Talk:COVID-19 vaccine/Archive 5

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doi:10.1001/jamapediatrics.2022.3581

According to the JAMA Pediatrics study with lactating women, published in September 2022, trace amounts of COVID-19 vaccine mRNA were detected in the expressed breast milk from five of the 11 women in the study at various times up to 45 hours after vaccination (with a vaccine detection limit of 1 pg/mL); the authors advised to refrain from breastfeeding infants under 6 months in the first 48 hours after the mRNA vaccination.[ref]"Detection of Messenger RNA COVID-19 Vaccines in Human Breast Milk". JAMA Pediatrics. 26 September 2022. doi:10.1001/jamapediatrics.2022.3581. Retrieved 5 October 2022. However, caution is warranted about breastfeeding children younger than 6 months in the first 48 hours after maternal vaccination until more safety studies are conducted.[/ref]

The section above has been deleted with the wrong explanation that doi:10.1001/jamapediatrics.2022.3581 wouldn't be "reliable". There is zero basis to assume this and as of now the Wikipedia article cites the "systematic review" doi:10.3390/v14030539 that states:

"No mRNA presence was detected, highlighting the fact that there is no transfer of mRNA to the baby via breast milk and no reason to discontinue breastfeeding for this reason at the time of vaccine administration [44]" But there's only ONE source [44] for that and [44] is an earlier study doi: 10.1001/jamapediatrics.2021.1929 - also published in JAMA Pediatrics and as small in terms of participants - that didn't find mRNA.

@Whywhenwhohow:@Bon courage:@Zefr: The earlier study is in no way superior to the later and so the conclusion that "No mRNA presence was detected" in the "systematical review"" is now outdated. So the Wikipedia article can and should address this issue. Without this the Wikipedia article would be biased here. That's not an option!--Myosci (talk) 20:39, 6 October 2022 (UTC)

As has been said before, if you want to overturn WP:MEDRS you need to post at WT:MED. Until then, using primary sources to undercut secondary ones is a no. Bon courage (talk) 20:44, 6 October 2022 (UTC)

The secondary source relies on one primary source doi:10.1001/jamapediatrics.2021.1929. On ONE source. So when a second source not inferior to the former contradicts it then this section in the "review" is in doubt. But it's worse, "systematical review" should only state settled information and address eventual shortcomings of the primary sources. This "systematical review" even fails to mention the shortcoming the authors of the primary source themselves stated:

"Limitations of this study are the small sample size and few participants who received the mRNA-1273 vaccine. In addition, milk storage conditions may affect mRNA stability." (2 participants who received Moderna and 5 Biontech! So 7 participants and only 13 milk samples. And there are other issues... (Is "0.195 pg and 1.5 pg for the BNT162b and mRNA-1273 vaccines" a proper measure for concentration??). They "systematical review" fails to mention that and boldly infers "No mRNA presence was detected" from this mini-study. The "systematical review"' assessment was shaky from the beginning now it clearly outdated (on the issue of "no mRNA in breast-milk")! --Myosci (talk) 21:58, 6 October 2022 (UTC)

Please post at WT:MED for further discussion and to include others. Thank you. --Whywhenwhohow (talk) 06:17, 7 October 2022 (UTC)

Primary research reports should not be included. If we're going to include primary research reports, we should not misrepresent them. I ask you to compare these two statements:

1. "We believe it is safe to breastfeed after maternal COVID-19 vaccination."
2. "Refrain from breastfeeding infants under 6 months in the first 48 hours after the mRNA vaccination."

One of These Things is not like the other, right? Guess which one is in the cited source.

As for what you should be relying on, I suggest these two very recent reviews:

• "There are no known or theoretical risks of vaccination of breastfeeding women and there are no restrictions to the vaccination." [1] (review, published 20 days ago)
• " No evidence suggests that women receiving a vaccine against SARS-CoV-2 is harmful to either the nursing mother or the breastfed infant....No non-live vaccine has previously been reported to cause infant adverse effects via breastfeeding.[17] Only a small percentage of milk samples from women who received an mRNA vaccine contained trace amounts of mRNA. Thirty-six of 40 milk samples in one study and 5 of 309 milk samples in another had detectable mRNA levels; the highest concentration found was 2 mcg/L in one study and the median concentration was 70 ng/L in another; mRNA has not been detected in the serum of any breastfed infants.18-20] mRNA has an estimated serum half-life of 8 to 10 hours.18,19]" [2] (review, published 21 days ago)

WhatamIdoing (talk) 16:01, 10 October 2022 (UTC)

To expand on this, future secondary studies may have different conclusions as a result of the above cited primary study. But we need to wait for those later secondary studies unless the circumstances are exceptional, and I don't think that's the case here. Bakkster Man (talk) 16:55, 10 October 2022 (UTC)

@WhatamIdoing You say that these two statements are different. And yes they are! #2 is in doi:10.1001/jamapediatrics.2022.3581 and #1 is in doi:10.1001/jamapediatrics.2021.1929. So why should one prefer the statement of the author one primary research over the other, both published in the same journal? Why should one prefer the earlier study at the expense of the later and superior study?

If you read the actual articles you will see: the second has more particpants, much more samples and a reasonable limit of detection. The first study even fails in terms of high school chemistry since "0.195 pg and 1.5 pg for the BNT162b and mRNA-1273 vaccines" is not a valid measure for concentration. Nowhere did the authors say if that's 0.195 pg per ml oder 0.195 per some other custom sample volume. And what's with that huge difference: 0.195 pg / 1.5 pg, there is no explanation or even discussion why Biontech's vaccine is so much better detectable than Modernas.

The first source is contained in the article by proxy, the "systematical review" as its SINGLE source for the statement.

In this case it seems: As long as the statement is that the Covid-19 vaccines are fine and without dangers, every study is o.k. If it's the other way -- even if it's only about a 48 hours pause -- no study is good enough. That bias has to come to an end. For the safety of the people who get vaccinated and for the safety of future vaccines and other drugs and for the validity of Wikipedia (as an important source of information for many people).--Myosci (talk) 12:34, 15 October 2022 (UTC)

References

Let's go to the newly mentioned review Covid and pregnancy in the United States – an update as of August 2022:

"... professional organizations such as ACOG and SMFM did not recommend COVID-19 vaccination to pregnant women at that time [...] Unfortunately, their fears have become reality when, possibly as a result of physician hesitancy and delaying vaccine recommendations for pregnant women by major organizations until later in 2021, many unvaccinated women died at the end of 2021 and beginning of 2022 as a consequence of a lower vaccine acceptance rate by pregnant women [4].

We believe that physicians and other health care providers should continue to strongly recommend COVID-19 vaccinations to pregnant patients, those trying to get pregnant, and those who breastfeed who initially decline vaccination."

So this "review" is not like the classical reviews. A "classical" review tried to give the whole picture about the pros and cons and then formed a more or less definitive conclusion at the end (or not). In this "modern review" the premise and conclusion is the same and it's no wonder that only studies have been included that concur with the premise to "strongly recommend". The cons come only from the old-school "hesitancy and delaying", responsible for "many unvaccinated women". That reviews can have a bias is not new but this "review" doesn't even try to hide it. It's more like an opinion piece with some facts.--Myosci (talk) 15:28, 15 October 2022 (UTC)

As evidence for the statements that the vaccines are fine ("In several analyses of pregnant women who received an mRNA vaccine, no concerning safety signals were seen") that article cites 3 sources:

doi:10.1056/NEJMoa2104983 (June 2021), doi:10.1002/uog.23729 (July 2021) and doi:doi.org/10.1016/j.ajog.2021.08.007 (August 2021). The review is from August 2022. A publication in June/July/August 2021 could only cover a very short time period of the start of the vaccinations. This "review" is therefore an opinion piece with outdated sources. --Myosci (talk) 15:53, 15 October 2022 (UTC)

Yes, there's a NHS position (top-tier MEDRS) that was updated just a few days ago. I have updated the article. Bon courage (talk) 15:57, 15 October 2022 (UTC)

That's only the statement of the NHS position, zero studies are cited there. (This article hasn't even a "doi".) So studies are irrelevant, experts from the government are enough? No, no, no! Then we would as well go back to the time before G. Galilei. (When the curch said that the Sun revolves around the Earth that was enough.) --Myosci (talk) 16:14, 15 October 2022 (UTC)

The Galileo gambit now? The NHS is not "government" and NHS documents are not DOI registered (so what?). Basically, if you want to spread misinformation about vaccines using unreliable sources you need to do it elsewhere; here you are becoming a pest. You are aware of discretionary sanctions in this topic area. Bon courage (talk) 16:16, 15 October 2022 (UTC)

Wikipedia articles are not primarily about assembling scientific evidence. Position statements from major, reputable medical organizations are considered one of the best possible sources for a Wikipedia article. Reliable sources are not required to cite other sources (penultimate item in the FAQ).

Wikipedia is supposed to report what the reliable sources say, not what an editor decides is The Truth™. This rule actually goes back to the early days of Wikipedia, when someone who scored high on the Usenet crackpot index wanted to use Wikipedia to tell the world that he'd proven Einstein's special relativity wrong. If you think the reliable sources are wrong, then Wikipedia should be exactly as "wrong" as the sources are. WhatamIdoing (talk) 17:52, 15 October 2022 (UTC)

@Myosci, #1 is *not* in the older paper. #1 is word-for-word out of the paper that you were citing. #2 is not in any paper.

doi:10.1001/jamapediatrics.2022.3581 says, in the last paragraph, "We believe it is safe to breastfeed after maternal COVID-19 vaccination. However, caution is warranted about breastfeeding children younger than 6 months in the first 48 hours after maternal vaccination until more safety studies are conducted."

You have twisted the "it is safe" into "refrain from doing the thing that the authors just said they believe to be safe". The source does not say that mother should refrain from breastfeeding for even five minutes, much less for 48 hours. The authors directly state that they believe breastfeeding to be safe after vaccination. "After vaccination" includes "immediately after vaccination". Please don't turn "it's safe" into "it's safe but not during the first 48 hours". WhatamIdoing (talk) 17:41, 15 October 2022 (UTC)

@Bon courage: You're acting insulting and non-Wikipedian and lack basic information about the UK: "The English NHS is controlled by the UK government through the Department of Health and Social Care (DHSC), which takes political responsibility for the service."

Last time you failed to answer the question: why did first retain a source doi:10.1161/CIRCULATIONAHA.122.059970 twice and then deleted it after I showed you that the source has critical information. Your answer was telling: "Dunno, probably still working out what to do and looking at sourcing. I cleaned it out later." Perhaps you can answer it now?

You know the study was published in the medical journal Circulation relied on NHS data what I appreciated multiple times ("And it's data from the British NHS where vaccine side effects are reported systematically - unlike ... ") so don't tell about the NHS, it has different levels and roles: a scientific role, the health-care provider role and the administrative-governmental role, This article belongs not to the scientific role.

