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How the Study Was Conducted
The team of 14 researchers — led by Martina Patone, Ph.D., a data scientist and medical statistician at the University of Oxford — analyzed data for people ages 13 and older who were vaccinated against COVID-19 in England between Dec. 1, 2020, and Dec. 15, 2021.The authors evaluated the association between vaccination and myocarditis for different ages and sex groups by tracking hospital admissions and deaths from myocarditis by age and gender and in relation to how many doses of a vaccine the person received.
In England, the three COVID-19 vaccines given to people at that time were the Pfizer, Moderna and AstraZeneca vaccines.
Roughly 20 million people got the AstraZeneca vaccine, 20 million got the Pfizer vaccine, and just over 1 million got the Moderna vaccine.
Over the period of the study, 345 patients were admitted to the hospital for myocarditis within 1 to 28 days of receiving a COVID-19 vaccine, the authors said.
Among those admitted to the hospital for myocarditis who recently received the AstraZeneca vaccine, the researchers counted 40 deaths due to myocarditis within 1 to 28 days after a first dose and 11 deaths due to myocarditis within 1 to 28 days after a second dose.
For those who received the Pfizer vaccine, 22 individuals died of myocarditis within 1 to 28 days of receiving their first dose, 14 died of myocarditis within 1 to 28 days of receiving a second dose and 13 died of myocarditis within 1 to 28 days of receiving a third dose.
The researchers reported no cases of fatal myocarditis among those who recently received the Moderna vaccine.
Following a second dose of the Moderna vaccine, they said, the increased risk ratio for developing myocarditis was 11.76 (95% CI, 7.25-19.08).
Men under age 40, as a group, showed a heightened increased risk of myocarditis following all three vaccine types.
After the first dose of the Pfizer vaccine, the increased risk ratio for men under 40 years old was 1.85 (95% CI, 1.30-2.62). It increased to 1.93 (95% CI, 1.51-2.45) after the second dose and was 1.89 (95% CI,1.34-2.67) after the third dose.
Similarly, the researchers reported a high increased risk ratio of 3.06 (95% CI, 1.33-7.03) after the first dose of the Modern vaccine for men under 40. The risk rose to 16.83 (95% CI, 9.11-31.1) after a second dose. After a third dose, the increased risk ratio was 3.57 (95% CI, 1.48-8.64).
Among men under 40 who received the AstraZeneca vaccine, the increased risk ratio for myocarditis after the first dose was 1.33 (95% CI, 1.03-1.72) and after the second dose was 1.26 (95% CI, 0.96-1.65).
The team said their findings will enable “an informed discussion of the risk of vaccine associated myocarditis.”
Researchers Misleadingly Claim High Myocarditis Risk From COVID Infection
In the study, Patone’s team attempted to compare the risk of getting myocarditis due to vaccination to the risk of getting myocarditis due to a SARS infection and concluded a SARS-CoV-2 infection posed a higher risk of myocarditis compared with the risk associated with a COVID-19 vaccine.They concluded that, in general, the “risk of hospitalization or death from myocarditis was higher after SARS-CoV-2 [COVID-19] infection than vaccination.”
McCullough said that conclusion is false. “It’s falsely worrying people that they could get myocarditis with a respiratory infection,” he said.
McCullough added:
“The Patone paper is misleading because it’s relying on ICD [International Classification of Diseases] codes of inpatients with COVID, who don’t have adjudicated myocarditis like the outpatients do.”
The ICD codes, he said, are the automated source of hospital data Patone’s team used to determine if a person had experienced myocarditis.
McCullough cited this reference in the study’s methods section:
The ICD codes are triggered by the measurement of cardiac troponin in the hospital, but the measurement of cardiac troponin alone may not be an indicator of actual myocarditis, according to McCullough.
“The reason the patients in the COVID group are hospitalized is due to COVID,” he said. “There’s no adjudication [proving they have an actual case of myocarditis]. There’s no indication that a cardiac MRI was done.”
McCullough continued:
The JAMA study authors said:
“In this cohort study of 1597 US competitive athletes with CMR screening after COVID-19 infection, 37 athletes (2.3%) were diagnosed with clinical and subclinical myocarditis.”
“So we know from large studies of the [COVID-19] respiratory infection,” McCullough said, “that the risk of myocarditis is negligible.”
He added:
“As a cardiologist, I would say that no case of myocarditis is mild or transient or insignificant. All of this is of extreme significance since it scars the heart. One case of vaccine-induced myocarditis is too many.”