Hi, Everyone,
Last week, I wrote this email about a study published in Germany indicating that the risk of hospitalization or death from COVID-19 in kids up to 18 years old is extremely low.
For example, in healthy kids 5 to 11 years old, the risk of severe illness (admission to the ICU) was only 2 per 100,000, and not a single child in this age group died.
Another very important study was also published last week, in this case by public health scientists in Ontario, Canada.
They looked at the incidence of myocarditis/pericarditis among males aged 18 to 24 after receiving 2 doses of Covid vaccines.
The results were disturbing—to say the least:
- Those who received Pfizer for the first dose, and then Moderna for the second dose (within 30 days), had a risk of 1 in 1,287.
- Those who received 2 doses of Moderna within 30 days (the recommended schedule) had a risk of 1 in 2,653.
- Those who received 2 doses of Pfizer within 30 days (again, the recommended schedule) had a risk of 1 in 10,526.
A similar paper published back in September 2021 examined rates of myocarditis in 12- to 17-year-old boys and found an overall vaccine-associated risk of myocarditis of 1 in 6,173 in 12- to 15-year-olds and 1 in 10,638 in 16- to 17-year-olds.
These may seem like relatively small risks. However, as the authors of the September paper point out, the risk of vaccine-induced myocarditis in 12- to 17-year-olds exceeds the risk of hospitalization from COVID-19 in healthy kids in this age range—even at the peak of the pandemic when hospitalizations were at their highest.
Here is the figure from that paper showing this:
The only time the risk of hospitalization from COVID-19 is greater than the risk of myocarditis is when kids have 1 or more pre-existing conditions and when disease prevalence and hospitalization rates are moderate or high.
How does the risk of hospitalization from COVID-19 compare to the risk of myocarditis in 18- to 24-year-old males?
We don’t have an exact age range comparison, but we can use data from the Centers for Disease Control and Prevention (CDC) to get close. According to a weekly report called “Rates of COVID-19-Associated Hospitalization,” segmented by age group, we see that as of November 27, 2021, the rate of hospitalization for men and women (this report doesn’t separate by sex) aged 18 to 29 was 3.2 per 100,000 or 1 in 31,250:
The highest rate of hospitalization at any time during the pandemic in this age group was last year at this time, the week ending December 12, at 6.4 per 100,000, or 1 in 15,625.
This compares to rates of vaccine-induced myocarditis in 18- to 24-year-old males ranging from 1 in 1,287 for Pfizer + Moderna to 1 in 10,526 for 2 doses of Pfizer, assuming both doses are taken within the recommended 30-day window.
You don’t have to be a math genius to come to the following conclusion: in males aged 12 to 24, the risk of vaccine-induced myocarditis is higher than the risk of hospitalization from COVID-19.
It’s way past the time to have a more nuanced conversation about the risk-benefit ratio of the Covid vaccines in different demographics. We also need to address the impact of different vaccines and different dose regimens on risk.
For example, from the Ontario study, we learned that:
- Two doses of Moderna are much riskier than 2 doses of Pfizer.
- One dose of Pfizer followed by 1 dose of Moderna is even riskier than 2 doses of Moderna.
- Spacing the second dose further out (i.e., >56 days) dramatically reduces the risk. In the case of 2 shots of Pfizer, it lowered the risk from 1 in 10,526 to ~1 in 91,000. That is not a small difference!
The data clearly show that the vaccines reduce the risk of serious illness and death from COVID-19 in older adults, particularly those who are older and who have pre-existing conditions.
But we’ve also known since the start of the pandemic that Covid tends to be a very mild illness in healthy children and young adults. It stands to reason, then, that the risk-benefit analysis of the vaccines would be different in this age group.
Unfortunately, the public health approach to the vaccination campaign has not been nuanced in this regard. And our children are suffering unnecessary harm as a result.
Before I finish, I’d like to pre-emptively answer a couple of questions that I anticipate getting.
Question #1: Shouldn’t we consider vaccinating children to protect more vulnerable populations?
This question is based on the idea that the vaccines stop transmission of SARS-CoV-2. But even the CDC has acknowledged that this is no longer the case with the Delta variant. (And early indications suggest that it’s even less likely with the Omicron variant.)
What’s more, studies have now conclusively shown that kids under 10 years old rarely transmit COVID-19, and all kids/adolescents up to 20 years old are 63% less likely to infect others than adults.
Question #2: What if Omicron presents a higher risk of hospitalization and death for children and young adults?
Omicron is still relatively new, so it’s difficult to reach firm conclusions. But all available evidence to date suggests that Omicron is no more severe than Delta (for either adults or children) and, in fact, may be considerably milder.
Of course, we’ll need to watch closely to see what happens. But thus far, I haven’t read anything that would indicate that the risk-benefit analysis presented here, based on published research, will change in favor of the vaccines in children and young adults.
In health,
Chris
P.S. I know this email will upset some of you and that the information in it conflicts with what you may have heard from your local physician or read about in the news. Please keep in mind that all of the data you see here come from studies published by reputable researchers in the field as well as the CDC’s surveillance reports. The links in this email go to the studies themselves, and the full text is available in each case, so you can read them yourselves and reach your own conclusions.