@Bon courage: By the way: my local time is 9 p.m. what's your local time? --Myosci (talk) 19:02, 15 October 2022 (UTC)

Time to WP:DENY. Bon courage (talk) 19:25, 15 October 2022 (UTC)

Oh dear, oh dear! You're well versed in WP shourtcuts. But in WP manners you're even worse than me!--Myosci (talk) 19:28, 15 October 2022 (UTC)

@WhatamIdoing:: Now I get what you mean literal quotes: But "However, caution is warranted about breastfeeding children younger than 6 months in the first 48 hours after maternal vaccination until more safety studies are conducted." has very much the meaning: "Refrain from breastfeeding infants under 6 months in the first 48 hours after the mRNA vaccination." Should we always copy the text word for word (even without quotation marks)? And the prior sentence is only the prelude to the diverging new information (That's called a qualification!). The article of the first source doi:10.1001/jamapediatrics.2021.1929 may not have a direct quote of sentence #1 but the review article summed it [44] up that way: "No mRNA presence was detected, highlighting the fact that there is no transfer of mRNA to the baby via breast milk and no reason to discontinue breastfeeding for this reason at the time of vaccine administration [44]" So according to the review article citing article 1 no reason to pause, according to article 2 there is reason to pause! So partial literal quotation can be in error. --Myosci (talk) 19:28, 15 October 2022 (UTC)

"However, caution is warranted" means in this context: it's advisable not to breastfeed for 48 hours. Because there there is no reasonable middle road since the option: Breastfeed and then watch and worry (and in the end transmit that worry to the baby) would be even worse.--Myosci (talk) 19:50, 15 October 2022 (UTC)

No, it doesn't. "Caution is warranted" does not mean "Danger: Do Not Do This". WhatamIdoing (talk) 20:44, 15 October 2022 (UTC)

Sometimes language is soft: "Beware of the dog" means: If you've no business there then any mishap with the dog is your one fault.

I'm not a native speaker but I've proof that this "be cautious" is understood as a warning since the senior author of the earlier study (that found no mRNA, had fewer samples, didn't explain the huge difference in limit of detection for Biontech-Pfizer / Moderna, used the wrong unit -- pg instead of pg/?) criticized the cautious approach of the authors of the 2nd study:

“There is absolutely no justification to withhold breastmilk after getting the vaccine, even with the detection of trace amounts of mRNA. There is mRNA from many sources in breastmilk, which is not dangerous and also unlikely to survive the digestive tract of the baby anyways,” Dr. Stephanie Gaw, a maternal-fetal medicine physician scientist at the University of California, San Francisco, told us in an email.

“The clinical or biological significance of these trace amounts is not studied, and most scientist[s] would consider it not clinically relevant,” she continued. “Suggesting that mothers pump and dump is reckless and potentially harmful to the mother and baby (withholds safe nutrition from the baby, disrupts the breastfeeding relationship, and imposes stress on the days) with absolutely no justification.” See No Indication Breast Milk After Vaccination Unsafe, Despite Posts About New Study

So ironically this factcheck confirms the antivaxxers in their distrust about science but it's biased science that is the culprit. So the authors of the second study are the real nightmare of the antivaxxers! --Myosci (talk) 22:45, 15 October 2022 (UTC)

P.S. 1st JAMA study: 7 participants, 13 samples, "did not use special methods to increase the ability to detect trace amounts"[3] <-> 2nd study: 11 participants, 131 samples. --Myosci (talk) 22:52, 15 October 2022 (UTC)

Your (@WhatamIdoing) earlier post: Wikipedia articles are not primarily about assembling scientific evidence. Position statements from major,...

This webpage isn't a scientific paper it's the public statement about the current position of the NHS on this topic. (Last page review: 8 Oct. 2022, next page review 28 Oct. 2022.) Whereas this is a scientific paper. So these two are different types of information. Both types of information are important and relevant for Wikipedia. But they must be discerned in the wikitext.

One reason is: The position of a health authority is often subject to balancing of diverging interests. For example the issue of masks at the beginning of the Covid pandemic:

The health authority in my country (as well as the CDC and the WHO) still stated in March 2020 that the masks are not sensible as scientific papers already said otherwise. At that time there was an acute shortage of masks and the advice was helpfull to reserve it to health care professionals. Why didn't the health authorities say: masks are useful but it's to spare the filter masks for health care and use the lesser masks to the general public? Don't tell me that the health authorities are dumb and didn't value the studies, they waited as long as there was a shortage. Because in a crisis, people tend to hoard: be it toilet papers or masks! --Myosci (talk) 13:27, 16 October 2022 (UTC)

A scientific paper should avoid this and must be frank and free of bias. Both types of information, the bare information from (science) studies and the balanced approach of the (health) authorities are important to be read and important to be differentiated.--Myosci (talk) 13:27, 16 October 2022 (UTC)

Florida Dep't of Health updated guidance

Possibly at the end of the "Post-vaccination complications" section or the "mRNA vaccines" section, could an authorized editor please consider adding the new Florida Dep't of Health guidance dated October 7, 2022? It first covers mRNA vaccines in general in the opening statement: "Today, State Surgeon General Dr. Joseph A. Ladapo has announced new guidance regarding mRNA vaccines." Then it focuses upon COVID-19 mRNA vaccines.

Also, if this is for some reason rejected from this page, could you please recommend an appropriate page?

Thank you very kindy, 2600:4040:780C:6F00:F5A3:AA5D:87D7:8A25 (talk) 16:22, 8 October 2022 (UTC)

References

See identical request at Talk:MRNA_vaccine#Florida_Department_of_Health_updated_guidance. This doesn't meet WP:MEDRS and we cannot use it. - MrOllie (talk) 16:23, 8 October 2022 (UTC)

Consider COVID-19 pandemic in Florida for state-level info. Bakkster Man (talk) 13:16, 10 October 2022 (UTC)

Thank you for both responses. 2600:4040:780C:6F00:9931:8C8F:46FA:EA94 (talk) 12:44, 17 October 2022 (UTC)

Question re: Aluminum health benefits assertion

The article seems to assert that aluminum has health benefits to the human body, yet over 8,000 studies warning of aluminum toxicity exist on PubMed. One wonders whether there might be another substance that could accomplish the task of stimulating the immune system other than Al, given the extremely large body of evidence against it?

2600:4040:780C:6F00:9931:8C8F:46FA:EA94 (talk) 12:44, 17 October 2022 (UTC)

Seems you want to be looking for Alum, the specific form of Aluminum used as the adjuvant here. Atoms in molecules do not act the same way as the chemical element itself (the amino acids cysteine and methionine contain a sulfur atom, but rather than being hazardous like elemental sulfur, they're essential for life). Bakkster Man (talk) 14:05, 17 October 2022 (UTC)

Thank you. 2600:4040:780C:6F00:9931:8C8F:46FA:EA94 (talk) 15:17, 17 October 2022 (UTC)

Level 3 Clinical Trial results missing

A 10/17/22 review of large scale clinical trials on general populations listed on clinicaltrials.gov shows red flags for an absence of published data for trials claiming completion of level 3, or not marked as being levels 1 or 2. Completion is claimed without published data for all trials except those on tiny populations. In a few cases, studies were marked "results submitted" but further down the page it was marked "results not posted." In other words, they were not available to the public, or to most researchers for that matter. Examples of studies claiming completion but labeled "NO RESULTS POSTED" (ones with obvious confounding variables are excluded here, such as trialing multiple vaccines at once):

2600:4040:780C:6F00:9931:8C8F:46FA:EA94 (talk) 15:19, 17 October 2022 (UTC)

So ? Bon courage (talk) 15:26, 17 October 2022 (UTC)

Myocarditis figures need to be updated

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

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There is a great MAINSTREAM article in "Science" that sharply contradicts what is currently in the article. PLEASE do not judge me by my recent kerfuffle on this page. I was out of my element and I refuse to let my past define me.

Seriously though, here is the article: https://www.science.org/content/article/heart-risks-data-gaps-fuel-debate-covid-19-boosters-young-people

The figures are more like 1 in 6,000 to 1 in 16,000, not 1 in a million. Other stuff that I think should be in the article can be seen in my edit: https://en.wikipedia.org/w/index.php?title=COVID-19_vaccine&type=revision&diff=1116937183&oldid=1116936946 and I'll let cooler and unbanned minds figure out what else to include. Thank you. BATTLECRUISER OPERATIONAL (talk) 03:49, 19 October 2022 (UTC)

Do you have a WP:MEDRS source for the value? Bakkster Man (talk) 22:30, 19 October 2022 (UTC)

I'm not quite sure what you mean. I know it's not a peer-reviewed article, but it's put out by Science. It's just some stats. This seems tedious to me. Here is a peer-reviewed JAMA article that has numbers that seem to line up with the Science piece: https://jamanetwork.com/journals/jama/fullarticle/2788346 Does this satisfy your request? BATTLECRUISER OPERATIONAL (talk) 01:34, 20 October 2022 (UTC)

Does the Science article "sharply contradict" what's in this article? According to the Science article, "one out of several thousand in those age groups is affected, and most quickly feel better". An episode of myocarditis from which the patient quickly recovers does not seem to be what would be considered a "serious" reaction. See, e.g., the European Medical Agency, which defines a serious adverse reaction as "An adverse reaction that results in death, is life-threatening, requires hospitalisation or prolongation of existing hospitalisation, results in persistent or significant disability or incapacity, or is a birth defect". It is not at all clear from the Science article whether the as yet unconfirmed 1 in 6,000 to 1 in 16,000 incidence of myocarditis translates to more than a minute fraction of those cases resulting in death or threat of death, requisite (as opposed to precautionary) hospitalization, or persistent disability or incapacity. If we had numbers on those things, I would certainly not be averse to adding that information to this article. BD2412 T 05:31, 20 October 2022 (UTC)

Ok at the very least we could update the sources for myocarditis to just this one by Patone et al: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8863574/ which is what is cited in the current Science source. I admit the strength here is that it looked retrospectively at hospitalizations, likely before people were aware of myocarditis. But we can't just discount those who wouldn't have otherwise made anything of their chest pain following vaccination, and claim this is some sort of social contagion. It's not. The new Science source says 2.8 percent of vaccine recipients had elevated troponin levels that was attributable to the vaccine, which is higher than the 2.3 percent figure of the 1,600 athletes, in the same article, who had elevated troponin levels post-covid. These things take a long time to have an effect--a crude analogy, but look at what happens with Chagas disease. Perhaps we could just explain all of this? I can see how leaving it out, as we are, could be problematic, but also how misstating the current consensus could harmfully discourage vaccination. Disclaimer: I'm not getting boosted because of this issue, but I'd also consider myself extremely healthy, and it pains me to see less healthy people who should be vaccinated misread the statistics and think they should shun the vaccine. I'd like to add that not only has the risk of repeated boosters and loss of heart muscle factored into my decision, but also that obviously you can still get covid post vaccination, and then get viral myocarditis. I have yet to see studies assess risk of viral vs. vaccine myocarditis in a stratified fashion, that accounts for "health status"...why are healthy young men lumped in with obese young men in these studies? See Simpson's paradox. Basically, there are two ways to err on the side of caution in reporting this, and it's not only challenging to do because of the scientific complexity, but also because of the extremely toxic ideological/partisan debate. This recent study https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(22)00244-9/fulltext shows that the percent who have not fully recovered is far greater than 1%, so in my opinion absolutely the current 1 in 1,000,000 figure is way off. Rather than 1%, try 26%: "320 (81%) of 393 patients with a health-care provider assessment were considered recovered from myocarditis by their health-care provider, although at the last health-care provider follow-up, 104 (26%) of 393 patients were prescribed daily medication related to myocarditis." Imagine being a young man who is now forced to take heart meds, possibly for life, because of a vaccine that wasn't properly vetted. That is definitely adverse in my book. I'm not saying we should make our own numbers here, but we absolutely should reconsider what is there now. BATTLECRUISER OPERATIONAL (talk) 16:56, 20 October 2022 (UTC)

Would need WP:MEDRS. Bon courage (talk) 15:38, 21 October 2022 (UTC)

Here: https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(22)00244-9/fulltext or are we going to trivialize formerly young and healthy men having to take heart medications 3 months after taking a vaccine? BATTLECRUISER OPERATIONAL (talk) 15:42, 21 October 2022 (UTC)

Not a reliable source, please read WP:MEDRS. Bon courage (talk) 15:46, 21 October 2022 (UTC)

