What is the risk of death from vaccine-induced Myocarditis? A new study just came out from
England looking at 1,956 deaths in vaccination records in the 12 to 29 year old age group. In
the video I'm going to talk about health outcomes after Myocarditis diagnosis and
Subclinical Myocarditis which is when people have evidence of myocarditis with or without
symptoms but don't come to health care providers like myself. I've talked a lot about myocarditis
with respect to the Covid-19 vaccines over the last two years the MRNA vaccines. It's of course
been a subject that those have spoken about it even doctors have been labeled anti-vaxx.
The issue here though is that this is a definite side effects to the vaccines and it's something
for people to consider when contemplating vaccination or boosting. One always needs to
consider the benefits of what you're doing against the risks and we do that for all interventions in
medicine. Now as a background I've spoken about the prospective Hong Kong study where there were
rates of one in 2,700 of Myocarditis after the second Pfizer dose in the 12 to 17 year
old male population. There have been multiple other observational studies which I've talked
about on the channel with rates of Myocarditis in the male subgroup in the 18 to 39 year old range
which can be anywhere from 1 in 1,300 to even 1 in 7,000. Studies have shown that the incidence of
Myocarditis from the vaccine do of course vary based on age, sex, second dose being higher,
and they're much more common with Moderna. For this reasons many countries have banned
the Moderna vaccine in the under 40 year old age group and other countries have only recommended
one vaccine for the younger healthy population. Some countries even below 18 not recommending
vaccination at all in that particular age group unless you of course have medical comorbidities.
In addition many countries have delayed the second dose which is something they should
have done at the beginning of the pandemic with the vaccination starting because you get a better
immune response when the second dose is delayed that's basic immunology and more people initially
get vaccinated so you can protect the higher risk people more of them faster. Now despite all of
this you still see people Physicians included in fact claiming that Myocarditis is more common from
Covid-19 than it is from vaccination and that's clearly in the young male age group below 40 not
true. It's far more common after vaccination in that age group than with infection and numerous
studies have suggested that this is on the order of 20 to 50 times greater. As a physician
who manages Myocarditis myself insisting that myocarditis is mild is not really appropriate.
We certainly do have some evidence to suggest that post-vaccine Myocarditis on average is less severe
than classic Myocarditis. There was a study in the Lancet in adolescents and young adults
looking at outcomes three months after myocarditis from their Covid vaccination and there's a link
to the study in the description below. There were 836 eligible patients in that study and
the important thing to notice is that 32% were still on activity restrictions at three months
and remember these are young people who would normally be active. 25% of the study group were
still taking medications for Myocarditis at three months. and 54 still had at least one abnormality
noted on their follow-up MRI. Remember that these young people with low risk from Covid-19 some of
whom would already have had the disease and the vast majority had no underlying health conditions.
There have been many case reports of people dying from vaccine-induced Myocarditis including
this autopsy study that I recently presented on the channel. On to the new study. This is from
England and as always is a link to all studies I talk about in the description below. The authors
themselves point out that there are rare cases of serious adverse effects reported with the
MRNA Covid-19 vaccines and they are Myocarditis, Mild Pericarditis, or Pericarditis, and there's
an association. In the study they looked at 1,956 deaths who had vaccination records in
England in the 12 to 29 year old range. In terms of cardiac deaths after the second MRNA vaccine
in males this slide shows that there was a 1.7 times increased risk which is a 70% increase risk
in Myocarditis in that age group. Unfortunately as you can see the quality of the slide is poor
but I have highlighted the area to look at. Now this was ever so slightly outside of our
usual statistical significance meaning that the confidence interval 95% confidence interval range
from a 2% decrease to a 297% increased incidence but if you take a look at the average which is 70%
that actually would correspond to an absolute risk of about 1 in 300,000 risk of cardiac
death after having your second dose of the MRNA vaccination if you're a male in that age group,
and that's about the same risk as death from Covid in an unvaccinated never previously infected male
in this age group and obviously most males in this age group have already had Covid so their risk of
death would be even less than that. Now as always we need to talk about some of the limitations of
the study and a limitation of the English study and I quote from the authors. "The main limitation
in our analysis of death registration data is the fact that there can be delay due to Corner
referrals and not all deaths that have occurred in the period would be registered and deaths of
young people are of course more likely to be referred to a corner and registration delays
of course can be substantial and so some deaths might not be counted. An adjustment for calendar
time can also account for the fact that more recent deaths are more likely to still be under
investigation and therefore less likely to be registered but this adjustment cannot account
for any increase in corner referral related to time since vaccination for instance if deaths
occurred very soon after vaccination they're more likely to be investigated by a corner
than if deaths occurred at a much later time. However further limitation of the analysis
is that sudden cardiac deaths which would have occurred out of Hospital would not be captured
so essentially they're due to the increased risk of cardiac death it could certainly have been a
little bit higher and not captured in the out of Hospital group. I make note that this risk is very
similar to now the problem with relative risk and you see this in the media all the time. It
doesn't tell the whole story. A relative risk increase of 70% in this study or 84% with the
Florida data may sound like a lot, but you've got to put it in perspective which is the absolute
risk which as I've mentioned is about 1 in 300,000 although it may be higher due to the limitations
of the study which I just mentioned so these numbers of clinical Myocarditis are thus rare.
