Florida Health Dept. - Exploring the relationship between all-cause and cardiac-related mortality following COVID-19 vaccination or infection in Flori

[sharon sanders]

hat tip Pathfinder


Exploring the relationship between all-cause and cardiac-related mortality following COVID-19 vaccination or infection in Florida residents: a self-controlled case series study

Discussion/Conclusion

In this statewide study of vaccinated Florida residents aged 18 years or older, COVID-vaccination was not associated with an elevated risk for all-cause mortality. COVID-19 vaccination was associated with a modestly increased risk for cardiac-related mortality 28 days following vaccination. Results from the stratified analysis for cardiac-related death following vaccination suggests mRNA vaccination may be driving the increased risk in males, especially among males aged 18 - 39. Risk for both all-cause and cardiac-related deaths was substantially higher 28 days following COVID-19 infection. The risk associated with mRNA vaccination should be weighed against the risk associated with COVID-19 infection.

https://floridahealthcovid19.gov/wp-...ce=govdelivery

 

[sharon sanders]

Joseph A. Ladapo, MD, PhD

@FLSurgeonGen
I love the discussion that we've stimulated. Isn't it great when we discuss science transparently instead of trying to cancel one another? I'm going to respond to the more substantive critiques.
8:07 AM · Oct 10, 2022·Hootsuite Inc.
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Joseph A. Ladapo, MD, PhD

@FLSurgeonGen
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45m
Replying to
@FLSurgeonGen
#1. "Diagnosis codes for cardiac-related deaths are imperfect." Yes! But that is true for every subgroup we examined. Only in young men was the risk extremely high, and it was also increased in older men.
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Joseph A. Ladapo, MD, PhD

@FLSurgeonGen
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#2. "COVID test information was only available on death certificates." No! We used all of our data resources-test results, vaccine records, death records-to exclude individuals who had documented COVID-19 infection, as we write in the Methods section.
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Joseph A. Ladapo, MD, PhD

@FLSurgeonGen
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#3. "The sample size is too small." 3a. Elevated cardiac risk was also found in older men, and there were thousands of deaths in this group. 3b. The total cardiac deaths meeting inclusion criteria among young men was 77, not 20, as has been going around the web.
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Joseph A. Ladapo, MD, PhD

@FLSurgeonGen
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3c. Read the references about the method! Self-controlled case series tell us whether events (death) are occurring unusually close to an exposure (mRNA Covid vaccine), or whether their timing is due to chance.
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Joseph A. Ladapo, MD, PhD

@FLSurgeonGen
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3c cont. Even if the sample size was half of what it is, if events cluster after an exposure, that is valuable information about causation.
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Joseph A. Ladapo, MD, PhD

@FLSurgeonGen
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43m
Finally, is it really that hard to imagine that mRNA COVID-19 vaccines that increase myocarditis in young men by 10x, 20x, or 30x (see Karlstad et al, JAMA Cardiology, 2022) also increase the risk of cardiac death in that age group? Of course it's not, and we all know that.
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[Pathfinder]

Heart risks, data gaps fuel debate over COVID-19 boosters for young people

Risk of heart inflammation is small but new studies suggest it may take months to fully recover

17 OCT 20225:40 PMBYJENNIFER COUZIN-FRANKEL

Florida Surgeon General Joseph Ladapo ignited a furor this month when, based on a state analysis purporting to show COVID-19 vaccines were linked to cardiac deaths in young men, he advised men ages 18 to 39 to steer clear of the shots. Scientists slammed his warning and decried the eight-page analysis, which was anonymous and not peer reviewed, for its lack of transparency and flawed statistics.

Still, COVID-19 vaccines do have a rare but worrisome cardiac side effect. Myocarditis, an inflammation of the heart muscle that can cause chest pain and shortness of breath, has disproportionately struck older boys and young men who received the shots. Only one out of several thousand in those age groups is affected, and most quickly feel better. A tiny number of deaths have been tentatively linked to vaccine myocarditis around the world. But several new studies suggest the heart muscle can take months to heal, and some scientists worry about what this means for patients long term. The U.S. Food and Drug Administration (FDA) has ordered vaccinemakers Pfizer and Moderna to conduct a raft of studies to assess these risks.

As they parse emerging data and fret over knowledge gaps, scientists and doctors are divided over whether such concerns should influence vaccine recommendations, especially now that a new COVID-19 wave is looming and revamped boosters are hitting the scene. Nearly all urge vaccinating young people with the first two vaccine doses, but the case for boosters is more complicated. A key problem is that their benefits are unknown for the age group at highest risk of myocarditis, who are at lower risk of severe COVID-19 and other complications than older adults.

“I’m a vaccine advocate, I would still vaccinate children,” says Jane Newburger, a pediatric cardiologist at Boston Children’s Hospital who has cared for and studied postvaccine myocarditis patients. But Michael Portman, a pediatric cardiologist at Seattle Children’s Hospital who’s also studying patients, says he would hesitate to recommend boosters to healthy teens. “I don’t want to cause panic,” Portman says—but he craves more clarity on the risk-benefit ratio.
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https://www.science.org/content/art...ps-fuel-debate-covid-19-boosters-young-people