Ok my bad. I thought "peer reviewed" was the gold standard, with few caveats. So, we want secondary coverage? That said, does the "Heart Risks, Data Gaps..." Science piece linked above qualify for "MEDRS"? BATTLECRUISER OPERATIONAL (talk) 15:52, 21 October 2022 (UTC)

Not really, it's a news story. Bon courage (talk) 15:56, 21 October 2022 (UTC)

Ok what about this review article: https://www.tandfonline.com/doi/full/10.1080/14760584.2022.2002690 which says of myo and pericarditis: "Both conditions have been implicated as adverse events following vaccinations. While the clinical presentation may vary, and prognosis differ based on severity of symptoms, most cases tend to be mild and respond well to clinical management." So basically, this reviewer says all myo and pericarditis cases are adverse, and WE are the ones who are offering our own original interpretation of "mild" and using a 1/1,000,000 figure instead of a more valid 1/10,000 one? BATTLECRUISER OPERATIONAL (talk) 16:11, 21 October 2022 (UTC)

That would be PMID:34738500 which looks promising, yes. It's interesting they're not even sure it's a causal link: "Current evidence suggests a probably causal association between inflammatory heart conditions and the receipt of mRNA vaccines". Bon courage (talk) 16:17, 21 October 2022 (UTC)

Here is a review that 1. calls myocarditis and pericarditis "adverse", and has a 1-2 / 10,000 figure: https://bmjopen.bmj.com/content/bmjopen/12/5/e059223.full.pdf Regarding causality: even if we report it as an association, anyone reading it will read it the same, in my opinion. The alternate explanation is that the vaccine "uncovers latent myocarditis", which seems and is far-fetched, even for a layperson reading it. By the way, that's a pooled result. The risk for specific strata is of course higher. When we report this new figure we must note that that's an overall risk while reporting that the majority of those cases were in young men. BATTLECRUISER OPERATIONAL (talk) 20:36, 21 October 2022 (UTC)

That would be PMID:35613761, which is also good. It makes the point that incidence rates cannot be derived from the data they use. Interesting that they think the reported numbers might be a bias artefect. You are correct about how it's difficult to write about associations for a lay audience without implying cause. Two ways to mitigate this is to flip the two things into a surprising order (myocarditis reporting is associated with COVID-19 vaccination) or - better in this case - to include some explicit wording ("there is a suspicion the association may be causal in nature"). Bon courage (talk) 05:54, 22 October 2022 (UTC)

Just a quick note that the OP has been blocked as a sock. Nil Einne (talk) 17:46, 23 October 2022 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Article in Circulation

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

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doi:10.1161/CIRCULATIONAHA.122.059970 ... [Continuation from above] The article in Circulation with the NHS data is the most comprehensive one: it includes all age groups and compares the rate to the rate post Covid-19 infection. And the astonishing result is: For males under 40 in England it's more likely to get myocarditis after the Moderna vaccination than after an positive Covid-19 test: "In men younger than 40 years old, the number of excess myocarditis events per million people was higher after a second dose of mRNA-1273 than after a positive SARS-CoV-2 test (97 [95% CI, 91–99] versus 16 [95% CI, 12–18]). In women younger than 40 years, the number of excess events per million was similar after a second dose of mRNA-1273 and a positive test (7 [95% CI, 1–9] versus 8 [95% CI, 6–8])." So for males younger than 40 years the vaccine is by the factor 97/16 ~ 6 times more likely to cause myocarditis than the actual infection. That's a disturbingly high factor!--Myosci (talk) 20:41, 29 October 2022 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Update on information regarding the risk of Covid-19 vaccine induced myocarditis needed

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

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The article relies on outdated numbers and therefore misinforms the reader about the incidence of myocarditis. It's not merely "an excess rate of about one or two cases per million vaccine recipients" but much more common:

• According to a study published in the journal Annals of Internal Medicine that is based on the data from the "Vaccine Safety Datalink" the incidence of vaccine induced myocarditis for any mRNA Covid-19 vaccine and any age group is in the U.S. 1:200,000 for the first dose, 1:30,000 for the second dose and 1:50,000 for the first booster. Especially in young males is's even higher much higher (there it's in the order of 1:10,000 for the 2nd dose and the first booster). See doi:10.7326/M22-2274#t1-M222274.
• And according to a study, published in Circulation (journal), based on the data of the British NHS, it significantly more likley for young males to get myocardits after a Moderna vaccination than after a positive Covid-19 test result and for young women it is about as likely.doi:10.1161/CIRCULATIONAHA.122.059970

These results are based on high qualtiy peer-reviewed publications from hughe data sets and the early data still included in this article needs to be updated. Wikipedia also fails to mention that the German vaccination body SITKO has advised since February 2022 to perform an "aspiration test" prior to the actual injection of Covid-19 vaccines as a precautionary measure to prevent the accidental injection of the vaccine into a (small) blood vessel.[4]

This information/update of information must be included, otherwise Wikipedia would fail especially its young readers who are at highest risk to develop vaccine-induced mycocaridtis (more than by the actual infection!) and who turn to Wikipedia for information. Myosci (talk) 10:14, 29 October 2022 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

3rd opinion on the closure

The upper discussion section was closed without reason. Third opinion requested. --Myosci (talk) 10:36, 29 October 2022 (UTC)

Yeah, you might want to mention that you've been pressing to use non-WP:MEDRS sources in multiple venues and have got push back, not least after requesting assistance from WP:MEDRS. It has now reached the point where I think further disruption would merit you being topic-banned from vaccination topics. Bon courage (talk) 10:52, 29 October 2022 (UTC)

What are you talking? These are articles in high-quality peer-reviewed journals and in no way inferior to the older sources and BTW: "1 to 2 excess cases per million" in the the Wikitext are even wrong from at least one cited (older) source. And I may advise you: You should should fix that wrong attribution by correcting the text and not by deleting the already established source! --Myosci (talk) 11:03, 29 October 2022 (UTC)

As you are well aware, "peer reviewed" does not means a source is WP:MEDRS. Or, if you haven't understood this maybe the issue is WP:CIR. Bon courage (talk) 11:18, 29 October 2022 (UTC)

The statement of the Wikitexttext about 1 to 2 excess cases turns out to be wrong after the first cited source doi:10.1126/science.abn1755: "A case series of reports from England estimated additional myocarditis cases at 1 to 2 per million for the first dose of AZ/ChadOx1 and Pfizer/BNT162b2, and 6 per million for Moderna/mRNA-1273 (12)." (emphasis added) So it's the first dose, after the second it's more and for Moderna it's even 6 after the first dose. So the Wikitext is simply wrong. Insted of closing discussion without reason please tell me: How can it be that the a wikitext misattributes even the first source?! --Myosci (talk) 11:31, 29 October 2022 (UTC)

About your Wikipedia shortcuts: Perhaps you're generally too involved in Wikipedia disputes.--Myosci (talk) 11:58, 29 October 2022 (UTC)

If you think there's some kind of editor problem you need to raise it at WP:ANI. Right now, you're wasting editor time by repeatedly arguing to use types of sources which consensus has determined are unsuitable for biomedical content. Bon courage (talk) 12:02, 29 October 2022 (UTC)

This subsection should be about the 3rd opinon on the topic, so I made our prior posts small since we're not part of the 3rd opinion. And I would suggest to make all of our subsequent posts small, or even better refrain from posting here till at least Monday.--Myosci (talk) 12:16, 29 October 2022 (UTC)

Regarding that...

I came for the 3rd opinion but taking a closer look at the sentence in question, myocarditis and pericarditis, or inflammation of the heart.[238] These were associated with the mRNA vaccines (AZ/ChadOx1, Pfizer/BNT162b2, Moderna/mRNA-1273), with an excess rate of about one or two cases per million vaccine recipients, mostly in teenage males.238234. It appears that the sources do not support the numbers. Note that I recently removed one of the sources in the process of looking into the sentence as it didn't provide any verification of this paragraph.

Source 238 cites a primary english study of millions of vaccinated to say estimated additional myocarditis cases at 1 to 2 per million for the first dose of AZ/ChadOx1 and Pfizer/BNT162b2, and 6 per million for Moderna/mRNA-1273. Source 234 miscites? from [5] that Post-vaccination myocarditis/pericarditis occurs mainly in young men, and the reported rate in males aged 12–17 years after the second dose of BNT162b2 or mRNA-1273 was 66.7 per million doses where in the source is says that the males aged 12−17 years had 62.8 myocarditis cases per million second doses of mRNA vaccines.

It would appear based on the sources cited that the sentence should be more like... AZ/ChadOx1 and Pfizer/BNT162b2 have excess rate of about one or two cases per million vaccine recipients while Moderna/mRNA-1273 has an excess rate of about 6 per million vaccine recipients. These cases most affect in teenage males where the highest reported rate of of mycarditis is in males 12-17 taking the BNT162b2 or the mRNA-1273 vaccine have around 62.8 myocarditis cases per million second doses of mRNA vaccines. Please tell me what I am missing. Pabsoluterince (talk) 14:59, 29 October 2022 (UTC)

One would have to include ...for the first dose... in the first sentence and I would suggest to also use the more recent articles [6] doi:10.7326/M22-2274 (with U.S. data) and doi:10.1161/CIRCULATIONAHA.122.059970 (with U.K. data). [cont below] ... --Myosci (talk) 21:45, 29 October 2022 (UTC)

Okay nm. @Myosci: It comes down to primary vs secondary and quality of the journal. Basically, allow the experts to pick out the significant data from the weeds of primary research. They understand the science better than us and are independent of the findings (unlike the primary researchers). This means secondary sources are prefered. The higher the quality of the publishing journal, produces higher quality papers (less errors, less bad science etc). So high quality journals are prefered. Now my 3rd opinion is

Response to third opinion request: It was a valid close. Previous attempts to explain the concept of WP:MEDRS [7][8][9] has fallen on deaf ears. In order to prevent more time spent trying to explain these concepts, a quick close is ideal. Myosci if you are so sure that the two editors here are understanding the MEDRS policy wrong and these sources are appropriate, then ask for community consensus here or here. Continuing to ignore editors to post inappropriate studies on this topic will likely lead to a topic ban.

Pabsoluterince (talk) 23:12, 29 October 2022 (UTC)

@Pabsoluterince: Above you did state "Source 234 miscites? from [10] that 'Post-vaccination myocarditis/pericarditis occurs...'". So you see that these secondary sources can have obvious faults in quoting their sources (and the wikitext can have obvious faults in describing the secondary source). So perhaps may have a second look into the arguments when you have the time.

