Anish Koka Profile picture
Jan 31 14 tweets 7 min read
Curious to see how the expert really did ?

Expert : Anyone who who gets myocarditis post vaxx Wld have had it way worse If they had instead got COVID.

This is a theory countered by multiple data sets that show in young men, vaxx > Covid myocarditis 1/ Image
Next, expert notes Covid mortality in the young is 1/1000. He’s corrected by a sharp @joshzepps that the # is actually 1/10000 (500/5mil) & that 5 mil is prob an undercount.

So @joshzepps facts check his expert live to combat misinformation from expert 😂 2/
When @joshzepps brings up recent study in Nature from Oxford that shows higher rates of myocarditis with vaxx than COVID in young men specifically, Expert discounts this..saying Israeli data is better. He’s referring to this paper by Barda et al. In Sep 2021 which does show ⬆️ 3/ ImageImage
But he doesn’t mention that a study published one month later in the same Journal also from Israel that stratified rates of myocarditis by age / sex, shows young vaxxed men have ~9x the rate of myocarditis as unvaxxed 4/ ImageImage
He also doesn’t mention a host of other studies that have found the same signal.. there’s the UK, Oxford data, JAMA data that shows no ⬆️ in myocarditis rates until 2.2021, and CDC/JAMA data that shows high rates in young males 5/ ImageImageImageImage
This is why there other countries that have paused use of the Moderna vaccine specifically for young men.. in October .. 6/ Image
Expert comments on broader benefit of vaccinating young ppl, citing lower chance of getting future more lethal mutations , and reducing transmitting to high risk.

Both are contentious claims where experts in the field disagree and r well outside the cardiology wheelhouse! 7/
There’s a lot more to say about the topic of myocarditis regarding severity, other cardiac effects, etc.. But what shouldn’t be really emotional or politicized is that there are vaccines on the market with widely differing rates of myocarditis .. 8/
And as is noted by many of the researchers writing these papers this data Shld at a minimum prompt evaluation of different options to what is currently available for healthy young men/boys… AZ/JNJ perhaps, or 1 dose, or delaying 2nd dose 9/
This adverse event should definitely be part of the conversation on vaccine mandates, and as I found out from talking to @eekymom , our vaccine injury compensation system that shields vaxx manufacturers from liability isn’t working 10/
@joshzepps seems like a really smart, nice guy, and I agree with his tweet here .. covid has been a lesson in epistemic humility for me as well 11/
Agree here as well, though not sure if this really turned out the way Josh wanted.. 12/
Like the 1st part about non mrna for boys, though in the US the only non mrna vaccine approved isn’t available for anyone < 18.. so hope ppl can understand some of the passion around mandates.

The 2nd part, not so much, more in depth dive coming for the 5 ppl interested .. 13/
Video version of the above here : cc @Accad_Koka

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More from @anish_koka

Jan 14
This is the myocarditis study that was brought up by journalist @joshzepps who 'debunked' @joerogan
tinyurl.com/2httdr9n
Only problem: paper made the diagnosis based on certain diagnostic codes that were charted. ICD10 codes listed include R01.1 (cardiac murmur unspecified)
Studies that are more rigorous about how myocarditis was defined (requiring lab abnormalities + imaging abnormalities + clinical symptoms) show vaxx myocarditis rates >> COVID myocarditis rates
There is a CDC report floating around that claims a 16x higher rate of myocarditis (this was mentioned by @drsanjaygupta on @joerogan ) . There are some basic major issues with this as well that I go into on this thread
Read 7 tweets
Dec 18, 2021
A quick word about Antibody Dependent Enhancement (ADE). Must say, there is nothing to suggest this is operative at present with Sars-COV2 or the vaccines for it, but the historical context is very interesting!
ADE occurs when the antibodies generated during an immune response recognize and bind to a pathogen, but instead of preventing infection, the complex allows easier access of the pathogen into the cell.

When vaccinated individuals fall ill this is but one possibility..
The other possibilities are :
1. A mild illness (evidence the vaccine worked to prevent more severe disease
2. A breakthrough (a term normally used to describe severe illness that results even after a vaccine, which cld mean the vaxx didnt work, didnt generate enough antibodies)
Read 9 tweets
Dec 18, 2021
Its possible for the following 2 things to be true :

1. Vaccines appear to be safe for most people, and appear to be effective in reducing the burden of severe disease

2. mRNA vaccines are associated with myocarditis (the CDC agrees : tinyurl.com/kfj9kc9y)
Much of the debate from mostly non-cardiologists focuses on "mildness" of vaxx-myocarditis, and risk of myocarditis from Sars-COV2 (COVID).
Some thoughts :
1st - multiple datasets beyond the much maligned VAERS report links vaccines with
myocarditis
Israeli Study: Notice uptick after 2nd shot.
"Most cases were mild or moderate in severity, but one patient had cardiogenic shock, and one patient with preexisting cardiac disease died of an unknown cause soon after hospital discharge."
tinyurl.com/hd3nrbun
Read 14 tweets
Dec 4, 2021
Appreciate the conversation with @Jabaluck

The TL/DR version

RCTs are attractive for divining cause and effect because randomization is supposed to deal with confounders
@Jabaluck acknowledges the concern about effective randomization because the survey teams that enrolled participants were more motivated to enroll patients in villages randomized to masks. [~14,000 more Pts were in the mask intervention than control.]
This imbalance creates a potential fundamental problem because the 1º endpoint (symptomatic sero positive patients) only differed by a total of 20 cases in the 10,000 out of 300,000 patients that were convinced to give blood samples.
Read 16 tweets
Nov 25, 2021
Again kudos to @beenwrekt for taking the trouble to find out what the raw numbers actually were in the Bangladesh mask RCT that’s been used in court to support school mask mandates.

The difference between the raw data and what was presented in the Preprint is striking 1/
Here is the verbiage from the study —> an 11% relative risk reduction in symptomatic seroprevalence with the treatment group that was given surgical masks,
The tables to support these words are here ..

The authors could have chosen to give us the actual raw numbers of symptomatic sero positives in treatment vs control, but instead we get interventional prevalence ratios and interventional coefficients ..

But they don’t.
Read 7 tweets
Nov 24, 2021
Appreciate authors of the 🇧🇩 RCT finally releasing raw data.

Dismayed at their topline conclusion on mask effectiveness that generated so much buzz

Out of ~340,000 ppl in mask and control arm.. the difference in symptomatic cases was 20 over 8 weeks.

benjamin-recht.github.io/2021/11/23/mas…
Brief summary for those interested. Bangladesh mask was a cluster RCT, (cluster because unit of randomization was a village) Treatment group had public policy intervention to increase use of masks, Control group was basically a poorly enforced govt. mask mandate)
Per pre-print 342,126 individuals in study. Endpoint was COVID 19 +ve symptoms AND positive antibodies.
Key Table shows of ~150k pts in each arm, blood samples could only be collect from ~5k patients in each arm.

poverty-action.org/sites/default/…
Read 14 tweets

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