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Comment by mikeyouse | Hacker News Reader

The study is preliminary - but they're being cautious and recommending young men switch to the Pfizer vaccine since the risk of myocarditis is lower.

But just so people don't get the wrong idea, they're finding that the risk of myocarditis in young men who've actually caught Covid is something like 6x more likely than in those who received the vaccine:

https://www.medrxiv.org/content/10.1101/2021.07.23.21260998v...

So if you're a young male, the correct response to avoiding myocarditis (among all of the other downsides that come with actually catching Covid) is to get vaccinated with the Pfizer or J&J shots.

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As a young male who got myocarditis from both covid and the vaccine, the other thing that's worth knowing that I wish I'd known earlier: if you do get it, then the best thing to do to prevent long-term damage is to avoid exercise completely (potentially for 6 months to a year, or until you've been cleared by a doctor).

Just out of curiosity, did you get COVID first and then decided to get the vaccine later on? Or was it the other way around? I'm guessing the former - I've had friends who had COVID and their doctors still advised them to get the vaccine - and find it quite troubling if so. We've known for so long now how robust natural immunity is - and before we "knew for sure" any sane person's priors would still assume natural immunity works the way it does for any other respiratory pathogen - yet there was a concerted institutional/media push to act as if immunity literally didn't exist, or the more subtle form that immunity might exist but that vaccine immunity is "better".

Not that it's super relevant but the friends I mentioned were mid 20's and in fine health, no weird immune disorders or anything, so the fact that their doc advised the vaccine was frankly just negligence in my book.

One answer I can think of is if you caught covid and then got regeneron. A month later, after the regeneron wears off, you’d probably want to build up your body’s immunity.

Because the officials are fucking cretinoids who can't understand it.

I had Covid, had immunity, and no one gave a flying fuck. I had to follow the same procedures as everyone else. PCR tests up the ass, waste of money, travel blocks.

Half a year later I got the J&J vaccine and had a mild fever for a day (proving my previous infection worked for immunity, just imo). Yet I still wear a fucking mask and shit. At least I have a QR code that I can use to travel...and some countries don't accept J&J as a valid vaccine.

What a fucking joke.

I didn't have COVID, and I also only had a day or so of fever after my J&J shot in June. My girlfriend had a similarly mild reaction, and we've both been tested regularly for various reasons, we're pretty certain that we haven't been infected.

I just got my recommended booster shot of Moderna yesterday, now I'm waiting to see how hard that will hit me.

There are no certainties, but I know that here you would also been considered immune if you had previously been infected, but not yet vaccinated.

Bad public policy unfortunately exists, same with the thing about not accepting the J&J vaccine as valid. It works about as well as the mRNA vaccines against hospitalizations and death, but with somewhat less efficacy against base infection, and of course a slightly larger risk of complications. That doesn't make it a bad vaccine, so countries not accepting it is completely insane.

Good to know. I was basing my opinion on the fact that the actual infection (confirmed via PCR) had me very fatigued for a week, with a fever for about half of it. And online reports for J&J showed several days of response effects.

I could've opted for Pfizer, but the wait time for it to arrive and to get the full two doses was too long. J&J is one shot, and some say it works better than "older" vaccines.

I did get into the country that didn't have it on their list to be fair. They probably added it later, AZ was on there.

If I got a serious case of covid, my priors would be that my immune reaction sucked, not that it was sufficient.

Your priors are messed up then.

BTW the feeling of being sick is literally the feeling of your immune system doing its thing. No immune response = no sickness symptoms (until huge swaths of your body have been destroyed by the pathogen)

A friend had COVID, positive by PCR result, loss of taste and all of that, at the beginning of the year. Mild case anyhow, she went to her doctor for a check-up 2-3 months later to make sure everything is fine and was asked afterwards if she is planning to go to get the vaccine, when she said no, at least not anytime soon, rollout was still in the early phases in our country, she got an absolutely insane scolding about how she doesn't care about others and is anti vaccines, and all this from a medical professional. Officially it wasn't even recommended to get it if you are in the first 6 months after recovery. She was quite shocked and dropped the doctor after that.

> absolutely insane

Probably not that insane if you recognise how many people this doctor has potentially seen or heard dying of it.

Is rest the only treatment for it?

Also, how was it diagnosed?

Ibuprofen also helps.

