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Comment by ozdave | Hacker News Reader

Thanks for the explanation.

> argues that the risk of myocarditis in under-40 males getting 2 shots is greater (perhaps much greater) than the risk of getting it from COVID

The way I read this is the risk of myocarditis is greater with vaccination, but this does not tell me about the overall risk of serious illness/death from Covid for vaxed VS unvaxed.

So - risk of myocarditis goes up - but is it still overall safer to be vaccinated for the under 40 males, or not?

Not pushing any angle or side here - just looking for clarity (as much as possible).

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IFR for males under 40 is 500/1000000 or .05% if they’re infected.

Source: https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...

That's a horribly misleading comparison. Compare the risk of illness with severity similar to heart complications, or compare death rates. Don't compare one to the other.

The majority of myocarditis cases due to the vaccine don't even require hospitalization.

Source? One friend with this exact issue was never hospitalized, was told that it couldn't possibly be due the vaccine, but ended up with several visits to a cardiologist and now had to deal with the long term effects. So no- there was no hospitalization. Technically. And they will never show up in any data set either. Because we aren't even tracking this stuff correctly in the USA.

Yes, your friend had no hospitalization. We don't count people who see a doctor a few times and have long term side-effects as hospitalized from COVID, so in an apples-to-apples comparison the example of your friend should not go into that column.

Here is the source: https://www.nejm.org/doi/full/10.1056/NEJMoa2110737:

> A total of 76% of cases of myocarditis were described as mild and 22% as intermediate; 1 case was associated with cardiogenic shock (Out of 100 cases)

In that case, I'm wondering how valuable the hospitalization metric is. Someone can be incidentally hospitalized, and discharged with no serious long term issues, the ER is the only option for many non insured in the USA, while a life altering long term side effect may never result in hospitalization, but is something that should go into the risk profile of either catching covid or an adverse reaction to the vaccine. But we have to work with what we have.

Another question- if I go into the hospital for a broken arm, then fail a covid test- am I counted as a covid hospitalization? I remember watching one video early on in the pandemic of a "whistleblower nurse" lamenting the scenario where a patient would be admitted into the hospital for some reason, test negative for covid, be held for quarantine, then test positive for covid- presumably because they caught covid while in the hospital.

It's quite rare to be incidentally hospitalized. If you are hospitalized, you are very very sick. You don't get hospitalized for a broken arm, you get a cast and maybe some painkillers and you're sent home.

If you are sick enough to be hospitalized, you are likely to be sick enough that COVID is dangerous to you and requires medical attention.

The vast majority of people hospitalized with covid have long term side effects. You need to be seriously in bad shape to be hospitalized. See: https://journals.plos.org/plosmedicine/article?id=10.1371/jo...

Since we're doing anecdotes, I have a friend who recently got an infection (not COVID) that left him bedridden and so dizzy he couldn't walk more than few steps, the doctors decided against hospitalization as he presented to the hospital because his symptoms were too mild. They ran a few tests, determined it was an infection, prescribed antibiotics and sent him home.

So yes, hospitalization is a very good predictor. Fyi, hospitalization rates for the general population is right around 0.1%, more or less, and definitely a lot less for people under 40, in normal times

There are many hospital patients who are admitted for other conditions and diagnosed with asymptomatic COVID-19 during routine admission screening. This is particularly common among pediatric patients.

The UK recently updated its stats on this. About a third of "hospitalized COVID patients" caught it in hospital. So it's really not that rare.

Going to the ER isn't being hospitalized.

And if you show up to the ER they don't send you to a hospital bed, they don't have hospital beds to give out like candy these days. Even if you have a suspected heart attack (based on cardiac enzymes in your blood not just clutching at your chest acting like you're in a stage play) then you're still going to be waiting hours for a bed to open up. Someone with the sniffles isn't ever getting close to a bed.

Even before covid, hospital resources in many countries are quite limited, a big responsibility of ER doctors is to triage patients, they would not hospitalize anyone for non-serious reasons just because you asked (in the UK). You can be hospitalized without a firm diagnosis if your symptoms possibly indicate something life threatening like stroke.

That's my story too. Only after the second jab did they start to go "I think you might have an allergy".

> The majority of myocarditis cases due to the vaccine don't even require hospitalization.

Interestingly, this stood out to me:

> The outcomes of interest in this study were hospital admission or death from myocarditis. Myocarditis was defined as the first hospital admission in the study period or death using International Classification of Diseases (ICD)-10 codes (Supplementary Table 6).

In other words, this study didn’t even attempt to measure the rate at which myocarditis occurred in each group - only the rate at which people were hospitalized or died from myocarditis.

Another thing that gave me pause: If someone with COVID-19 developed myocarditis, was hospitalized, and died… I would expect their reported cause of death to be COVID-19, not myocarditis.

Such a person would be included as a COVID-19 death in the statistics because those data sets all assume correlation = causation, actually you don't even need to test positive at the time of death. Any positive within 28 days of the death is sufficient. But the death certificate might record the cause differently, depending on arbitrary factors like how hard working the relevant staff are feeling that day.

I say we are all still in the experimental ... we are trying to figure things out phase but really we aren't totally sure. Learning as we go... OMG!!

I mean the CDC recommended the J&J shot earlier this year now many months later they recommend against. Scary..along with this research here ... yikes!

I would presume so, though I don't have any numbers on me right now. Myocarditis was not the biggest risk from covid, lung damage/blood clots/strokes where iirc.

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