But now let's return to this case, do you stand by your proposed correction of the wikitext? (with or without my suggestion of inlcuding ...the first dose... in some way)--Myosci (talk) 07:09, 30 October 2022 (UTC)

I notice that Golan1911 has been doing some great work on myocarditis elsewhere. Perhaps they could take a look? My hunch is sourcing here could be upgraded. Bon courage (talk) 09:39, 30 October 2022 (UTC)

Regarding my opinion to this question (Myosci), you haven't heard a peep. I'd hardly call it agreement as you did here. I have been questioning the validity of the statements from these sources, given some perceived discrepancies. The proposed correction is very much is the discussion phase. I wouldn't be comfortable reworking the language and the results surrounding the articles given I am but an editor. I think if we were to continue using these sources, I would ask the same questions of the relevant noticeboards, get an opinion there before adding it in. I agree with Bon courage that the best way forward is to cite more recent - get this - secondary papers on the topic. Pabsoluterince (talk) 14:39, 30 October 2022 (UTC)

When upgrading means that the current sources are discarded because don't want to update the wikitext then no, not yet again.--Myosci (talk) 09:51, 30 October 2022 (UTC)

The two sources in the (current) corresponding section of the article myocarditis is now an article in NEJM with subscribers only (therefore inacessible for many readers but one could perhaps back-translate it from the free Mandain translation there ("Google translate" fails there, so I've to translate it section-wise) and the other only relies only on old data (before 1/1/2022).--Myosci (talk) 10:14, 30 October 2022 (UTC)

Doesn't matter; WP:PAYWALL Pabsoluterince (talk) 10:53, 30 October 2022 (UTC)

Maybe the source we're looking for... A Systematic Review and Meta-analysis of the Association Between SARS-CoV-2 Vaccination and Myocarditis or Pericarditis. "Compared to unvaccinated people, myocarditis or pericarditis in those following COVID-19 vaccines were 2.13-fold higher"... "this risk was more pronounced after receiving the second dose". Pabsoluterince (talk) 10:21, 30 October 2022 (UTC)

The article sections myocarditis#vaccination and myocarditis#myocarditis in COVID-19 have a strong relationship to this section COVID-19 vaccine#adverse effecs. So it's appropriate to discuss them when another editor talks about them. It wasn't me that introduced it! And I pointed out that the sources there have issues and you replied back that WP:PAYWALL isn't so bad. That's your opinion. Other users like me might want to check assertions made in a Wikipedia text. All it did was to access them via the Chinese text that was free and post a few lines of translation (along with the original). The maschine translation won't catch evry nuance of the Chinese language but this is a scientific text whose original is in English. So this translation should be sufficient to get the main content of the two subsections. (The sources were in Englih btw.) This argument about a post of a few machine-translated sentences shows me that you're (also?) too distracted by side-issues. The real topic is: The incidence of myocarditis induced by Covid-19 vaccines.--Myosci (talk) 13:37, 30 October 2022 (UTC) (update, mostly spelling errors)--Myosci (talk) 13:51, 30 October 2022 (UTC)

In fact WP:PAYWALL is part of core policy. Many of the WP:BESTSOURCES are paywalled. Bon courage (talk) 13:40, 30 October 2022 (UTC)

But Wikipedia should reach out for OPEN CONTENT when possible, even when it's in a foreign language, you agree with that?--Myosci (talk) 13:51, 30 October 2022 (UTC)

@Pabsoluterince: With source-based I mean that Wikipedia should make the sources of information available to the readers. Because this is the way a reader can check that information in a Wikipedia article is correct on an important issue: The readers won't check every source but when there is a content that's interesting and the reader wants to go to the bottom of the information it should be possible without paying money.--Myosci (talk) 14:12, 30 October 2022 (UTC)

All other things being equal, a free-to-access source wins. Otherwise, source quality is paramount. If somebody can't access a text (e.g. by using a library) that is not a concern in this. Bon courage (talk) 14:14, 30 October 2022 (UTC)

My approach is different that I view Wikipedia as a means to access the sources of information. It's a gateway, not as a source in itself. This is the other side of the coin that Wikipedia is free to be edited by everyone. And this is connected with the primary/secondary source disagreement: I prefer primary sources, even if I'm aware that I could possibly be tricked by deceptive primary sources. Here I have to rely on the good name of the peer-reviewed journals that publish the primary sources. What's the point in the meta-articles that make a database search and find hundreds of articles that are all based on a few national and big hopsital databases, only accessed at different time points of the past? These hundreds of articles are in no way independent so the large number is like the empty magnification of a microscope and on top of that they're outdated by design:

If you compute the mean value of the rate of myocarditis based on publications from 2021-06 till 2022-06, the 2021-06 rate will be over-represented because the primary publications almost certainly will not restrict themselves only to newer data to make it possible for meta-articles to compute the average from non-correlated data: So instead of $X_{av}=(X_{1}+X_{2}+...+X_{n})/n.$ you effectively get $X_{av}=(X_{1}+{\frac {X_{1}+X_{2}}{2}}+{\frac {X_{1}+X_{2}+X_{3}}{3}}+...+{\frac {X_{1}+X_{2}+X_{3}+...+X_{n}}{n}})/n$ (simplified model).

That's my issue with these meta-articles about articles that itself rely on shared databases.--Myosci (talk) 15:34, 30 October 2022 (UTC)

This is the nub of the problem: you do not respect the consensus the community has settled on about what an WP:ENC is. Instead you value your own interpretation of the science, something that is simply not the job of a Wikipedia editor. As I've said before if you continue along this path you will become too much of an irritant, and the community will take action to stop it. Bon courage (talk) 15:41, 30 October 2022 (UTC)

I'm againt WP:ENC? That's not the case since "Wikipedia is not for unverifiable material." is part of it and I was routing for: Verifiable material and therefore open access of sources isn't only "nice to have" but a very important aspect. So I don't understand your argumention. --Myosci (talk) 15:58, 30 October 2022 (UTC)

Sources must be WP:PUBLISHED. Such material is verifiable, whether it's behind a paywall, only extant in printed form in one library, or whatever. You have been pointed at core policy. Bon courage (talk) 16:04, 30 October 2022 (UTC)

Bon courage is 100% correct. 'Verifiable' doesn't mean 'online and free'. In some cases you might have to pay something. In some you might have to travel to a library. In some you might even have to travel to a specific historical society to look at materials that can only be viewed in person. The medical space goes even further and explicitly rejects the use of primary sources. The Wikipedia community has specifically rejected your position on several occasions. If you want to take a whack at changing that, the venue would be WP:VPP. But in the meantime, in discussions like this one, you'll just have to follow the existing policy. MrOllie (talk) 16:09, 30 October 2022 (UTC)

Wikipedia isn't Nupedia! Only sources for the 0.1% (or less) of Wikipedians that have subscriptions of journals like NEJM shouldn't be the norm in articles that affect everyone. It can be different when it's an article about some special topic like about the Hamadryas_(butterfly) and even there the editors tried to make the information more freely available by using a Google service. Information (and its sources) that affects everyone should be available to everyone! (And when some of sources of the Hamadryas_(butterfly) information is avaiable to everyone that's not bad either.) Wikipedia is part of the grassroouts movement for that goal, isn't it your distant goal, too? --Myosci (talk) 16:38, 30 October 2022 (UTC)

No, you are wrong. Bon courage (talk) 16:43, 30 October 2022 (UTC)

I don't want to exclude non-free sources but I don't like non-free sources to stay exclusive. That's a big difference. I can see no real problem with a longer reference list: meta:Wikipedia is not paper! To go back the the start: Remember the other user scolded me because of a deepl.com translation of a Chinese version of an article I couldn't access in English because I didn't have a subscription of the NEJM journal. So I may ask you: Do you have a subscription of that journal? What's your opinion on machine translation of a Chinese scientific text or a Google books preview?--Myosci (talk) 17:09, 30 October 2022 (UTC)

WP:V says Editors should not rely upon machine translations of non-English sources in contentious articles. You should read WP:V thoroughly, most of what you are bringing up is dealt with there. If you have general questions about sourcing, please ask them at WP:TEAHOUSE or WP:RSN, that isn't what this talk page is for. MrOllie (talk) 17:22, 30 October 2022 (UTC)

(identation reset) @MrOllie: "The medical space goes even further and explicitly rejects the use of primary sources." Can you provide the link? --Myosci (talk) 17:20, 30 October 2022 (UTC)

You have been linked to WP:MEDRS several times. MrOllie (talk) 17:22, 30 October 2022 (UTC)

But the sentences I've read don't say that. Please provide the exact sentence you're reffering to. And for instance the text about machine translations in WP:V is "Translations published by reliable sources are preferred over translations by Wikipedians, but translations by Wikipedians are preferred over machine translations." So machine translations are not forbidden! --Myosci (talk) 17:30, 30 October 2022 (UTC)

You didn't read the bolded sentence at the top of WP:MEDRS? They're not forbidden, except in contentious articles - such as this one. MrOllie (talk) 17:33, 30 October 2022 (UTC)

(First I may say that I didn't use it in the article but on the discussion page. So in this instance I'm excused by the exact wording.) And now to the real justification: May I remind you of a very basic Wikipedia principle of "Wikipedia has no firm rules"? The rules have a background and the background here is the word "rely on": rely on means when there is some likelihood that the translation can get fundamentally wrong. Of course that is a subjective measure. But be honest: Are the sentences I've of translated with deepl.com so nuanced/complicated that a machine can screw them up? --Myosci (talk) 18:00, 30 October 2022 (UTC)

Many people have read that 'no firm rules' bit and thought that means they can do whatever they like and ignore policy. It simply isn't so. - these people inevitably learn better or find themselves blocked from Wikipedia sooner or later. My experience with machine translation is that it can screw anything up, no matter how simple the text might be. MrOllie (talk) 19:27, 30 October 2022 (UTC)

Hmm. Do you have an example of Google translate or DeepL translation scew-up that is not subject to irony, idiomatic expression, figurative speech, poetry or slang terms (as I don't think that scientific articles should use this kind of language)? You could post it here or on your talk page if you like. I won't reply for eleven days. Perhaps the whole issue is more relaxed after the midterms. (I would – I think its obvious that I'm not American – be in the boat of the Concervatives in regard to vaccine side effects but I wouldn't be in their boat in regard to relaxed limits of lead in drinking water![11]) --Myosci (talk) 20:14, 30 October 2022 (UTC)

Nah, I'm done indulging this tangent. This isn't the place to litigate whether or not the policies are valid. MrOllie (talk) 20:20, 30 October 2022 (UTC)

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

---

WP:PAYWALL would matter in a negative way because it's a problem when readers can't access the source as WIKIPEDIA HAS TO BE SOURCE BASED. But as mentioned above, the Chinese text is free, so I've translated it section for section with the help of deepl.com. And now I can say that this article is about myocarditis in general, there are only two small subsections related to the specific issue of Covid-19 vaccine-induced myocarditis. Is that a "Wikipedia best source" that remains so vague: Recently, an increased risk of myocarditis after COVID-19 mRNA vaccination (e.g., BNT162b2 or mRNA-1273 [Moderna]) was reported in multiple age and sex strata, and the risk was highest after a second dose of vaccine in adolescent and young men, according to passive surveillance reports in the United States. ... And all sources are from 2021, so in conclusion: This article hardly touches the topic of the Wikipedia-article-subsection and relies on outdated data. (Note: Footnote [55] is missing in the text.) --Myosci (talk) 11:37, 30 October 2022 (UTC)

COVID-19-associated myocarditis

Myocarditis is uncommon, but fulminant manifestations have been reported in 38.9% of confirmed or highly suspected patients.20 Patients with pneumonia are more likely to be hemodynamically unstable and require temporary mechanical circulatory support and death than those without pneumonia.

COVID-19相关心肌炎

心肌炎不常见，但据报道，38.9%的确诊或高度疑似患者出现暴发性表现20。伴发肺炎的患者比未伴发肺炎的患者更容易出现血流动力学不稳定，需要临时机械循环支持和死亡。

COVID-19 vaccine-associated myocarditis

Analysis of retrospective data from large populations has shown that myocarditis after vaccination with the mRNA vaccine BNT162b2 (Pfizer-BioNTech) in vaccine-eligible individuals is very rare, most commonly in young men and within days of the second dose, and is usually self-limiting21,22,5.

Recently, an increased risk of myocarditis after COVID-19 mRNA vaccination (e.g., BNT162b2 or mRNA-1273 [Moderna]) was reported in multiple age and sex strata, and the risk was highest after a second dose of vaccine in adolescent and young men, according to passive surveillance reports in the United States.56 Symptoms had resolved at hospital discharge in 87% of cases.

