CFR in my state is rising due to overburdened hospitals. While MCAB have made a big difference, it's not enough, and our CFR is now higher than prior to vaccines and MCAB. The stress on the health system here is creating a huge problem.
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But the risk of myocarditis from COVID is still ~100x the risk of myocarditis from the COVID vaccine. https://jamanetwork.com/journals/jam...rticle/2780548Comment
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Also, I think it is intellectually dishonest to use a 100 year old precedent evaluating a mandated vaccine on something with a case fatality rate of 1/3 in a small, densely populated area as compared to something with a case fatality rate of ~1/200, probably closer to 1/1000-1/10,000 in certain populations across an entire massively geographically diverse country.
There is a benefit of getting to herd immunity and that's the purpose. Delta clearly showing we need a higher rate and immunization is way forward to protect. Kids and 40s yo in hospitals with no good reason being there.👍 2Comment
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Does that include the Supreme Court?👍 2Comment
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Does that include the Supreme Court?👍 1Comment
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Objectives Establishing the rate of post-vaccination cardiac myocarditis in the 12-15 and 16-17-year-old population in the context of their COVID-19 hospitalization risk is critical for developing a vaccination recommendation framework that balances harms with benefits for this patient demographic. Design, Setting and Participants Using the Vaccine Adverse Event Reporting System (VAERS), this retrospective epidemiological assessment reviewed reports filed between January 1, 2021, and June 18, 2021, among adolescents ages 12-17 who received mRNA vaccination against COVID-19. Symptom search criteria included the words chest pain, myocarditis, pericarditis and myopericarditis to identify children with evidence of cardiac injury. The word troponin was a required element in the laboratory findings. Inclusion criteria were aligned with the CDC working case definition for probable myocarditis. Stratified cardiac adverse event (CAE) rates were reported for age, sex and vaccination dose number. A harm-benefit analysis was conducted using existing literature on COVID-19-related hospitalization risks in this demographic. Main outcome measures 1) Stratified rates of mRNA vaccine-related myocarditis in adolescents age 12-15 and 16-17; and 2) harm-benefit analysis of vaccine-related CAEs in relation to COVID-19 hospitalization risk. Results A total of 257 CAEs 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. Conclusions Post-vaccination CAE rate was highest in young boys aged 12-15 following dose two. 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 at both moderate (August 21, 2021 rates) and high COVID-19 hospitalization incidence. Further research into the severity and long-term sequelae of post-vaccination CAE is warranted. Quantification of the benefits of the second vaccination dose and vaccination in addition to natural immunity in this demographic may be indicated to minimize harm. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement There was no funding received for this study. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: NA All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes Data used in this analysis are available at the link listed below.Comment
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What in the world are you talking about? The above case is the SC deciding that a law was constitutional. They weren’t legislating. As above, my primary concern is an executive branch legislating with a simple utterance. You can debate whether or not a vaccine mandate in this setting is constitutional, and certainly we will hear about it in the SC; my concern is that it seems like a massive overreach of presidential authority. This is literally why congress exists.Comment
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As to no mandate, you know what happens if there is no mandate in healthcare. One system will not mandate it because it will cause depletion of staff to the competing health system because they don't have the mandate. The other system will also not do it because the first one is not doing it. The patients and workers in both system will benefit in the end if all had mandate but no one wants to be the first👍 6Comment
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Also, I think it is intellectually dishonest to use a 100 year old precedent evaluating a mandated vaccine on something with a case fatality rate of 1/3 in a small, densely populated area as compared to something with a case fatality rate of ~1/200, probably closer to 1/1000-1/10,000 in certain populations across an entire massively geographically diverse country.
But anyway, I agree that the SCOTUS precedent is not reliable, at least as applies to a society wide mandate.👍 2Comment
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1/500 of the entire population has already died of COVID and the pandemic is far from over. Even if every American has gotten covid (which is patently absurd) the death rate is 2-20x those figures. In the end the CFR today is still 1.5%, and the IFR (which is likely what you meant) is probably at least 0.5%. For huge swaths of the population this disease has an IFR of 1% or much more: the poor, the elderly, the obese, diabetics, etc. It’s been clear from the outset this disease was going to be very nasty to America because it picked on fat, sick, poor people, of which America has a plethora.
But anyway, I agree that the SCOTUS precedent is not reliable, at least as applies to a society wide mandate.
Regarding CFR vs. IFR, kind of depends how in the weeds you want to get on whether CFR is defined as a diagnosed cohort or ill cohort. I meant symptomatic cases not tested, not asymptomatic infections. My brother got Covid not too long ago. His kids all got a febrile illness but were not tested. When you see the cumulative CFR of 1.6, this isn’t part of the denominator.Comment
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