#COVID #vaccineswork OK, lets analyze this study properly. This study out of Thailand used the prospective cohort method to attempt to characterize the rate of myocarditis and its clinical/ lab/ EKG/ echo findings in a group of > 300 students. 🧵1/9
The findings as presented in the tweet are a distortion by someone who did not take into account what normal pediatric EKG findings are; the study listed above preprints.org/manuscript/202… did not take pre-vaccination EKGs. (2/9)
The structure of the study was essentially, enroll some students, give informed consent for vaccination, and see what lab/ imaging/ EKG findings exist after COVID vaccination #2. They also calculated an estimated rate of myocarditis based upon this cohort. (3/9)
The overall conclusions mirror what has been produced by several health departments, but I push back the strongest on what readers consider to be abnormal EKG findings: (4/9) Image
I can make the strongest pushback on sinus arrhythmia - this is not a matter of opinion, this is a fundamental pediatric cardiology fellow learning point. Sinus arrhythmia is the natural variation in respiratory rate in kids. It is grossly misleading to call this abnormal. (5/9)
Sinus tachycardia just means the heart rate is faster than normal for age. By itself, this is insufficient to diagnose myocarditis but is one of the most sensitive findings on EKG for myocarditis. (6/9)
Ectopic atrial rhythm is highly likely to be normal in the absence of other cardiac abnormalities. Junctional escape rhythm is known to occur in well trained athletes especially during sleep but must be measured formally. (7/9)
PACs and PVCs are also quite common in kids; it is their quantity that is one of the determining factor of how much cardiologists worry. In the absence of baseline EKGs, it is harder to call the above EKGs not normal (especially when lots of kids already have this). (8/9)
Conclusion: this article supports the prior work publications.aap.org/pediatrics/art… and nature.com/articles/s4159…. A tweet associated with @HealthyFla doesn't necessarily mean the writer knows how to deal with pediatric EKGs. (9/9) There's really nothing stunning to the trained observer.
Detailed blog post explaining these tweets in detail: TLDR- the criteria for myocarditis as presented in the preprint are not rigorous enough to establish a rate of asymptomatic myocarditis. Paper needs work sciencebasedmedicine.org/covid-19-vacci…

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More from @han_francis

Jun 18, 2023
Here's how @RobertKennedyJr got it all wrong with the #vaccines on his @joerogan podcast. A thread dealing with his entire interview would be endless, so this is sticking to his statements on vaccines.
1. "why is it that CDC and every state regulator recommends that pregnant women do not eat tuna fish to avoid the mercury, but that CDC is recommending mercury-containing flu shots with huge bolus doses of mercury, I mean, massive doses, that pregnant women in every trimester..."
This sentence is simultaneously, wrong, misleading, and pulling on the emotional heartstrings. As a chemistry graduate I can see through his first lie, which is to conflate all types of mercury with each other. Ethyl mercury 🚫methyl mercury🚫mercury metal.
Read 31 tweets
Jun 18, 2023
There is great interest at the moment in seeing what an #antivax V #provax debate actually looks like. Luckily, there are a handful of which one is here:
The topic was #vaccines and #autism, with @stkirsch J(AV) and @MsAmitripped (PV).
MSAmitripped did a superlative job in the face of all the usual #debate tactics. The discussion centered around the usual talking points, but here's where the discussed went off the rails:
1. People who were in Kirsch's camp felt the need to mansplain and talk over MSAmitripped to show their points. PSA: Normal gentlemanly manners, and proper science communication, dictates that you shouldn't need to mansplain and shout to make your point.
Read 13 tweets
Jun 4, 2023
Congrats to the team out of #southkorea for completing a huge #COVID19 💉 #myocarditis study on their entire population to better characterize immunization myocarditis for all of us. Let's talk about what the paper really showed, instead of what the pundits think it showed.
I know how much work it is to coordinate all the moving parts and all the healthcare professionals to put together something like this, so if you ever meet this team, they deserve a digital round of applause.
The primary objective was to look at the medium term and long term outcomes of COVID vaccine myocarditis, count the amount, stratify by age, and find out what the most severe outcomes were. There were several levels of results, some of which confirm other studies, others are new:
Read 18 tweets
May 20, 2023
@drcole12 is making mistakes here that even a #pathology trainee would be embarrassed to make. His core claim is that spike protein from vaccines is inducing blood clotting. This is generally false. Image
The source of his data is @ArneBurkhardt , who first off, makes so many logical errors that it deserves a thread of its own.
Next, Cole presents slides from Burkhardt's presentation free of context, to give the reader a veneer of legitimacy, but in reality, all deceased people have blood clots. The basis of his claim is essentially the slide shown above, with an absence of awareness of basic dying.
Read 12 tweets
May 19, 2023
#Enterovirus #Myocarditis is getting a lot of attention in the media right now so, I'm here to share a general overview of what this is.
According to our professional organization, @ACCinTouch , the definition of myocarditis is any condition that causes inflammation of the heart. There are a big list of causes, and the most common ones in adults are different from the most common ones in kids. https://www.nature.com/arti...
Enterovirus is a specific category of virus, and it is one of the infections (overall most common cause in all ages) which is capable of causing heart inflammation.
Read 17 tweets
May 16, 2023
O, let me list the ways, that @VPrasadMDMPH tried to hoodwink you, and hope you didn't notice.
#FreeSpeech #MedTwitter #myocarditis #COVID19
The most basic way - he blocked almost all of #Medtwitter for disagreeing with him, and simultaneously claims that everyone needs to at least listen to people who disagree.
Whatever happened to actions speak louder than words @VPrasadMDMPH?
@VPrasadMDMPH criticized other physicians for attempting to debunk homeopathy, while forgetting that an unwavering belief in pseudoscience actually gets people killed sciencebasedmedicine.org/responding-to-… jamanetwork.com/journals/jamao…
Read 16 tweets

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