Moderna has fewer breakthrough cases than Pfizer's, but higher myocarditis rates(cnbc.com)
cnbc.com
Moderna has fewer breakthrough cases than Pfizer's, but higher myocarditis rates
https://www.cnbc.com/2021/11/11/moderna-says-covid-vaccine-has-fewer-breakthrough-cases-than-pfizers.html
65 comments
Wow I didn't realize that about the dose difference, I wondered why they gave us a half dose for our booster
What’s interesting is that in the initial trials, moderna tested 50, 100 and 250mcg in humans and ultimately decided on 100mcg as the sweet spot.
https://www.nih.gov/news-events/news-releases/nih-clinical-t...
Meanwhile pfizer tested 10, 30 and 100 and ultimately settled on 30mcg as their sweet spot.
https://www.nature.com/articles/s41586-020-2639-4
Was this due to differences in the vaccine itself, different study environments, or different tolerances for the balance between side effects and effectiveness?
https://www.nih.gov/news-events/news-releases/nih-clinical-t...
Meanwhile pfizer tested 10, 30 and 100 and ultimately settled on 30mcg as their sweet spot.
https://www.nature.com/articles/s41586-020-2639-4
Was this due to differences in the vaccine itself, different study environments, or different tolerances for the balance between side effects and effectiveness?
It's more than 'not really a surprise', it is obvious and I'm pretty sure this had already been widely discussed months ago.
Obvious in what way? It wasn't obvious to governments. So far only the Nordics and France have banned Moderna (and only for the under 30s). And at the beginning, there was no mention of heart damage for anything.
Obvious that Moderna side effects would be more common given the larger dose. It's... obvious.
The problem is teasing out whether differences in vaccine effectiveness are due to the vaccine or which patients got which.
I don’t think we’ve done any blinded head to head studies of one vs the other.
I don’t think we’ve done any blinded head to head studies of one vs the other.
Meanwhile the mechanism behind peri/myocarditis and why it mainly affects young males is still unknown. Needle aspiration, LNP, spike protein exosome... ? this all being bleeding edge technology and applied at such scale is really is amazing.
Without being applied at massive scale we probably wouldn't even be able to link the two. 13.3 cases of myocarditis per 100,000 (moderna) or 2.7 cases per 100,000 (pfizer) would be very hard to detect if we weren't giving out billions of doses. For perspective, the global before-covid rate of myocarditis was something like 1.5 cases per 100,000.
Is it possible for cases of myocarditis to go undetected? For instance can people just ignore the symptoms and go without treatment?
I am in no way an expert, but I would guess it can. Wikipedia says:
> Symptoms can include shortness of breath, chest pain, decreased ability to exercise, and an irregular heartbeat.[1] The duration of problems can vary from hours to months.
That's the kind of thing people often ignore. Especially if it only happens once. _Especially_ when getting healthcare is expensive.
> Symptoms can include shortness of breath, chest pain, decreased ability to exercise, and an irregular heartbeat.[1] The duration of problems can vary from hours to months.
That's the kind of thing people often ignore. Especially if it only happens once. _Especially_ when getting healthcare is expensive.
Is this something an Apple Watch could detect? Seems like a wearable with diagnostic capabilities is uniquely positioned to detect this at scale at no cost. If you use Apple Health, I believe it may also have access to your digital vaccination record depending on jurisdiction and if you’ve granted Apple access to it (which would allow segmenting by vaccine manufacturer and correlation with heart anomaly detection).
Yes, especially in men
My understanding is that the incidence of myocarditis is much higher in a COVID infection than from any of the vaccines.
Any source available on this?
You can easily find sources with a simple Google search. I searched for "myocarditis risk of covid vs covid vaccine" and the second organic result is from Nature [1] and states:
> Previous research co-authored by Balicer found that in this age group, becoming infected with SARS-CoV-2 made a person 18 times more likely to develop myocarditis — a much more significant risk than is observed following vaccination.
Sources are in the article. You can easily find sources for COVID, please try searching it yourself first.