COVID-19疫苗相关心肌炎

对大规模人群的回顾性数据进行的分析表明，符合疫苗接种条件的人接种mRNA疫苗BNT162b2（辉瑞-BioNTech）后，心肌炎非常罕见，最常见于年轻男性和注射第二剂后数日内，通常具有自限性21,22,5。

最近，根据美国的被动监测报告，接种COVID-19 mRNA疫苗（如BNT162b2或mRNA-1273[Moderna]）后的心肌炎风险增加在多个年龄和性别分层中有报道，并且该风险在青少年和青年男性接种第二剂疫苗后最高56。87%病例的症状在出院时已消退。

21. Witberg G, Barda N, Hoss S, et al. Myocarditis after Covid-19 vaccination in a large health care organization. N Engl J Med 2021;385:2132-2139.
22. Mevorach D, Anis E, Cedar N, et al. Myocarditis after BNT162b2 mRNA vaccine against Covid-19 in Israel. N Engl J Med 2021;385:2140-2149.
55. Rosner CM, Genovese L, Tehrani BN, et al. Myocarditis temporally associated with COVID-19 vaccination. Circulation 2021;144:502-505.

56. Oster ME, Shay DK, Su JR, et al. Myocarditis cases reported after mRNA-based COVID-19 vaccination in the US from December 2020 to August 2021. JAMA 2022;327:331-340.

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Incidence of myocarditis with mRNA Covid-19 vaccines

Hello, I would like to bring this to the attention of the Wikipedia community before editing the article as the risk of myocarditis after Covid-19 vaccination in this article has been a contentious issue. There is a well known, but extremely rare risk of myocarditis with the Covid-19 mRNA vaccines. The article currently states it is "an excess rate of about one or two cases per million vaccine recipients, mostly in teenage males". I think we can update this information with new sourcing. According to this Israeli study, in which the recipients of the BNT162b2 mRNA vaccine (Pfizer-Biontech) vaccine were monitored using healthcare database monitoring, there were only 54 cases of myocarditis per 2.5 million recipients of the vaccine. This is a incidence rate of about 2 cases per 100,000 persons and the incidence was highest in males aged 16-29 with about 10 cases per 100,000. Of note 76% of the cases were mild, with only 1 case (per 2.5 million) of cardiogenic shock (heart failure) and 0 deaths due to myocarditis. (https://www.nejm.org/doi/full/10.1056/NEJMoa2110737)

Further, according to this review article from NEJM (https://www.nejm.org/doi/full/10.1056/NEJMra2114478) the incidence of myocarditis after Covid-19 vaccination is 0.3 to 5 cases per 100,000 persons, again with the highest risk in young males. With the US Food and Drug Administration and the European Medicines Agency estimating the risk at 1 per 100,000 per the NEJM review article.

The study cited, shows that myocarditis or pericarditis after the mRNA Covid-19 vaccine was 0-35.9 cases per 100,000 in male vaccine recipients with the highest incidence in males aged 12-17 and 0-10.9 cases per 100,00 in females. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8989373/) please see tables 2 and 3 for males and females respectively. But it is important to note that this study showed the risk of myocarditis or pericarditis to be much higher (up to 5 x higher) in all age groups after Covid-19 infection.

Maybe we can update this section in the article. Thank you. Golan1911 (talk) 05:37, 3 November 2022 (UTC)

Golan1911 (talk) 05:37, 3 November 2022 (UTC)Golan1911

That would be great. I noticed also

• Gao J, Feng L, Li Y, et al. (September 2022). "A Systematic Review and Meta-analysis of the Association Between SARS-CoV-2 Vaccination and Myocarditis or Pericarditis". Am J Prev Med. doi:10.1016/j.amepre.2022.09.002. PMID 36266115.

but the NEJM review is even newer. Bon courage (talk) 05:43, 3 November 2022 (UTC)

Yeah that looks good . Pabsoluterince (talk) 08:46, 3 November 2022 (UTC)

New Science-Based Medicine article about this by Steven Novella: We also have to keep in mind that COVID-19 infection itself causes myocarditis. The relative risk here is 16 times – with the absolute risk increasing from 9/100,000 to 150/100,000. [12] --Hob Gadling (talk) 19:44, 3 November 2022 (UTC)

Yes, whatever source we use, we should be sure we're reporting the risk relative to infection. Bakkster Man (talk) 20:28, 3 November 2022 (UTC)

Is there anything in the literature that covers the risk of viral myocarditis in vaccinated young men vs. the risk in unvaccinated young men? If the risk is unchanged by vaccination, it would be simply additive, and the risk ratio would be a meaningless value. 2600:1012:B046:503E:BC00:20FB:21D7:AB4B (talk) 02:00, 5 November 2022 (UTC)

Measuring myocarditis rates in the wild seems to be difficult, as most cases are mild enough not to require medical intervention. I don't think we cite any sources identifying any deaths from vaccine-related myocarditis, most cases are mild with a limited number of hospitalizations. Whether or not the risk of myocarditis from a breakthrough infection is additive, our sources seem to agree that the overall risk of severe illness is reduced by vaccination.[13] Bakkster Man (talk) 23:01, 7 November 2022 (UTC)

There are huge differences between the sexes, the ages and the deployed vaccines-combinations in regard to the rate of myocarditis. Read for example SARS-CoV-2 Vaccination and Myocarditis in a Nordic Cohort Study of 23 Million Residents doi:10.1001/jamacardio.2022.0583 (or the study from NHS data I've linked numerous times). Both tell that the Moderna vaccine has far higher rates than the Pfizer-Biontech vaccine. And according to the Nordic Cohort Study the highest rate occurs with the heterologous vaccination (first Pfizer-Biontech and then Moderna). See table 3 that displays the incidence risk ratio (IRR), compared to unvaccinated people (with 95% CI).

• For male people ≥ 12: IRR(BNT162b2/BNT162b2) = 1.65 (1.43 to 1.91), IRR(mRNA-1273/mRNA-1273) = 4.63 (3.75 to 5.72), IRR(BNT162b2/mRNA-1273) = 8.21 (6.20 to 10.88)
• For female people ≥ 12: IRR(BNT162b2/BNT162b2) = 1.26 (0.95 to 1.68), IRR(mRNA-1273/mRNA-1273) = 2.88 (1.87 to 4.45), IRR(BNT162b2/mRNA-1273) = 6.64 (3.90 to 11.30)
• The most affected cohort are male people between 16 and 24 years: IRR(BNT162b2/BNT162b2) = 4.20 (3.15 to 5.58), IRR(mRNA-1273/mRNA-1273) = 11.36 (7.32 to 17.65), IRR(BNT162b2/mRNA-1273) = 20.04 (12.29 to 32.69)

And the article containes a very detailed data analysis that is also published in the supplement: its download address is https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9021987/bin/jamacardiol-e220583-s001.pdf. And then regard look at eTable 7: There it rate of myocarditis in the 28 days post a positive SARS-CoV-2 test with IRR compared to non-infected people:

• male people 16 to 24 years old: IRR = 2.99 (1.10 to 8.12) and for
• male people ≥40: IRR = 14.67 (9.94-21.66)

So to sum up: the Covid-19 vaccine of is most dangerous for young male people and for them the combinations mRNA-1273/mRNA-1273 and BNT162b2/mRNA-1273 are worse than the infection in regard to myocarditis while for male people ≥ 40 the infection is more dangerous in regard to myocarditis than even the worst vaccine combination.

@Golan1911: So ... the risk of myocarditis or pericarditis to be much higher (up to 5 x higher) in all age groups after Covid-19 infection... cannot be stated, it's in direct contradiction to the two major studies conducted in the GMT+0 to GMT+3 time zones.

(@Pabsoluterince: Good Saturday morning! In my time zone it's later evening, so I'll pause now.) --Myosci (talk) 20:29, 11 November 2022 (UTC)

There are huge differences between the sexes, the ages and the deployed vaccines-combinations in regard to the rate of myocarditis. We already highlight the highest rate being in adolescent males, and we'll need a WP:MEDRS source for the difference between manufacturers. Is there anything specific in the wording of the article you're suggesting should be changed?

So to sum up: the Covid-19 vaccine of is most dangerous for young male people and for them the combinations mRNA-1273/mRNA-1273 and BNT162b2/mRNA-1273 are worse than the infection in regard to myocarditis. As I said, the increased risk of myocarditis is already mentioned. When you use words like "dangerous", you need to compare all-cause morbidity and mortality. As an example, if vaccination increases the risk of a sore arm muscle compared to COVID-19 infection, we wouldn't call that a "danger" of the vaccine. Because muscle soreness does not have severe outcomes, and COVID-19 infections do. The muscle soreness is just the mild adverse effect of a treatment that provides benefits far outweighing sore arms. Bakkster Man (talk) 21:19, 11 November 2022 (UTC)

Myocarditis isn't muscle soreness that almost always goes by, it can cause initial defects that may get better or worse over time by itself. (And even if a biceps muscle soreness would stay permanent, what's this problem in comparison to sudden cardiac death?) There are other viruses like influenca or smallpox or the (older) smallpox vaccine that can cause myocarditis too, but how many times does one get in touch with influenca in a lifetime? And how many contacts will one have with mRNA Covid vaccines or the Coronavirus? Every new contact with the Covid vaccine or the Coronavirus can restart it and make it worse.

This was tested (in part) with mice with deliberate intravenous injection of the BNT vaccine and the mice subsequently developed myocarditis and after the priming with the i.v. injection (i.e. the excessive contact) the myocarditis worsened even with only i.m. injection (i.e. mild/moderate contact), see Intravenous Injection of Coronavirus Disease 2019 (COVID-19) mRNA Vaccine Can Induce Acute Myopericarditis in Mouse Model (doi:10.1093/cid/ciab707):The histological changes of myopericarditis after the first IV-priming dose persisted for 2 weeks and were markedly aggravated by a second IM- or IV-booster dose.(emphasis added)

So one excessive contact can start it and subsequent mild/moderate contacts aggravate it. So every excessive contact must be avoided and apart from the difficult question of getting the vaccine there would have been (and woud still be!) a quite simple safety procedure with no real downside, the aspiration test: Both Pfizer/BioNTech and Moderna have clearly stated that their vaccines should only be given via IM route [30, 31]. However, current CDC [6] and WHO guidelines [5] no longer recommend precautionary measures during IM vaccine administration. Brief aspiration for blood return during intramuscular injection of medication as a preventive measure against accidental IV injection was previously present in most guidelines [32]. --Myosci (talk) 09:58, 12 November 2022 (UTC)

We need reliable sources, not fake research.[14] As you have been told repeatedly. Bon courage (talk) 10:01, 12 November 2022 (UTC)

It's reckless to call this "fake research".--Myosci (talk) 10:13, 12 November 2022 (UTC)

Tell it to Elizabeth Bik. As it is you have proved the point perfectly about why Wikipedia does not use primary biomedical research. Please take your vaccine agenda elsewhere. Bon courage (talk) 10:23, 12 November 2022 (UTC)

Do you have forgotten that there was an error in the publication that has already been fixed? And if you argue by the line "once an error-> always an error" then tell this to the German STIKO that recommended the aspriation test based on this study after that. And besides of the mechanism (more research is indeed needed, for instance other animals that are susceptible to the coronavirus infectioN itself to test the combination of mRNA vaccine + infection) do you also refute the findings of the two major European studies about the rates? Aren't you from Europe, too?--Myosci (talk) 10:42, 12 November 2022 (UTC)

I don't care; all I care is that we correctly follow the WP:PAGs, ensuring that the encyclopedia properly reflects accepted knowledge. You need to drop the WP:STICK. Bon courage (talk) 10:51, 12 November 2022 (UTC)

What you need to do is to prove or correct your claim of "fake research"! --Myosci (talk) 10:55, 12 November 2022 (UTC)

