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Tracy Høeg, MD, PhD Profile picture
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23 Nov, 6 tweets, 3 min read
Recent data from the UK's @ONS indicating those previously infected are less likely to test + for covid than those w/2 doses mRNA vax >90 days ago.
I wish they had data for hospitalizations, but this is important info we should expect from the @CDCgov ons.gov.uk/peoplepopulati…
Understanding natural immunity seems especially important for vax policy in kids given low risk of severe disease, the myocarditis risk & high percentage of people (56.2% in California, 80.36% in Arizona, for example) having previously been infected 👇
covidestim.org
Myocarditis rates in boys 12-17 post Pfizer now greater than 1/5000 in Ontario & FDA's Optum database indicates 1/5000-1/5600 for boys 12-17.(fda.gov/media/153447/d…)
The point here is we need to know how much benefit a boy will derive from being fully vaccinated if they have already been infected - if we are going to recommend they are given a vaccine which has a greater than 1/5000 risk of myocarditis
If much of Europe is pausing or stopping Moderna in those <30 for a myocarditis rate of 1/4800, what is our threshold for discussing policy change for Pfizer in children 12-17? I am asking bc I want to know.

fhi.no/nyheter/2021/m…
The UK's natural immunity data is similar to the Danish data I posted 2 days ago

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More from @TracyBethHoeg

Tracy Høeg, MD, PhD Profile picture
3 Nov
"Should our youth be vaccinated? Experts say no - not necessarily" From the major Danish newspaper @politiken w/special focus on those <18. The crazy Danes are once again not censoring open scientific discussion. politiken.dk/forbrugogliv/s…
"If we don't use the principal of first and foremost vaccinating for an individual's sake, we risk children potentially experiencing a serious rare side effect for society's sake" Lone Graff Stensballe, professor in pediatric vaccinology infectious disease epidemiology.
She goes on to say, she's not against vaccinating children, but doesn't understand the strong pressure.

My addition to this would be we don't have the same safety data on this vax as we do on other routine childhood vaccines. We are also aware of 1 serious rare side effect.
Read 7 tweets
Tracy Høeg, MD, PhD Profile picture
21 Oct
Yes👇. @FLSurgeonGen is spot on & has been asking me & certainly many others to send data on masking kids in schools- he wants the truth. We don't have good data showing they prevent COVID spread & certainly have downsides for kids. 🧵
( And OMG @GovRonDeSantis mentioned me?😯)
What downsides?
Ask the kids. Outstanding radio journalism here by @NPR highlighting how *they* feel about masks.

They describe: "suffocating", can't see when their glasses fog, can't see other kids smile. And "I don't want to get my parents sick" 😢npr.org/2021/10/20/104…
I've talked about the lack of data for masking kids in school before. We have existing data showing child mask mandates don't do much if anything in terms of prevention of COVID spread

Read 8 tweets
Tracy Høeg, MD, PhD Profile picture
14 Oct
Nice to hear @drsanjaygupta & @joerogan debate & respectfully disagree about multiple topics. They spent a fair bit of time discussing our pre-print (medrxiv.org/content/10.110…) on post-vaccination myocarditis in boys. I want to clarify a few things cnn.com/2021/10/13/hea…
First, Joe does say it correctly once, but our study compared the risk we identified via VAERS of post-vaccination myocarditis (1/6200 in 12-15 yo boys and 1/10,600 in 16-17 yo boys) to the risk of hospitalization over the next *4 months* and *not overall* from COVID-19.
We did find that, even at times of high disease prevalence, that boys 12-17 without medical comorbidities were more likely to have post vax myocarditis after dose 2 than be hospitalized for COVID (over a 120-day period)
Read 11 tweets
Tracy Høeg, MD, PhD Profile picture
12 Oct
The Nordic data on the frequency of myocarditis after dose 2 of Moderna (Spikevax) in 18-29 year old men have been released: 1/4,800.
For Pfizer, it's 1/25,000.
fhi.no/nyheter/2021/m…
>5x difference, but see data from Ontario below (1/5)
Ontario rate is now 1/5600 (mostly Pfizer) in boys 12-17
My ?: Is some of the increase in frequency simply due to awareness of condition? (in addition to increased Moderna use?) 2/5
- Israel rate from NEJM 1/6600 for 16-19 yo (Pfizer) nejm.org/doi/full/10.10…
(For ref our VAERS pre-print: 1/6200 in 12-15 yo males, 1/10,600 in 16-17 yo (Pfizer))

Reports taken together point to ⬆️ rate in younger boys & after Moderna & ⬆️ awareness of this condition 3/5
Read 5 tweets
Tracy Høeg, MD, PhD Profile picture
7 Oct
The Israeli @nejm study published today that stratified for myocarditis rates post vax dose 2 in males age 16-19 found a rate of 1/6600 for Pfizer. Our preprint found a *lower* rate of 1/10,600 for 16-17 yo males. For 12-15 yo males we found 1/6200 nejm.org/doi/full/10.10…
I'm really grateful for this NEJM study⬆️ & glad to see our VAERS-based study didn't provide an overestimate in 16-17 yo males. This was as expected with VAERS typically underreporting. I hope more studies are published with 12-15 year old estimated rates. medrxiv.org/content/10.110…
From second NEJM study "Most cases of myocarditis were of mild or intermediate severity" "1 patient had cardiogenic shock, & 1 patient w/preexisting cardiac disease died of an unknown cause after.. discharge Left ventricular dysfunction in 29% of patients" nejm.org/doi/full/10.10…
Read 6 tweets
Tracy Høeg, MD, PhD Profile picture
25 Sep
MMWR AZ 🌵 mask study #1 limitation:
-Not adjusting for community cases in Maricopa Co (R) rising more during the study (see Figures)
-They adjusted for pre-study case rates, but that was not enough
-remember ~ 95% of school cases come from the community!
cdc.gov/mmwr/volumes/7… Image
Maricopa also had a lower vaccination rates: 47.6% vs 59.2% in Pima.

Likely the entire story here is more school cases in schools w/o mask mandates (mostly in Maricopa) due to higher comm. case rates related to lower vax rates. How did this become a mask story?🤔
Since I am literally sitting on the side of a soccer field in Stockton, for further info, I want to refer you to @VPrasadMDMPH 's discussion of these two MMWR studies & why we unfortunately can't learn about the effectiveness of masks from them. vinayprasadmdmph.substack.com/p/two-new-cdc-…
Read 4 tweets

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