[1]: https://www.nature.com/articles/d41586-021-02740-y
> Previous research co-authored by Balicer found that in this age group, becoming infected with SARS-CoV-2 made a person 18 times more likely to develop myocarditis — a much more significant risk than is observed following vaccination.
Sources are in the article. You can easily find sources for COVID, please try searching it yourself first.
[1]: https://www.nature.com/articles/d41586-021-02740-y
Might depend partly on age as well:
"Healthy boys may be more likely to be admitted to hospital with a rare side-effect of the Pfizer/BioNTech Covid vaccine that causes inflammation of the heart than with Covid itself, US researchers claim."
https://www.theguardian.com/world/2021/sep/10/boys-more-at-r...
"Healthy boys may be more likely to be admitted to hospital with a rare side-effect of the Pfizer/BioNTech Covid vaccine that causes inflammation of the heart than with Covid itself, US researchers claim."
https://www.theguardian.com/world/2021/sep/10/boys-more-at-r...
> Healthy boys may be more likely to be admitted to hospital with a rare side-effect of the Pfizer/BioNTech Covid vaccine that causes inflammation of the heart than with Covid itself, US researchers claim.
Anecdata from another thread: https://news.ycombinator.com/item?id=29122896
Anecdata from another thread: https://news.ycombinator.com/item?id=29122896
One of the authors, Tracy Beth Høeg, was clearly against any children vaccination way before authoring this biased and heavily criticized paper.
It's hard to Google for sources on this since you just get people talking about the vaccine. Here's something I found:
> Across all ages, the risk of myocarditis was almost 16 times higher for people with COVID-19 compared to those who aren’t infected. The myocarditis risk is 37 times higher for infected children under 16 years and seven times higher for infected people ages 16-39 compared to their uninfected peers.
https://publications.aap.org/aapnews/news/16388
> Across all ages, the risk of myocarditis was almost 16 times higher for people with COVID-19 compared to those who aren’t infected. The myocarditis risk is 37 times higher for infected children under 16 years and seven times higher for infected people ages 16-39 compared to their uninfected peers.
https://publications.aap.org/aapnews/news/16388
That particular quote seems to be comparing infected to non-infected, not infected to vaccinated.
Yes, I thought that was clear. That is what I was trying to find.
I see. But I think the question at hand raised by OP is infected vs vaccinated, not infected vs uninfected?
> My understanding is that the incidence of myocarditis is much higher in a COVID infection than from any of the vaccines.
> My understanding is that the incidence of myocarditis is much higher in a COVID infection than from any of the vaccines.
Yes it takes one extra step to answer that question. We have numbers comparing infected to uninfected, and numbers comparing vaccinated to unvaccinated (and presumably uninfected).
But what's the risk profile of Moderna + myocarditis versus Pfizer + breakthrough case (and remember, odds of contracting Covid at all are less than 1) + myocarditis?
Any stats on how many 13-29 year olds vaccinated with Pfizer have gotten myocarditis from a breakthrough case specifically?
Any stats on how many 13-29 year olds vaccinated with Pfizer have gotten myocarditis from a breakthrough case specifically?
Anecdotal:
Had covid twice. No heart complaints.
Had two vaccine shots. Both times, 10 days after the shot, my heart hurt like hell. Really painful and scary experience. It lasted a couple days and back to normal.
Had two vaccine shots. Both times, 10 days after the shot, my heart hurt like hell. Really painful and scary experience. It lasted a couple days and back to normal.
Adding more anecdata:
1. Had covid early 2021, felt like a mild cold for a week, couldn't smell my farts for 3 weeks. No heart issues.
2. 8 months later, got the Pfizer double dose, and had 6 weeks of heart pain and palpitations. Finally got in to see the doctor after the pain was basically gone, and the EKG showed an irregular heart beat and I was told to go to the emergency room... Got an echocardiagram the next week which turned out normal, thankfully.
Still waiting on that $1,000+ medical bill to come in the mail for the 20 minute echocardiagram...
1. Had covid early 2021, felt like a mild cold for a week, couldn't smell my farts for 3 weeks. No heart issues.
2. 8 months later, got the Pfizer double dose, and had 6 weeks of heart pain and palpitations. Finally got in to see the doctor after the pain was basically gone, and the EKG showed an irregular heart beat and I was told to go to the emergency room... Got an echocardiagram the next week which turned out normal, thankfully.