O is that the one that had to correct, again? Whatever, it is an unreliable source for claims about biomedicine on Wikipedia and so not usable. We have plenty of great sources and Golan1911 has done a nice job deploying them. Bon courage (talk) 11:18, 12 November 2022 (UTC)

Don't meander: the terminology you've used implies scientific misconduct and needs to be backed up or corrected.--Myosci (talk) 12:18, 12 November 2022 (UTC)

Read the link. In any event we're not using the source. Bon courage (talk) 12:23, 12 November 2022 (UTC)

In this blog E. Bik raised concerns (I have some concerns about this study.) but did not imply scientific misconduct like your terminus. And her first specific concern were resolved very quickly: 1. Mice were given much higher doses of the vaccine than humans ... Maybe the authors could clarify which weight they were referring to in their paper, and why they chose such a unrealistic higher dose? I mean, drinking 2 liters of water per day might be good for me, but drinking 50 or 500 times more might kill me. Too much of a good thing is never good. was answered by M.V. Simkin: Drug dose should not be proportional to body weight. Because of different metabolic rates. A common scaling for drug dose is body weight to the power of 2/3. So a 20g mouse should get 14.4 times more per unit of body weight than a 60 kg human. So it seems that your numbers imply that the mouse actually got only 3.5 times more than it should have. So I cannot see how you can back up your terminus with this source. Please give a direct quote.--Myosci (talk) 13:17, 12 November 2022 (UTC)

@Myosci: I am curious, since you began editing a year ago and have pressed this myocarditis issue the entire time you have edited, and your username suggests your purpose here to be pressing myocarditis as an issue, if there is any evidence that you would accept that it is not, in fact, a more substantial issue than is already reflected in this article? BD2412 T 13:49, 12 November 2022 (UTC)

First to your observation: The suggestion in the username is a bit wrong since the "s" doesn't match. But yes I see myocarditis as a serious side effect. The study I mentioned a few sentences above is doi:10.1093/cid/ciab707. It's a study about a possible mechanism. Yes it's small study with only 21 BALB/c mice in the treatment group – but be aware that the study to authorize the Biontech-Pfizer BA.5 booster vaccine also had only 8+8 BALB/c mice in the treatment groups. And important for Wikipedia is that in mid-February 2022 the German vaccination authority STIKO used this (earlier) mouse study to reverse course on the issue of aspiration test: before they recommended against it and since then they recommend to do it. (And then the later mouse study to o.k. the BA.5 booster.)

Second: From this and the time when I edit you may easily infer that I'm living in a region with time zone GMT+1 (or GMT+2). May I ask you in what time zone do you live?

And third: Can you explain what you mean with ...if there is any evidence that you would accept that it is not, in fact, a more substantial issue than is already reflected in this article? I think you made sentence structure error. I'm not asking you in order to criticize: as a non-native speaker I can't fix an error that easily and I don't want to get you wrong.--Myosci (talk) 20:50, 12 November 2022 (UTC)

Your username reads like "Myo" for myocarditis, and "sci" for science, which suggests an outsized importance of myocarditis to your thinking. As for my question, the article already summarizes the established science on COVID-19 vaccines and myocarditis. What would convince you that the content currently in the article is the correct state of the science? As for my time zone, I don't see the relevance. BD2412 T 21:39, 12 November 2022 (UTC)

You seem to have a link to the other user, he also rudely avoids questions after his time zone. And your account name suggests that you see yourself as one of many perhaps a sign for a robot? Just guessing from your username... That's wrong? So are you with your guess, too! But not only with your guesses also with your manners.--Myosci (talk) 00:24, 13 November 2022 (UTC)

I gather, then, that your concern about myocarditis will continue to outweigh any evidence to the contrary. BD2412 T 00:29, 13 November 2022 (UTC)

What evidence to the contrary? Didn't you read the articles? Two major articles tell that the rate is far higher than stated in this article: For young male people it is likelier to get myocarditis post 2nd Moderna vaccination than post Covid-19 infection! Read doi:10.1161/CIRCULATIONAHA.122.059970 and doi:10.1001/jamacardio.2022.0583 These are population based serious studies unlike these of Myoclinic size studies. (Oops: Mayoclinic!) --Myosci (talk) 00:44, 13 November 2022 (UTC)

From your source: "Median hospital length of stay was 4 to 5 days for both vaccinated and unvaccinated cases (eTable 11 in the Supplement). For all age groups, the 28-day mortality of the unvaccinated cases with myocarditis was 0.8% (95% CI, 0.3%-2.0%) and ranged from 0.2% (95% CI, 0.0%-0.4%) after the second dose of BNT162b2 to 4.5% (95% CI, 0.0%-13.2%) after the second dose of mRNA-1273; there were no deaths among cases for patients younger than 40 years". So, out of over 18 million COVID-19 vaccine recipients, not a single death attributable to myocarditis. BD2412 T 01:22, 13 November 2022 (UTC)

Your emphasis is way too selective, read also the half-sentence before and you also see the problem with lumping together BNT162b2 and mRNA-1273 and the problem with the 95% CI:

Even for this "Nordic Cohort Study of 23 Million Residents" that has population base (not cases!) of 23.1 million redidents with 81% vaccinated by the end of the study has recorded so few fatal cases (has something to do with the good health care system there!) that the 95%-CI ranges are quite large: for the unvaccinated cases it's 0.3 to 2.0% (best estimate 0.8%), for BNT it's 0.0% to 0.4% (best estimate 0.2%, thats the so-called "healthy vaccinee effect") and for Moderna it's 0.0 to 13.2% (best estimate 4.5%, this vast range it also due to fact that far fewer people received Moderna there). And what happens when university-clinic-size studies lump together BNT172b2 and mRNA-1273 data (since the CI ranges would otherwise be extremely large), let's says 20% with Moderna and 80% BNT? The estimate would be 0.8*0.2%+0.2*4.5%=1.1%, so nothing to see here too!

And these undifferentiated studies are then bundled together and it's a called a "meta-analysis": undifferentiated data in, undifferentiated data out. --Myosci (talk) 08:37, 13 November 2022 (UTC)

But I'm glad that you read the articles. Perhaps I may lure you into reading another source. I think that a 28 day survival rate for people (regardless of age) isn't a sensitive measure for myocarditis since that's a prolonged condition. A 5 year survival rate would normally be a more appropriate primary outcome but first one cannot wait that long and second there may be recurrent events (due to re-exposure to the S-protein). So one needs to go after secondary outcomes, it's clinical myocarditis cases or even better serological myocarditis cases. What? Who the heck reports serological markers post vaccination in people without symptoms? I can tell you who, it's the small vaccine manufacturer Bavarian Nordic that has done that with its smallpox vaccine. A search for "troponin" in PRODUCT MONOGRAPH INCLUDING PATIENT MEDICATION INFORMATION IMVAMUNE® retrieves for instance this: The higher proportion of IMVAMUNE recipients who experienced cardiac AESIs was driven by 28 cases of asymptomatic post-vaccination elevation of troponin-I in two studies, that used a different troponin assay than was used in the other previous studies,... (empahsis added).--Myosci (talk) 09:27, 13 November 2022 (UTC)

But I don't want to be seen as an advocate for BNT, as the rate is highest for the combination BNT/Moderna in the Nordic Cohort study. This should be a warning sign that the BNT vaccine is no less dangerous in terms of priming. But to dectect it one would need to measure troponin after vaccination regardless of symptoms. One can object: When one sticks to BNT, what's the real problem with an elevated marker? The problem is that almost everyone will get a non-BNT booster, it's called Omicron. Are there studies that report the rate for the combinations BNT/BNT/Omicron, MOD/MOD/Omicron or BNT/MOD/Omicron against unvaccinated/Omicron? --Myosci (talk) 10:22, 13 November 2022 (UTC)

Right, I'm out. If this gets to WP:AE ping me as I'd have something to say. Bon courage (talk) 10:34, 13 November 2022 (UTC)

@BC: Don't forgert about the assertion of "fake research" you leveled against doi:10.1093/cid/ciab707 and didn't back up or correct despite repeated inquiries.--Myosci (talk) 10:46, 13 November 2022 (UTC)

That paper [15] is a mouse model. It's not strong evidence for anything and wouldn't be cited on Wikipedia as it is a primary source. Psychologist Guy (talk) 19:24, 13 November 2022 (UTC)

Following from this and being clear, the relevant element from WP:PAGs is WP:MEDANIMAL: in vitro and animal-model findings do not translate consistently into clinical effects in human beings... Using small-scale, single studies makes for weak evidence, and allows for cherry picking of data. (emphasis added) It's simply not a reliable study, particularly not for such a significant claim which we have human data for.

On this note, I did tag the sentence The rate of myocarditis and pericarditis can be up to 5 times higher after Covid-19 viral infection as compared to Covid-19 vaccination. This is currently cited to MMWR, and I'd suggest that might be a weaker source than we should use. I've also clarified the sentence in the meantime to be more specific about the paper's limitations and findings, which others may find to be sufficient if a stronger study isn't available. Bakkster Man (talk) 14:49, 14 November 2022 (UTC)

Please don't mix up the mouse study about a possible mechanism with major population based studies about the observed rates in the population:

(1) England: doi:10.1161/CIRCULATIONAHA.122.059970

(2) Nordic Cohort study: doi:10.1001/jamacardio.2022.0583.

These two major studies show that it is wrong to say "the mRNA vaccines" would cause less myocarditis cases than a Covid-19 infection in young male people since for the combinations MOD/MOD (shown by (1)(2)) and BNT/MOD (shown by (2)) it is the opposite. The CDC hestitated to approve the mix and match approach for the primary series and in light of the bad outcomes from the Nordic cohort study the CDC was right then, but now it allows mix and match for the booster.--Myosci (talk) 22:39, 14 November 2022 (UTC)

The first source (Circulation), is what we were citing indirectly already (I've replaced that), so there's a point of commonality. And with these results, I would agree there's a notable finding to report. I'd recommend we should cover the following results of the Circulation study, pleast let me know if there's something in the Nordic Cohort that's missing or potentially contradictory.

• At the population level the risk of myocarditis is substantially higher after SARS-CoV-2 infection in unvaccinated individuals than the increase in risk observed for most vaccine/demographic combinations studied
• although the risk of myocarditis with SARS-CoV-2 infection remains after vaccination, it was substantially reduced, suggesting vaccination provides some protection from the cardiovascular consequences of SARS-CoV-2
• Highlighting the particular findings where myocarditis risks were not lower than infection, notably both younger men and women were at increased risk of myocarditis after a second dose of mRNA-1273

Bakkster Man (talk) 15:56, 15 November 2022 (UTC)

I suggest we keep the secondary source (the press release from the AHA) in addition to the original study as secondary sources I believe are preferred in Wikipedia. I also suggest we keep the MMWR source, as the AHA article cited did not address pericarditis (which is much higher after infection as compared to vaccination). Golan1911 (talk) 16:21, 15 November 2022 (UTC)

I don't think we would typically consider a press release a secondary source, WP:MEDRS tends to be referring to secondary peer-reviewed studies rather than press releases. That said, it is from a major WP:MEDORG, though I think the press release falls a bit short of being a "guideline or position statement" (and might not be recommended as is due to WP:MEDINDY with Circulation being published by AHA). None of this is to say it's a bad source, just that I'm not sure it's the WP:BESTSOURCE.

If there's uncovered content from the MMWR you can pull out and re-add, I think that would be a worthwhile edit.

