Covid-19 Vaccines and Myocarditis: Balancing Benefits and Risks in Adolescents and Young Adults — The Skeptical Cardiologist

Two days ago the FDA indicated it will add a warning about rare cases of myocarditis in adolescents and young adults to information sheets for the Pfizer/BioNTech, and Moderna COVID-19 vaccines. This followed a decision made by CDC advisor that myocarditis in adolescents and young adults is likely linked to the vaccines, but that the benefits…

Covid-19 Vaccines and Myocarditis: Balancing Benefits and Risks in Adolescents and Young Adults — The Skeptical Cardiologist

Thank you Dr. Pearson.

Full vaccination with AstraZeneca offers 92% protection against hospitalisation with delta variant — Science Chronicle

With the delta variant, both AstraZeneca and Pfizer vaccines offer high protection against hospitalisation. One dose of AstraZeneca vaccine offered 71% protection against hospitalisation, while two doses offered 92% protection. In the case of Pfizer vaccine, the protection against hospitalisation was 94% after one dose and 96% after two doses. A real-world study undertaken by […]

Full vaccination with AstraZeneca offers 92% protection against hospitalisation with delta variant — Science Chronicle

The study referenced is a pre-print and has not been peer reviewed.

The Saddest Covid-19 Statistic

“For those of us in public health, it’s nothing short of amazing,” Dr. Jeff Duchin, the chief health officer for Seattle and King County, told me the other day. I had called Duchin to ask about a startling claim he made recently. At a weekly health briefing, he offhandedly remarked that of King County’s recent COVID-19 cases, 97% had occurred in unvaccinated people. It effectively meant the only people still catching coronavirus here in King County are people who haven’t gotten the shots. It also means the disease that just a few months ago threatened the entire nation is now almost exclusively circulating among a shrinking few.

“We’re getting to the point where it’s a tale of two societies,” says Dr. Umair Shah, the state health secretary.Shah reported this past week that unvaccinated people between ages 45 and 64 are now being hospitalized for COVID at rates 21 times higher than the vaccinated.

The ‘two societies’: 97% of new COVID cases are among people who haven’t gotten the shots — https://www.seattletimes.com/seattle-news/health/the-two-societies-97-of-new-covid-cases-are-among-people-who-havent-gotten-the-shots/#comments

At the Seattle Times website for this article you’ll find over 500 comments. After reading several comments I had to stop. Every comment I read made me sad about all of the things we have gotten wrong during the pandemic. One of the worst things that has happened was the politicization of Covid-19. Sometimes I just wish it would stop.

If for whatever reason you choose to refuse the vaccine I have no interest in debating your decision. I’ll present some facts and we can remain cordial.

PPI’s and Gastric Cancer Risk

Objective The association between proton pump inhibitor (PPI) use and gastric cancer related to Helicobacter pylori eradication has not been fully investigated in geographical regions with high risk of gastric cancer. We aimed to evaluate the association between PPIs and gastric cancer in Korea.

Design This study analysed the original and common data model versions of the Korean National Health Insurance Service database from 2002 to 2013. We compared the incidence rates of gastric cancer after 1-year drug exposure, between new users of PPIs and other drugs excluding PPIs, by Cox proportional hazards model. We also analysed the incidence of gastric cancer among PPI users after H. pylori eradication.

Results The analysis included 11 741 patients in matched PPI and non-PPI cohorts after large-scale propensity score matching. During a median follow-up of 4.3 years, PPI use was associated with a 2.37-fold increased incidence of gastric cancer (PPI≥30 days vs non-PPI; 118/51 813 person-years vs 40/49 729 person-years; HR 2.37, 95% CI 1.56 to 3.68, p=0.001). The incidence rates of gastric cancer showed an increasing trend parallel to the duration of PPI use. In H. pylori-eradicated subjects, the incidence of gastric cancer was significantly associated with PPI use over 180 days compared with the non-PPI group (PPI≥180 days vs non-PPI; 30/12 470 person-years vs 9/7814 person-years; HR 2.22, 95% CI 1.05 to 4.67, p=0.036).

Conclusion PPI use was associated with gastric cancer, regardless of H. pylori eradication status. Long-term PPIs should be used with caution in high-risk regions for gastric cancer.