Still waiting on that $1,000+ medical bill to come in the mail for the 20 minute echocardiagram...
Could you elaborate on the timeline and circumstances of getting Covid twice and getting fully vaccinated? Time line, which vaccines, how did Covid happen?
Don’t think I’m questioning it, I’m just surprised so I want to hear more because I thought even getting Covid twice was fairly rare, after all isn’t that a widely held conception by survivors who don’t want vaccinated.
Don’t think I’m questioning it, I’m just surprised so I want to hear more because I thought even getting Covid twice was fairly rare, after all isn’t that a widely held conception by survivors who don’t want vaccinated.
Pfizer.
Covid in April 2020. One of my housemates infected me.
Vaccines in summer 2021.
Second time covid two months after vaccine. My brother, also Pfizer vaccinated, infected me.
First time was probably the original strain and second time delta. The second experience was worse, minor breathing problems.
I’m early 30s.
Thanks! Wow that’s very interesting and extremely unlucky, makes me want to be more cautious
Another Anecdotal: Had COVID once. Heart pain went back to normal after a week of testing negative. No side effects from both vaccine shots. I’m a young male too so I’m in the risk group for these side effects.
Sucks folks are experiencing them though. Definitely a scary time.
Sucks folks are experiencing them though. Definitely a scary time.
numbers:
> Burton cited data from France on males ages 12 to 29. It showed there were 13.3 cases of myocarditis per 100,000 people for Moderna’s vaccine compared with 2.7 cases per 100,000 people for the Pfizer vaccine.
> there were 86 breakthrough cases per 100,000 people for the Moderna vaccine. That compares to 135 breakthrough cases per 100,000 for Pfizer’s, he said
Are the differences meaningful? Assuming the data is real, Pfizer does seem quite a bit safer!
> Burton cited data from France on males ages 12 to 29. It showed there were 13.3 cases of myocarditis per 100,000 people for Moderna’s vaccine compared with 2.7 cases per 100,000 people for the Pfizer vaccine.
> there were 86 breakthrough cases per 100,000 people for the Moderna vaccine. That compares to 135 breakthrough cases per 100,000 for Pfizer’s, he said
Are the differences meaningful? Assuming the data is real, Pfizer does seem quite a bit safer!
It’s a good question. Is there a statistical test that can be / has been done with the data? Are the numbers between Pfizer and Moderna statistically different (and are they different than the incident rate in the general population)?
For things that happen with a small probability over lots of trials you can generally assume they're approximately Poisson distributed.
Which on its own isn't too helpful but then you know that the standard deviation is equal to the square root of the average. In this case both values bracket 100 so the square root should be around 10 making this a difference of roughly 5 standard deviations.
This isn't a Gaussian distribution so the 5-sigma limit used in physics can't be applied directly, but it's still a pretty big difference, especially for medical data.
You could (and in some cases should) do the work to get a proper number for the significance but this back of the napkin estimate suggests it's a statistically meaningful difference. And this being a calculation that can be done at the top of one's head, it is useful when the news reports on a change in some statistic that isn't anywhere close to significant.
Which on its own isn't too helpful but then you know that the standard deviation is equal to the square root of the average. In this case both values bracket 100 so the square root should be around 10 making this a difference of roughly 5 standard deviations.
This isn't a Gaussian distribution so the 5-sigma limit used in physics can't be applied directly, but it's still a pretty big difference, especially for medical data.
You could (and in some cases should) do the work to get a proper number for the significance but this back of the napkin estimate suggests it's a statistically meaningful difference. And this being a calculation that can be done at the top of one's head, it is useful when the news reports on a change in some statistic that isn't anywhere close to significant.
I wouldn't draw that conclusion. That's a 50% increase in break through cases with Pfizer, which seems like a far greater threat than even a 5x increase of myocarditis.
Especially when you take into account that your risk of developing myocarditis is higher if you get Covid.
Especially when you take into account that your risk of developing myocarditis is higher if you get Covid.