For both, I think WP:MEDPRI gives good examples of how to phrase the strength/reliability of the studies themselves. They're strong enough to note, but perhaps not strong enough to wikivoice. Bakkster Man (talk) 16:33, 15 November 2022 (UTC)

Two other quick notes:

• The AHA noted the Circulation findings but any change in clinical recommendations from them, CDC, etc would be even more notable and worth including.
• The Circulation findings are probably better here because they showed relative risk of SARS-CoV-2 infection pre- and post-vaccination, which was the missing element that led me to be cautious with the other sources being recommended.

Bakkster Man (talk) 16:24, 15 November 2022 (UTC)

Additional topics in relation to myocarditis and vaccination

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The discussion about the main topic is in professional water now, so in order not to spoil it, I've created this spin-off:

IRR for the combination BNT/MOD

The large Nordic Cohort study did consistently show that the IRR for the combination MOD/MOD was higher than BNT/BNT in the primary series but the rate for BNT/MOD is consistently (i.e. among male and females and age groups) higher than for MOD/MOD, about twice as high.doi:10.1001/jamacardio.2022.0583 (BNT=BNT162b2, MOD=mRNA-1273)

• For male people ≥ 12: IRR(BNT/BNT) = 1.65 (1.43 to 1.91), IRR(MOD/MOD) = 4.63 (3.75 to 5.72), IRR(BNT/MOD) = 8.21 (6.20 to 10.88)
• For female people ≥ 12: IRR(BNT/BNT) = 1.26 (0.95 to 1.68), IRR(MOD/MOD) = 2.88 (1.87 to 4.45), IRR(BNT/MOD) = 6.64 (3.90 to 11.30)
• The most affected cohort are male people between 16 and 24 years: IRR(BNT/BNT) = 4.20 (3.15 to 5.58), IRR(MOD/MOD) = 11.36 (7.32 to 17.65), IRR(BNT/MOD) = 20.04 (12.29 to 32.69)

Are there other major studies that report this result?

Non-vaccine-brand related countermeasure: Aspiration test

It's a bit late since the Covid-19 pandemic is dwindling down now. But there's a mouse study that suggests there may be a viable measure to decrease the rates of myocarditis post vaccination by strictly avoiding intravasal injection. This study doi:10.1093/cid/ciab707 showed that mice that received the BNT vaccine via the i.v. route developed serological and histological signs of damage to the myocytes and the heart tissue (and also potential damage to the liver cells) in significant difference to the controls (with the standard i.m. route). And that the conditon for the i.v. group was aggravated by the second shot even if it was i.m. this time. But this study has been contested in this Pubpeer blog [16]

• Are there other studies that replicate this finding of the animal model?
• What's the occurrance rate of accidential intravasal injection when the injection site is the deltoid muscle? Are there differences dependent on the general technique (apart from the aspiration test)?
• Could the "aspiration test" really avoid intravasal injection in practise, i.e. after the aspiration test procedure with good outcome (-> initially no blood vessel compromised) how save is it that the needle will not slip afterwards?

--Myosci (talk) 10:14, 19 November 2022 (UTC)

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Vaccine targeting "stem helix" better?

FWIW - seems a newer, and possibly better, approach to designing an effective, and much longer lasting Covid vaccine, may involve targeting the "stem helix" (or "spine helix") of the Covid virus, based on some very recent peer-reviewed studies.

References

Drbogdan (talk) 04:07, 21 November 2022 (UTC)

Inclusion of study about cTn levels after vaccination (if peer-reviewed)

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A Swiss study (not yet peer-reviewed) from the University of Basel found that 2.8 % of the 777 participants who received a 3rd dose of Covid-19 vaccine had elevated cardiac-specific troponin levels. See "Temporary mild damage to heart muscle cells after Covid-19 booster vaccination". www.unibas.ch. 9 November 2022. Retrieved 23 November 2022. From the previous passive observation of severe cases, it had been concluded that around 35 out of 1,000,000 vaccinated individuals would develop myocarditis. In our study, we found evidence of temporary mild damage to cardiac cells in 22 of the 777 participants – 2.8% instead of the anticipated 0.0035%. So there's slight damage to heart muscle cells in almost 3% of the cases, which shouldn't be overestimated, but also not ignored.

As said this study isn't peer-reviewed yet and another drawback is that there isn't a preprint as of now,(*) only the press release of the university. And elevation of cardiac troponin (cTn) could be false-positive, see (peer-reviewed) study from 2016:doi:10.3402/jchimp.v6.32952 Yet the inclusion of these two studies could/should be considered when the Swiss study has been published in a peer-reviewed journal.

(*) Pfizer/Biontech didn't a publish a preprint of its Omicron BA.5 study and now we're reaching the second month of its vaccine update authorization. This is bad example to follow! Myosci (talk) 21:09, 23 November 2022 (UTC)

No. See WP:MEDRS, which you have been pointed to many times before. You really need to read and follow that if you want to contribute on medical topics. MrOllie (talk) 21:18, 23 November 2022 (UTC)

There appear to be many sources in our current COVID-19 vaccine Wikipedia article that are primary studies or news releases that are either not in the spirit of MEDRS or blatant violations of it. It seems to me that an undue standard is being applied to the topic of myocarditis. Might I remind you that this is not antivax chicanery. Many OECD countries don't recommend the shot for young men for this very reason. Subclinical myocarditis is a salient part of the story. 2600:1012:B00B:FA2F:C92F:6DB2:1B72:9066 (talk) 18:12, 24 November 2022 (UTC)

"Dr. Jeff Duchin, the Health Officer of King County, Washington found that unvaccinated people were six times more likely to test positive, 37 times more likely to be hospitalized, and 67 times more likely to die, compared to those who had been vaccinated." Looking at that source, it doesn't seem to be MEDRS. What integrity in the article exactly are you guarding? There are too many instances of MEDRS noncompliant sources in the article to list here. I am the same IP editor who just posted, btw. 2600:1012:B05C:1816:D55B:C04E:3BDA:34F (talk) 18:24, 24 November 2022 (UTC)

Sources 252 and 253, in the myocarditis section, are not review articles. Are those MEDRS? 2600:1012:B01C:EFFB:C1B:6E6C:A2D3:AE0B (talk) 22:33, 24 November 2022 (UTC)

And these review articles sometimes have only weak primary sources and also fail to mention the shortcomings of the primary sources. In this case it's like a repackaging that hides the weakness of the primary sources.

For instance the review article doi:10.3390/v14030539 states: "No mRNA presence was detected, highlighting the fact that there is no transfer of mRNA to the baby via breast milk and no reason to discontinue breastfeeding for this reason at the time of vaccine administration [44] And this one source [44] was doi:10.1001/jamapediatrics.2021.1929. Some questions for reading this source: How many participants did this study have, how many samples were used (BNT/MOD), what does this primary source say in regard to the limits of detection for BNT resp. MOD, what did the authors of the primary source advocate for (in the discussion part) and what's the message of the review article?--Myosci (talk) 20:46, 25 November 2022 (UTC)

You can think that the policy is wrong, but you'll still have to follow it. If you want to try to change it, take that stuff to WP:VPP. But it will not help your cause on this talk page. - MrOllie (talk) 20:49, 25 November 2022 (UTC)

So you waited all the time to reply to me, but you've nothing to say about the arguments of the user before. As far as I'm concerned, I don't know anything of you, so only one question. My local time the 10 p.m., what's your local time?--Myosci (talk) 20:58, 25 November 2022 (UTC)

I make it a point not to engage with Whataboutism whenever possible. MrOllie (talk) 20:59, 25 November 2022 (UTC)

Likewise, I don't engage with people who say "what about...whataboutism". It seems like I have revealed opportunities to improve the article. Myosci, it seems like one should be able to delete content that is not WP:MEDRS, then. I think you should carefully delete away.2600:1012:B01C:859:1455:30FF:6D18:78B7 (talk) 21:21, 25 November 2022 (UTC)

I'm an inclusionist, so I'm generally skeptical of cuts. Sometimes cuts are quite good, especially if they manage to reconcile several things. But as an inclusionist and non-native speaker, I'm probably not so good at it.--Myosci (talk) 22:13, 25 November 2022 (UTC)

Another thing is that the WP:MEDRS pyramid with the review articles on the top and the primary sources below is to not always correct. Like the example before there are exceptions and who am I to judge that some source should be thrown out? Instead I keep the old sources like doi:10.3390/v14030539/doi:10.1001/jamapediatrics.2021.1929 that say for instance: No mRNA presence was detected,... (7 participants, 13 samples) and contrast that with the newer information of other sources like doi:10.1001/jamapediatrics.2022.3581 (11 participants, 131 samples) and the readers can draw their own conclusions. For me Wikipedia is more like a gideway to the sources.--Myosci (talk) 23:08, 25 November 2022 (UTC)

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Undue reverts by a cooperating group

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The latest reviews are so undue. A source that isn't a peer-reviewed article but only dubbed "news" that states that mix and match wouldn't have more side effects is retained will the other source, the large Nordic cohort study (Denmark, Finland, Norway, Sweden with 23 million residents) that found that the IRR for BNR/MOD is twice as high MOD/MOD is erased. And these reverters seem to be on Wikipedia all the time and seem to cooperate (It takes less than two minutes to see that my claim about the superiority is wrong and revert and post the edit summary? Come on.) One common trait is that they like to counter on a more personal level but then refuse to answer my question about their time zones. Another common trait is that they like to use the WP:XYZ abbreviations. Myosci (talk) 15:08, 26 November 2022 (UTC)

then refuse to answer my question about their time zones. You are not entitled to other people's personal information. MrOllie (talk) 15:10, 26 November 2022 (UTC)

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Mix and match

According to studies, the combination of two different COVID-19 vaccines, also called cross vaccination or mix-and-match method, provides protection equivalent to that of mRNA vaccines – including protection against the Delta variant. Individuals who receive the combination of two different vaccines produce strong immune responses, with side effects no worse than those caused by standard regimens. Note: The "mix-and-match" in this article applies to the combination one dose of ChAdOx1 nCoV-19 and one dose of either BNT162b2 or mRNA-1273 not the combination of two different mRNA vaccines.

This note is the least what must be said! --Myosci (talk) 20:03, 26 November 2022 (UTC)

@BD2412: OK? --Myosci (talk) 20:47, 26 November 2022 (UTC) @Bon courage: This section doesn't fall under your explanation for closure and on top of that it's the entry point for a 3M. Did you read the content?--Myosci (talk) 21:25, 26 November 2022 (UTC)

References

Your suggested note misrepresents the mainstream view here. I've added an additional cite to a review article that makes it clear all sorts of mix and matching are the same. Also, the 'third opinion' process is used when two (and only two) editors are at an impasse. That is not at all the case here. You should have a read of WP:1AM, it might help. - MrOllie (talk) 21:37, 26 November 2022 (UTC)

In the new source I've looked at "Table 2" for the combinations and there are only combinations of AstraZeneca for the first dose and mRNA for the second dose listed. (So at least in terms peer-reviewed studies you cannot make your point with this source.) And then I searched the text for "mRNA-1273" and didn't find any matches for the combination BNT/MOD. Can you please quote the text passages that refer to the combination BNT/MOD or MOD/BNT?--Myosci (talk) 22:15, 26 November 2022 (UTC)

Last time the 3rd opinion was successful in retrospect. The article section about adverse effects was updated by two other editors. This article needs more editors.--Myosci (talk) 22:21, 26 November 2022 (UTC)

Perhaps what we need is a WP:RFC to obtain broader community input. BD2412 T 00:43, 27 November 2022 (UTC)

As is made clear in the 'UNDERLYING MECHANISM' section of the source I added, mixing different vaccine platforms isn't new to COVID vaccines. There is no reason to think the effect is limited to any specific pairing or ordering, because it never has been before. Adding a note such as the one you are advocating is WP:OR - suggesting to the reader that there is a difference where none has been shown to exist. We can't do that. - MrOllie (talk) 16:26, 27 November 2022 (UTC)

"There is no reason to think...": Nature is more complicated than human assumptions (it's called a "model"), so in natural sciences the experiment is paramount. 140 years ago it was unbelievable that the Galilean transformation would fail at high velocities. And yet the Michelson–Morley experiment (1881) suggested that there was something wrong with the model. And in this case the Nordic cohort study doi:10.1001/jamacardio.2022.0583(see Table 2) assumes the role of the Michelson–Morley experiment.--Myosci (talk) 18:22, 27 November 2022 (UTC)

Even if it did support the note you want to add (I do not believe it does, but will not argue that point as it is irrelevant), As has been explained to you again and again, we cannot use a primary source for this purpose. MrOllie (talk) 18:26, 27 November 2022 (UTC)

First: Don't look at the envelope (title) but at the individual content! And in a review article any assumption that is not backed up by experiments would not count as "review"-class evidence but as "expert opinion"-class evidence. And according the Wikipedia:Identifying_reliable_sources_(medicine) a cohort study (and this is a large one!) is considered superior to "expert opinion".--Myosci (talk) 19:09, 27 November 2022 (UTC)

Second. I've read the section "4. UNDERLYING MECHANISM" and it doesn't say that mixing is all the same in terms of side effects. In fact it says something different:

The underlying mechanism for higher immunity when mixing COVID‐19 vaccines has not been clearly described. [...] This suggests that the same mechanism, long known for other heterologous vaccines, can also be the underlying mechanism for the higher immune response achieved from mixing COVID‐19 vaccines.

