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Tracy Høeg, MD, PhD Profile picture
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14 Jan, 6 tweets, 4 min read
So, is myocarditis after vax more common than after covid in 12-17 yo boys?
Let's look at the two studies they are discussing
I would tend to agree w/ @joerogan the better-designed study is the one from Oxford showing myo after vax more than after covid in males <40
Here's why🧵
The oxford study is a re-analysis of a paper published in @Nature (link in tweet below) where they had 38 million people from the UK over 8 months who they knew the vax/myo diagnosis/covid + status. Reanalysis found myo>after vax than covid in males 16-39
The 2nd study identified only *6* cases of post-covid myo over *a year* in males 12-17 in a hospital system w/a cachement of 60 million people. They provided an inappropriately low estimate of # infected giving inappropriately high rate of post-covid myo medrxiv.org/content/10.110…
The 2nd study also said myocarditis occurs after vax at a rate of 66/million in this age group which is not correct. Two studies now, one out of Hong Kong and one out of Kaiser Permanente put that risk at about 380/million for boys 12-17 after dose 2.
References in next tweet.
Pre-print with 6 cases of post-covid myo from @joshzepps : medrxiv.org/content/10.110…
Hong Kong post vax estimate: academic.oup.com/cid/advance-ar…
Kaiser post vax myo estimate: medrxiv.org/content/10.110…
Typo in the first tweet. It should have read
"I would tend to agree w/ @joerogan; the better-designed study is the one from Oxford showing myo after vax more *common* than after covid in males <40"
Same message.
& this thread is just addressing the post vax/post covid myo topic

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More from @TracyBethHoeg

Tracy Høeg, MD, PhD Profile picture
11 Jan
Now, using new 0.48 hazard ratio for hosp w/omicron, we get
1/5000 risk of covid hosp requiring treatment for 12-17 yo w/o comorbidities pre vax
Hong Kong & Kaiser data 1/2700 risk of post dose 2 vax myo boys 12-17
If vax doesn't stop transmission, how is this ethical to mandate?
Considering the above, I wonder why we are not asking "should all teen boys get vaxed" with mRNA vaccines? For example, what about children who have already been infected? Agree w/@walidgellad "benefits vary patient by patient"
theatlantic.com/health/archive…
Here are the Kaiser data on omicon's decreased severity:
Read 6 tweets
Tracy Høeg, MD, PhD Profile picture
5 Jan
🇩🇰Updated data from Denmark showing highest rates of infection in those who have received *boosters* who are >40 yo
🟢booster
🔵2 doses
🔴previously infected
🟠unvaccinated
But see adjustment for test # s below
Denmark now w/around 85% omicron
@SSI_dk (covid19danmark.dk/#gennembrudsin…)
The appearance of negative vax efficacy against infection has been puzzling, especially when separating out prev infected, but @KT_Baek seems to be onto something⬇️ when he adjusts for # of tests taken; this gives v similar infection rates in all 4 groups

Though 2 & 3 doses of vax not effectively preventing infection, 2 doses evidently protecting against severe disease & death in adults & 3 doses seem to offer extra protection in those >70
👇 hospitalization & death rates/100,000 by vax status
🟢booster
🔵2 doses
🟠unvaccinated indlæggelser: hospitalizations
Read 5 tweets
Tracy Høeg, MD, PhD Profile picture
31 Dec 21
When considering boosters in children:
1 child/78 developed myo in the booster trial among 16-17 yos
& Pfizer's own analysis shows booster would
-prevent 29-69 hospitalizations/mill but would
-result in 23-69 vax myocarditis/mill in males 16-17
🤔Not a great ratio for most boys
Also remember myocarditis after Pfizer dose 2 & booster (and Moderna 1 &2) more common in males 16-39 than after Covid
And @MartyMakary makes an excellent point here about there not being a VRBPAC expert advisory committee meeting before the FDA authorizes boosters for 12-15 year olds
Read 4 tweets
Tracy Høeg, MD, PhD Profile picture
26 Dec 21
🇬🇧 The research group at Oxford who compared myocarditis rates after covid to after the vax (nature.com/articles/s4159…) have just released a new analysis:
In males 16-39,
Myocarditis more common after Pfizer dose 2 & 3
&
Moderna dose 2 than after infection medrxiv.org/content/10.110…
I'm already personally aware of 5 cases of post-booster myo in males 16-24; remember, this @NEJM study on boosters by age, the "rate of severe disease in the youngest age groups (16-39) was v low ...not enough cases to estimate the rate ratio reliably" nejm.org/doi/full/10.10…
Current college booster mandates do not seem to have the best interests of the students, especially the male students, at heart. We need better data on the risks and benefits of boosters in the <40 age group.
Read 4 tweets
Tracy Høeg, MD, PhD Profile picture
22 Dec 21
Danish 🇩🇰 data via @KT_Baek & @SSI_dk
>1/3 of all cases now omicron
No difference in case rates between vax (🔵) & unvax (🟡) in age group w/the most omicron
Prev infection (🔴) still gives some protection
So can we expect vax to protect others? 1/5
covid19danmark.dk/#gennembrudsin…
Based on data above from omicron (no diff in infection risk vax vs unvax) & from delta in @TheLancetInfDis (no significant difference in transm once infected between vax & unvax), it seems:

No, the vax can not be relied on to protect others (2/5)

But, the vaccines still appears effective against severe disease. Here are Danish data on ICU admission by vaccination status
(🟡) unvaccinated
(🔵) 2 or 3 doses
So it appears your vax protects you, not others
(3/5)
Read 5 tweets
Tracy Høeg, MD, PhD Profile picture
21 Dec 21
I'm being asked to comment on @joerogan's captivating interview of @P_McCulloughMD bc he mentioned our myocarditis study 3 times, 1 here👇. In honor of Dr McCullough saying "the truth is kryptonite" (I love that quote), I wanted to clear up a few things
🧵
1. We found that boys 12-17 w/o medical comorbidities have a risk of myo following vax #2 that exceeds their *120-day* hospitalization risk from covid even at times of high disease prevalence.
The way Dr. McCullough worded it sound like it was overall risk of hospitalization.
2. We identified 257 myocarditis cases in this age group in VAERS up through June 18th, not "thousands".
3. He was spot on about the 86% hospitalization rate
Read 8 tweets

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