For that age group it's not a risk at all though.
Covid increases your chances of myocarditis by an order of magnitude, so it seems obvious that the vaccine that prevents covid is the way to go.
I don't think this assertion holds since most breakthrough cases are much milder than unvaccinated infections.
But the odds of getting Covid are far less than the odds of getting the vaccine.
You have to compare the odds of getting the vaccine (100%) AND getting myocarditis with Moderna versus the odds of being exposed to Covid AND getting a breakthrough case with Pfizer AND getting myocarditis from said breakthrough case with Pfizer since the vaccine makes the symptoms of breakthrough cases milder anyway.
The problem is that getting the vaccine is a 100% event, versus a far less than 100% event in scenario 2 (breakthrough Covid case with Pfizer that causes myocarditis in that age group specifically). Add up ALL the maths.
Edit - this isn't a vaccine versus no vaccine comparison. This is vaccine versus vaccine. Pfizer (in the current recommended dose) has proven very effective AND safer. Also, what percentage of breakthrough cases with Pfizer have resulted in myocarditis? Maybe that particular stat changes the risk profile. I'm guessing it's low though.
Edit 2 - also maybe the risks of Moderna can simply be reduced by reducing the dosage. Who knows. More testing will occur over time I'm sure.
You have to compare the odds of getting the vaccine (100%) AND getting myocarditis with Moderna versus the odds of being exposed to Covid AND getting a breakthrough case with Pfizer AND getting myocarditis from said breakthrough case with Pfizer since the vaccine makes the symptoms of breakthrough cases milder anyway.
The problem is that getting the vaccine is a 100% event, versus a far less than 100% event in scenario 2 (breakthrough Covid case with Pfizer that causes myocarditis in that age group specifically). Add up ALL the maths.
Edit - this isn't a vaccine versus no vaccine comparison. This is vaccine versus vaccine. Pfizer (in the current recommended dose) has proven very effective AND safer. Also, what percentage of breakthrough cases with Pfizer have resulted in myocarditis? Maybe that particular stat changes the risk profile. I'm guessing it's low though.
Edit 2 - also maybe the risks of Moderna can simply be reduced by reducing the dosage. Who knows. More testing will occur over time I'm sure.
> But the odds of getting Covid are far less than the odds of getting the vaccine.
At this point my conclusion is that everyone either get
- the vaccine,
- the vaccine and covid
- or covid without the vaccine
- or just covid
within the next couple of years unless they live outside of society.
I see no way an ordinary unvaccinated person can avoid catching covid now except using extremely much more invasive countermeasures than the vaccine.
But I might have missed something. How do you suggest people avoid it?
(Just theoretical interest. I took the vaccine as soon as it was clear that those charge took it themselves ;-)
At this point my conclusion is that everyone either get
- the vaccine,
- the vaccine and covid
- or covid without the vaccine
- or just covid
within the next couple of years unless they live outside of society.
I see no way an ordinary unvaccinated person can avoid catching covid now except using extremely much more invasive countermeasures than the vaccine.
But I might have missed something. How do you suggest people avoid it?
(Just theoretical interest. I took the vaccine as soon as it was clear that those charge took it themselves ;-)
> I see no way an ordinary unvaccinated person can avoid catching covid
Read my post again. I specifically said I'm comparing vaccines, not comparing vaccine to no-vaccine.
Don't try to argue a strawman.
Pfizer prevents enough infections that the risk of a breakthrough case is low. Plus the risk of getting exposed to Covid over any given time period is less than 1, even if it's 1 over a long enough time period. It's also a low enough risk for the age group being discussed that they can take the time to make an informed choice of Pfizer vs. Moderna.
Read my post again. I specifically said I'm comparing vaccines, not comparing vaccine to no-vaccine.
Don't try to argue a strawman.
Pfizer prevents enough infections that the risk of a breakthrough case is low. Plus the risk of getting exposed to Covid over any given time period is less than 1, even if it's 1 over a long enough time period. It's also a low enough risk for the age group being discussed that they can take the time to make an informed choice of Pfizer vs. Moderna.