So the authors say that the mechanism for higher immunity is still unclear (to a significant degree). So when the mixing yields a stronger effect with a yet not sufficiently understood mechanism why is it unreasonable that the mixing could also yield higher side effects for some combinations? So in this case we even have the situation that the Wikipedia:Identifying_reliable_sources_(medicine)-green layer (cohort study) is not in contradiction to the orange layer (expert opinion)! So why discard the green layer?--Myosci (talk) 19:20, 27 November 2022 (UTC)

@MrOllie: Principle of source fidelity!--Myosci (talk) 21:46, 2 December 2022 (UTC)

You need to gather WP:CONSENSUS to proceed, and you will not get that by flogging close reading of primary sources, WP:MEDRS does not permit it. MrOllie (talk) 21:48, 2 December 2022 (UTC)

@MrOllie: Wikipedia:Verifiability#Responsibility for providing citations Please stick to this basic principle by providing a citation for a wider reading. At least here on the talk page.--Myosci (talk) 22:04, 2 December 2022 (UTC)

Citations are already in the article. MrOllie (talk) 22:07, 2 December 2022 (UTC)

I mean not only a reference to a whole article or a whole section (as here) but a full citation (quote).--Myosci (talk) 22:33, 2 December 2022 (UTC)

Study showed association, not causality

"A September 2021 study found that having two doses of a COVID-19 vaccine halved the odds of long COVID."

This should say "A September 2021 study found that two doses of a COVID-19 vaccine was associated with a halved probability of developing long COVID."

The cited study did not establish causality.

2600:1012:B01E:7FCB:1CC:77B9:3002:826A (talk) 21:38, 19 December 2022 (UTC)

Since there is a direct connection between Cov-19 and COVID vaccines, the latter being made of the former, using known techniques that are expected to make it work, it would be stupid to assume there is no causal connection. "Correlation is not causation" mainly applies to situations where there is no reason for a possible causation. I cases such as this, one can skip it until there is evidence that it is false. --Hob Gadling (talk) 11:32, 20 December 2022 (UTC)

"Correlation is not causation" is said because of the possibility of confounders (covariates that are correlated, i.e. the existence of multicollinearity). My reasoning is not stupid.2600:1012:B01E:7FCB:818:A66:B5EF:DB8A (talk) 13:59, 20 December 2022 (UTC)

I thought your reasoning was that non-causation was possible. I said it was stupid to assume non-causation, which is a stronger position than the fence-sitting one you professed earlier. Can we conclude from My reasoning is not stupid that your actual reasoning is different from what you wrote?

Are there any reliable sources who think that there may be a factor which causes vaccination and prevents long COVID? We follow the sources here. The source we quote says, We found that the odds of having symptoms for 28 days or more after post-vaccination infection were approximately halved by having two vaccine doses. This result suggests that the risk of long COVID is reduced in individuals who have received double vaccination. "Halved by" means causation. We do not weaken the wording of our reliable sources just because some user disagrees with it. --Hob Gadling (talk) 17:27, 20 December 2022 (UTC)

Fair enough re: "stupid". Moving on, I am most definitely not saying that correlation rules out causation. I thought saying it is a correlation was trending closer to the source anyway. I do think the language in the status quo in our article is somewhere between definitively saying there is causation, and that there is ambiguous correlation, but we really should be saying there is ambiguous correlation here, in my opinion. COVID morbidity is influenced by lifestyle factors and there are strong dependencies between vaccine status and lifestyle. For example, there was a recent study that linked vaccine hesitancy to unsafe driving and auto accidents, and the explanation was a propensity for risk taking. It's not absurd to presume other unsafe behaviors could also be correlated, like alcohol use, poor diet, smoking, etc. All of those influence COVID morbidity and could be confounders here. This is all speculation made up on the fly, but it's definitely not argument for the sake of argument, as I think that's a perfectly viable avenue to explore. Now can you see why we must retain the ambiguity of the relationship, and call it correlation, when we paraphrase the paper here? Also, this is getting technical, but you could interpret the language of the article as NOT causal, since it is in the past tense and refers to the subjects in the study. If it used the future tense, that would suggest a causal argument. It's basically describing a conditional probability within the study data. Conditional probabilities can sound causal, but they're not. Note also how they said "suggests" in the final sentence. 2600:1012:B01E:7FCB:818:A66:B5EF:DB8A (talk) 17:42, 20 December 2022 (UTC)

OK, I can see that. (Maybe long Covid is facilitated by wearing tinfoil hats, which correlates with being antivax. Har har.) I even retract my it would be stupid. --Hob Gadling (talk) 18:23, 20 December 2022 (UTC)

Causal inference is never casual inference, as I have always said. 174.193.198.113 (talk) 18:41, 20 December 2022 (UTC)

@Hob Gadling: On the note of source reliability, this isn't a WP:MEDRS study, and case control studies are listed on the lower-reliability side of primary studies. So there's a reasonable question of just how reliable the study is, and whether we need to add further caveats as described in WP:MEDPRI to clarify the actual weight of evidence in this study. I'd suggest this is a much larger potential issue with this section (transcluded from COVID-19 vaccine clinical research), putting too much weight into a large number of low-quality studies. Bakkster Man (talk) 17:45, 20 December 2022 (UTC)

True randomized controlled trials are called the gold standard for a reason. 2600:1012:B01E:7FCB:818:A66:B5EF:DB8A (talk) 18:04, 20 December 2022 (UTC)

If the amount of non MEDRS sources in this wikipedia article concerns you, I have bad news for you... 2600:1012:B01E:7FCB:818:A66:B5EF:DB8A (talk) 18:19, 20 December 2022 (UTC)

Should we even cite that study then? --Hob Gadling (talk) 18:23, 20 December 2022 (UTC)

I think we need a broader look at the whole set of citations to know which side of the line it falls on. I think there's a very good argument to be made that COVID vaccines fit into the circumstances where we can non-wikivoice notable results, and we should look at all of them as a whole to find the most reliable and notable studies and trim the least reliable. I'd say the local news citation of a county health officer is more indicative of the issue, and I'm going to remove that now as clearly not meeting the threshold. Bakkster Man (talk) 18:28, 20 December 2022 (UTC)

Regarding casualty , association hypothesis ,and types of associated neurological diseases post COVID19 vaccine the following article can be cited and the term Co-VAN (COVID-19 Vaccine Associated Neurological Diseases) can be used for the depiction of the same.

https://doi.org/10.1016/j.jocn.2022.12.015

https://www.sciencedirect.com/science/article/abs/pii/S0967586822004854 Mendellwiki (talk) 19:39, 24 December 2022 (UTC)

Semi-protected edit request on 14 February 2023

CHALLENGES FOR THE IMMUNITY OF THE COVID-VACCINE

Boosters are sometimes required to maintain a strong and effective immune response, as the level of memory B-cells and T-cells can decline over time. Memory B-cells provide a ready source of antibodies to quickly respond to a re-infection. However, the number of memory B- cells can decline over time as a result of waning immunity, especially in the absence of booster shots, which can result in a decreased ability to produce adequate amounts of specific antibodies. Boosters can stimulate the production of new memory B-cells and maintain the level of protection against the pathogen. In addition, Memory T-cells also play a crucial role in recognizing and responding to a re-infection. However, the number and function of memory T- cells can also decline over time, also as a result of waning immunity, especially in the absence of booster shots or with age. Boosters can stimulate the production of new memory T-cells and maintain the level of cell-mediated immunity against the pathogen. Stampynoodles (talk) 02:38, 14 February 2023 (UTC)

 Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. Cannolis (talk) 03:17, 14 February 2023 (UTC)

Nanoparticles and coding mrna

@BD2412: Thanks for the copy edit - what I meant was the nanoparticles contained mrna that got turned into proteins (luciferase in this case - if I remember correctly) but not for the spike protein itself. Talpedia (talk) 19:14, 25 March 2023 (UTC)

Proposed merge of Post-Vac into COVID-19 vaccine

not a distinct topic, seems like a POVFORK (t · c) buidhe 06:46, 18 April 2023 (UTC)

It's not a POV-spin-off, it's really quite an issue in Germany:

• Post Covid- /Post Vac-Syndrom
• Long- und Post-COVID, Post-Vac-Syndrom sowie zu ME/CFS
• ""Post-Vac-Syndrom": Mehr als die Hälfte der weltweiten Fälle in Deutschland registriert". www.aerzteblatt.de (in German). 29 June 2023. Retrieved 13 July 2023.

And it's likely (inferred from the articles found) that's also the case in Switzerland:

• "Post-Vac-Syndrom - Schwer krank nach Covid-Impfung: Seltenheit oder Leid mit System?". www.srf.ch. 10 February 2023. Retrieved 15 July 2023.
• Post-Vac-Syndrom: Impf-Chef Berger anerkennt schwere Schäden durch Corona-Impfung

And there are also articles from Austria but not so high-level than from Switzerland and Germany. The question is: What are the reasons for it?--Lugioner (talk) 14:35, 15 July 2023 (UTC)

start of deletion debate--Lugioner (talk) 15:07, 15 July 2023 (UTC)

Wiki Education assignment: ENGL A120 Critical Thinking

This article was the subject of a Wiki Education Foundation-supported course assignment, between 28 August 2023 and 15 December 2023. Further details are available on the course page. Student editor(s): Cpdus0923 (article contribs).

— Assignment last updated by Cpdus0923 (talk) 06:54, 23 October 2023 (UTC)

Updated Advice Needs Updating

"In April 2021, Astrazeneca and the European Medicines Agency (EMA) updated their information for healthcare professionals about AZD1222."

Given this, could the article expand on what was meant by "causal relationship" between the vaccination and the occurrence of thrombosis? For even if the adverse reactions where said to be "very rare", by how much had they "exceeded what would be expected in the general population"? Also, could the EMA Statement be updated to include their last advice on vaccination and any risk of thrombosis? — Preceding unsigned comment added by 95.149.166.237 (talk) 20:11, 19 November 2023 (UTC)

EMA stated in writing, as do the manufacturers, that the vaccines do not, and were never intended to, stop or reduce transmission. The article should be edited to be truthful 85.94.248.27 (talk) 20:19, 11 January 2024 (UTC)