It would mean that you'd need to vaccinate 300,000 young males in order to create a
single cardiac death from myocarditis and as I mentioned before that's the same risk that
we were getting from Covid-19 in an unvaccinated never previously infected male in this particular
age group at the beginning of the pandemic. Another interesting point that people often
don't consider is the concept of Subclinical Disease. With any disease in medicine you've got
patients that come to doctors and they present with symptoms which we call Clinical Disease.
This of course is the tip of the iceberg and there will be many other people that don't come
to Physicians which are the iceberg underneath the water. They have the same disease, they may have
similar symptoms, or maybe it's less significant, and that's what we call subclinical disease.
This is the same concept as at the beginning of the pandemic when the media was reporting case
fatality rates of Covid a 3 to 10% because they were only looking at the cases that were coming
to Physicians attention and that's not what's important. You need to look at all of the cases
because there are many people that have an asymptomatic infection or minimally symptomatic
infection that wouldn't come to Physicians. The infection fatality rate was on the order
of 0.25% which of course is a tiny fraction of what the media was initially reporting and
the 0.25% number was from the US CDC based on a number of Investigations primarily blood work to
show that some people were previously infected but didn't know. Obviously there's a huge difference
in mortality rates with this illness depending on your age and comorbidities so if the incidence of
Myocarditis is somewhere in the 1 to 1,300 to 1 in 7,000 range in the population I'm talking
about. Well what's the incidence of Subclinical Myocarditis? Now they've only been a couple of
studies. There is a small one from Thailand and one from Switzerland. I've talked about
the one from Thailand on the channel before and in that study there were 301 students in the 13
to 18 year old range and they were followed both before vaccination as well as after
with cardiac tests and they found a 3.5% incidence of Subclinical Myocarditis after
the second dose of Pfizer. A similar prospective in other words going forward study in Switzerland
with 777 young health care workers that I've not reported on the channel found an estimated
2.8% incidence of subclinical Myocarditis. Now the incidence is significant enough that in Singapore
it's quite interesting that they recommended in young men who had the vaccine to not do any high
intensity exercises for a couple weeks after vaccination. To me this makes a whole lot of
sense but other countries certainly did not follow suit that I'm aware of. Subclinical Myocarditis in
comparison is obviously more frequent. These two studies suggesting 2 to 3% although the number in
these two studies were small so it may be that the number is a little bit different from that
probably not a whole lot. We should obviously have this sort of data from the manufacturers.
It's disappointing that larger prospective studies were not done by the MRNA companies Pfizer and
Moderna or governments given the large number of young people getting vaccinated. So if subclinical
Myocarditis occurs in 3% of the population then for every 35 men that receive the vaccine
we would expect to see 1 case of subclinical Myocarditis. Because subclinical Myocarditis
has not been well characterized it's difficult to know whether this is simply a transitory illness
with minimal or no symptoms and that whether that has medical complications or whether it's
simply going to go away on its own without any ill effects. Research certainly will be needed if we
continue to vaccinate people at higher risk for Covid-19 vaccine Myocarditis. I think the number
one mistake that I think almost all countries made during this pandemic is the fact that no one seems
to talk about being healthy. Governments didn't talk about it the media didn't talk about it and
people didn't talk about it. If you're healthy you're so much less likely to develop disease and
if you do you'll have a milder course. It's why sign off all my videos with the phrase get healthy
and stay healthy. Not focusing on this during the pandemic was a major mistake. A lot less people
would have ended up in the hospital or died if they had made efforts to improve their health and
stay healthy. Many people have seen a significant decline in their health with this pandemic simply
because they've not been eating properly, sleeping properly, exercising properly, managing their
medical problems optimally if you have any, and trying to reduce stress. That's important as well.
All of these things are very important to your overall health. They help optimize your immune
system other organ systems in your body and of course your overall health. Thank
you for joining me today on Medicine with Dr. Moran. Get healthy and stay healthy.