiction in @Forbes showing COVID in schools vs. from schools vs in the community as observed in Wood, Co, WI. As senior author of this study, it was tempting for me to believe this pattern was contingent on masking kids, but for many reasons I have come to doubt this 🧵:
First, around 8% of the kids in the study were not compliant with masking. Second, kids ate lunch indoors (unmasked, of course). Third, the Scandinavian experience has been similar to Wood Co where school spread minimal but kids unmasked (eurosurveillance.org/content/10.280…).
Fourth, as my son says "Mom, kids just take off their masks when the teachers aren't looking." [aka child compliance].
Read 7 tweets
Tracy Høeg, MD, PhD Profile picture
1 Sep
Something that strikes me as off with this study if only 1.8% of kids tested positive for COVID during the 10 month study period (64,898/3.7 million). This seems way too low and would inappropriately inflate post-COVID myocarditis risk in kids.
cdc.gov/mmwr/volumes/7…
For reference, seroprevalence was estimated to be 25.3% among kids at the beginning of February. covid.cdc.gov/covid-data-tra…
Re the myo study ⬆️, I would tend to look at 218 total (86 in kids with covid) cases of myocarditis out of 3.7 mill kids over 10 months of the pandemic as reassuring. But this points out why it is crucial to get the denominator right. Please correct me if I have misunderstood.
Read 5 tweets
Tracy Høeg, MD, PhD Profile picture
5 Aug
Fascinating. Looking at the @CDCgov 's COVID-NET, you see that it has been the 0-4 year olds driving up COVID hospitalization rates recently. 5-17 year olds have decreased/remained stable. I wonder if the recent RSV surge is resulting in some infant RSV cases being labeled COVID.
COVID-NET: gis.cdc.gov/grasp/covidnet…

RSV typically affects this 0-4 age group and, a child hospitalized for RSV may be labeled "covid" if they test positive for COVID.

Figure below via @contrarian4data showing recent increase in RSV in the US (syndromictrends.com).
And this ⬇️. Please teach me. Tell me if I am wrong. I don't have all the answers (I suppose that is obvious).

Read 4 tweets
Tracy Høeg, MD, PhD Profile picture
28 Jul
This is worth retweeting since many are discussing masks and schools. British Columbia (BC, green) kept schools open all year and did not require masks in schools. Ontario kept schools closed all year; Quebec and Ontario required masks.
@JuliaSLehmanMD this in addition to these two studies are what I reference if people ask why I don't think masking in schools will make much if any difference w/delta.

1. Norway's minimal transmission in schools without masks ncbi.nlm.nih.gov/pmc/articles/P…
2. No correlation with mask mandates in schools and case numbers in Florida and New York

medrxiv.org/content/10.110…
Read 4 tweets

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