Is this true for the young male population? I've not seen that data.
It's difficult to judge the tradeoff between Covid and myocarditis. I got my Moderna booster shot about 2 weeks ago, and I felt palpitations next day. Was that myocarditis. Maybe. I guess I'll never know. Did it bother me? Very little. I'm quite happy that my immunity to Covid went up. I'll personally trade a few palpitations for good Covid immunity.
But that's just a case of 1. How severe is the myocarditis other people experience? According to a study I just googled [1], out of 2 million people, only 32 were hospitalized with myocarditis or pericarditis, with median hospitalization time of 1 to 2 days, no ICU, and no deaths. Doesn't sound so bad to me.
[1] https://jamanetwork.com/journals/jama/fullarticle/2782900
But that's just a case of 1. How severe is the myocarditis other people experience? According to a study I just googled [1], out of 2 million people, only 32 were hospitalized with myocarditis or pericarditis, with median hospitalization time of 1 to 2 days, no ICU, and no deaths. Doesn't sound so bad to me.
[1] https://jamanetwork.com/journals/jama/fullarticle/2782900
bool3max(2)
higher, but low, but higher
have you seen the new psyop where vaccine holdouts now get the shot but believe they can quickly remove it, similar to reacting to venom? I’ve been starting to think of things like that at their level of comprehension. I’m getting better at it. Will be procedurally generating this benign nonsense soon.
I started noticing someone was already doing it after the prior psyop was so obvious. Many anti vaxxers began believing could only avoid “shedded spike proteins of the vaccinated” by social distancing and masking up forever. Ironically gaining compliance with all guidelines but in a way they believed was original and never having to argue with them ever.
Got to think like them! Similar to what comedians do.
have you seen the new psyop where vaccine holdouts now get the shot but believe they can quickly remove it, similar to reacting to venom? I’ve been starting to think of things like that at their level of comprehension. I’m getting better at it. Will be procedurally generating this benign nonsense soon.
I started noticing someone was already doing it after the prior psyop was so obvious. Many anti vaxxers began believing could only avoid “shedded spike proteins of the vaccinated” by social distancing and masking up forever. Ironically gaining compliance with all guidelines but in a way they believed was original and never having to argue with them ever.
Got to think like them! Similar to what comedians do.
> have you seen the new psyop where vaccine holdouts now get the shot but believe they can quickly remove it, similar to reacting to venom? I’ve been starting to think of things like that at their level of comprehension. I’m getting better at it. Will be procedurally generating this benign nonsense soon.
I'm not saying I agree or disagree with anything you're saying here, but more and more I wish I had some kind of debugger that I could run on internet comments, and it would show me all of the inputs that a commenter saw that led to the comment in question. All the various social media threads, conversations with friends/family/doctors, published papers, news articles, every single input that factored into what was written.
I say this because this comment to me seems like nonsense, because it doesn't line up with any of my inputs. Which of course doesn't mean it actually is nonsense, it just looks that way to me.
I think if we had this capability, people would actually be able to understand each other. Instead we just have everyone thinking that the sum of their own inputs is the ground truth, and everyone else is a nutjob.
I'm not saying I agree or disagree with anything you're saying here, but more and more I wish I had some kind of debugger that I could run on internet comments, and it would show me all of the inputs that a commenter saw that led to the comment in question. All the various social media threads, conversations with friends/family/doctors, published papers, news articles, every single input that factored into what was written.
I say this because this comment to me seems like nonsense, because it doesn't line up with any of my inputs. Which of course doesn't mean it actually is nonsense, it just looks that way to me.
I think if we had this capability, people would actually be able to understand each other. Instead we just have everyone thinking that the sum of their own inputs is the ground truth, and everyone else is a nutjob.
Haha Ive been advocating for something similar! And by advocating, I mean saving what people say and bringing it up to them months later for public shaming, to reveal how idiotic their influences are. Because right now everyone is just part of a gradient in a void, indistinguishable from the last person that said something similar to them.
I personally think that shaming is mostly counterproductive. For it to be the right move, you have to 1) know you are 100% correct, and 2) have a pressing need to alter the persons behavior/understanding, and 3) know that shaming is the most effective way to achieve the result.