The study you linked does not prove what you think it does. Check out the inclusion criteria:

> Inclusion criteria were a first COVID-19 diagnosis during the April 1, 2020 - March 31, 2021 time period, with an outpatient visit 1 month to 2 years before, and another 6 months to 2 years before that

To actually compare fairly against vaccination, you need to compare the infection myocarditis rate, not the case myocarditis rate. (Technically you should really compare infection myocarditis rate * chance of actually getting infected w/ SARS-2 [while very slightly adjusting for time decay], but let's ignore that especially since the chance of getting COVID over a 2-3 year window is quite high)

So the study you linked will give an unfairly high estimate of the rate of myocarditis. This is the same principle as the fact that looking at hospitalized COVID-19 patients will show much worse effects than looking at rates of bad effects for all PCR+ individuals, and even moreso if extrapolating from serology.

This isn’t true, the risk for young men 22 and younger from vaccine induced myocarditis exceeds the risk from COVID. Even more true for 17 and younger males: https://www.medrxiv.org/content/10.1101/2021.08.30.21262866v...

https://www.science.org/news/2021/06/israel-reports-link-bet...

> exceeds the risk from COVID

To be clear the result in the paper is that myocarditis in that age group is greater than hospitalization risk from covid. No?

"For boys 12-17 without medical comorbidities, the likelihood of post vaccination dose two CAE is 162.2 and 94.0/million respectively. This incidence exceeds their expected 120-day COVID-19 hospitalization rate"

There's no result there about myocarditis from covid infection.

Tracy Beth Høeg was touting ideas against children vaccination well before this study she coauthored.

A cardiologist commentary for this was that raw VAERS data is not to be trusted and CDC will know better. End of story.

This study also seriously underestimates the virus speed and complications.

Do not let any random quack fool you. Verify it.

Ahh yes the classic “if it doesn’t agree with my preconceived notions it must be a poorly done study” but if it furthers my beliefs then “anyone that questions it is obviously denying the truth/anti-science”. You dismiss this study without realizing that one of the authors is a very good cardiologist who chose strict criteria for what data to allow into this study.

I recommend you to read the comments section under the study.

Many other cardiologist disagree with this selection criteria and there exists clear bias that can affect the authors.

TL;DR: up to a 6.1x rate of cardiac adverse effects from mRNA vaccination compared to Covid 19 hospitalization for teen-aged boys.

> Results A total of 257 CAEs [cardiac adverse effect] were identified. Rates per million following dose 2 among males were 162.2 (ages 12-15) and 94.0 (ages 16-17); among females, rates were 13.0 and 13.4 per million, respectively. For boys 12-15 without medical comorbidities receiving their second mRNA vaccination dose, the rate of CAE is 3.7 to 6.1 times higher than their 120-day COVID-19 hospitalization risk as of August 21, 2021 (7-day hospitalizations 1.5/100k population) and 2.6-4.3-fold higher at times of high weekly hospitalization risk (7-day hospitalizations 2.1/100k), such as during January 2021. For boys 16-17 without medical comorbidities, the rate of CAE is currently 2.1 to 3.5 times higher than their 120-day COVID-19 hospitalization risk, and 1.5 to 2.5 times higher at times of high weekly COVID-19 hospitalization.

Not quite enough info available yet, to be certain.

First need to know what the risk of myocarditis is when being vaccinated and having covid, and how much lower the risk of covid-infection is when having been vaccinated.

I don't think all of that data is available right now, so I would hesitate coming with certain conclusions about the right thing to do for young people. (Especially boys)

Also I would be a little careful using the 6x estimate for myocarditis caused by covid infection for these age groups, as in these age groups there may be quite a few undetected/asymptomatic covid infections. (That is it may be that: P(detected infection | covid, myocarditis) >> P(detected infection | covid) in young people)

> So if you're a young male, the correct response to avoiding myocarditis (among all of the other downsides that come with actually catching Covid) is to get vaccinated with the Pfizer or J&J shots.

This is probably also the reason the health authorities stopped recommending the Moderna vaccine for that demographic. Since the Pfizer vaccine is available, and AFAIK it's not in short supply, it's pretty much just a question of which vaccine to use for that demographic.

When I got the second (Pfizer) shot, I was also given a leaflet saying that extreme physical exertion should be avoided for a few days afterwards as that might increase the risk of myocarditis.

Do you if the study you link considers someone who gets myocarditis that is vaccinated and had covid as vaccine caused case or covid caused case? I couldn't find it in the full text.

Typically how severe is the post-Covid myocarditis in young males versus that which can be induced by the vaccine?

Also, since the vaccine doesn't prevent contraction of Covid, does it really make sense to frame this as though the two risks are mutually exclusive?

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