Without those 3 things, I think there is a good chance that you're just antagonizing someone for little benefit to you or them.
Without those 3 things, I think there is a good chance that you're just antagonizing someone for little benefit to you or them.
It is applicable here as many of the conspiracies are time constrained, but by the time the event doesn't occur the person susceptible to believing that stuff is already being led on to the next variant without even noticing what happened with the last thing
Doing a callback without offering any opinion or arguments helps them introspect about how incongruent their world is with reality.
“<person that died while with covid> was still doing research?”
“The last president didn’t get reinstated?”
“I like hooking up with antivaxxers because you only have to pay child support for 5 years instead of 18. the mom/baby will still be doing research(tm)”
Doing a callback without offering any opinion or arguments helps them introspect about how incongruent their world is with reality.
“<person that died while with covid> was still doing research?”
“The last president didn’t get reinstated?”
“I like hooking up with antivaxxers because you only have to pay child support for 5 years instead of 18. the mom/baby will still be doing research(tm)”
Lots and lots of flagged and deleted posts here. I thought Hacker News was outside of what Eric Weinstein likes to call the Distributed Idea Suppression Complex[1]. That the DISC is deeeeeply troubled by the comments on this story should tell you everything you need to know about this topic. Speaking of which, is there anything like Snoo for reddit that keeps track of deleted and flagged posts on HN?
[1] https://theportal.wiki/wiki/The_Distributed_Idea_Suppression...
[1] https://theportal.wiki/wiki/The_Distributed_Idea_Suppression...
Plenty of independent ideas are also nonsensical
For popular controversial posts like this, the mods often override the flags and show everything.
There are tons of flagged and deleted posts on every HN thread because there are tons of really bad posters on HN. Honestly I think some of the absolute dumbest things I've ever read on the internet were on this site. Thank god we can flag the really low signal garbage.
> is there anything like Snoo for reddit that keeps track of deleted and flagged posts on HN?
Not for deleted but you can "show dead" in your HN settings.
> is there anything like Snoo for reddit that keeps track of deleted and flagged posts on HN?
Not for deleted but you can "show dead" in your HN settings.
One of the deleted comments was calling HN a breeding ground for conspiracies for sharing an CNBC article? Another was spewing a complaint about having to wear masks.
It isn’t censorship or suppression to delete comments that insult a community and provide nothing constructive to a conversation.
I also don’t care to define what “constructive” is in this context.The HN Mods can handle that.
It isn’t censorship or suppression to delete comments that insult a community and provide nothing constructive to a conversation.
I also don’t care to define what “constructive” is in this context.The HN Mods can handle that.
>Lots and lots of flagged and deleted posts here.
No there are not. Your account is old enough to have known that there aren't even that many comments at all on this page. IIRC, comments never get deleted, only flagged.
>That the DISC is deeeeeply troubled by the comments on this story should tell you everything you need to know about this topic.
Even accepting your premise of the "DISC" from contrarian podcaster on a wiki with few citations of any claims: No, one little "clue" doesn't tell anyone "everything they need to know" about a topic.
>Speaking of which, is there anything like Snoo for reddit that keeps track of deleted and flagged posts on HN?
I'm not aware of one.
No there are not. Your account is old enough to have known that there aren't even that many comments at all on this page. IIRC, comments never get deleted, only flagged.
>That the DISC is deeeeeply troubled by the comments on this story should tell you everything you need to know about this topic.
Even accepting your premise of the "DISC" from contrarian podcaster on a wiki with few citations of any claims: No, one little "clue" doesn't tell anyone "everything they need to know" about a topic.
>Speaking of which, is there anything like Snoo for reddit that keeps track of deleted and flagged posts on HN?
I'm not aware of one.
I think GP is using "deleted" colloquially to mean what this site calls "dead", which definitely happens to comments all the time.
What does it tell us about the topic? That rhetorical comments are inbound?
At least where I am, booster doses using moderna are recommended at half doses (50mcg).
They both use the same spike protein sequence.
No idea how the excipients differ between the two, but neither has adjuvants.