Association between proton pump inhibitor use and gastric cancer: a population-based cohort study using two different types of nationwide databases in Korea — https://gut.bmj.com/content/early/2021/05/11/gutjnl-2020-323845?rss=1
  • Prevacid 24HR
  • Nexium 24HR
  • Prilosec OTC
  • Zegerid OTC

OTC PPIs are only intended for a 14-day course of treatment and can be used up to three times per year.

Over-The-Counter (OTC) Heartburn Treatment — https://www.fda.gov/drugs/information-consumers-and-patients-drugs/over-counter-otc-heartburn-treatment

I was thinking of a snarky comment but decided against posting any snark.

But if you routinely pop a PPI before and/or after chowing down on a meat lover’s pizza you can’t say you weren’t advised that maybe it might be a better idea to give up the pizza.

My Only Other Comment on Covid-19 Vaccine Blood Clot Risk

My only comment on the J&J vaccine blood clot risk was a technically correct statement. This is my only other comment on Covid-19 Vaccine induced blood clot risk. Get vaccinated. We now know how to fix it.

“Our experience shows us that these clot reactions are very rare, but they can be treated,” lead co-author Dr. R. Todd Clark, an assistant professor of emergency medicine at the University of Colorado School of Medicine, said in a statement. “Americans can feel comfortable getting vaccinated and should discuss any vaccination concerns with their doctor.”

Doctors successfully treat rare J&J blood clot, case report shows — https://www.livescience.com/johnson-and-johnson-vaccine-blood-clot-treatment-case-report.html

“COVID-19 infection is a significant risk factor for CVST. A preliminary analysis of U.S. data during the COVID-19 pandemic, available online, preprint on April 15, 2021, found that the risk of CVST due to infection with COVID-19 is 8-10 times higher than the risk of CVST after receiving a COVID-19 vaccine. The public can be reassured by the CDC’s and FDA’s investigation and these statistics – the likelihood of developing CVST after a COVID-19 vaccine is extremely low. We urge all adults to receive any of the approved COVID-19 vaccines.”

Karen L. Furie, M.D., M.P.H., lead author of the special report, chair of the department of neurology at The Warren Alpert Medical School of Brown University, and chief of neurology at Rhode Island Hospital, The Miriam Hospital and Bradley Hospital in Providence, Rhode Island

Guidance on diagnosis and management of cerebral venous sinus thrombosis after a COVID-19 vaccine — https://www.news-medical.net/news/20210429/Guidance-on-diagnosis-and-management-of-cerebral-venous-sinus-thrombosis-after-a-COVID-19-vaccine.aspx

Like I said earlier, I have a lot of respect for Brownies.

My Only Comment on the J&J Covid Vaccine Blood Clot Risk

Dr. Karb was in the same residency class at Brown as Dr. Lee.

I have much respect for Brownies.

That’s it. My only comment on the J&J vaccine blood clot risk.

COVID-19 Vaccinations by Race/Ethnicity

While the data provide useful insights, they also remain subject to gaps, limitations, and inconsistencies that limit the ability to get a complete picture of who is and who is not getting vaccinated. For example, data gaps and separate reporting of data for vaccinations administered through the Indian Health Service limit the ability to analyze vaccinations among American Indian and Alaska Native people and Native Hawaiian and Other Pacific Islander. Moreover, some states have high shares of vaccinations that are missing race/ethnicity or that are classified as “other,” limiting the ability to interpret the data. For example, in Alaska, over 30% of vaccinations were among people classified as “other” race, and race was unknown for over 30% of vaccinations in Virginia. Four states were not reporting vaccination data by race/ethnicity, including Georgia which halted reporting its data in March. Comprehensive standardized data across states will be vital to monitor and ensure equitable access to and take up of the vaccine.

Latest Data on COVID-19 Vaccinations Race/Ethnicity — https://www.kff.org/coronavirus-covid-19/issue-brief/latest-data-on-covid-19-vaccinations-race-ethnicity/

Meanwhile in Oklahoma…

Just Another SARS-CoV-2 Vaccine Chart – Updated 03.25.21

Vaccine table produced by Monica Gandhi MD MPH. Downloaded from Twitter 03.27.21

Monica Gandhi MD, MPH is Professor of Medicine and Associate Division Chief (Clinical Operations/ Education) of the Division of HIV, Infectious Diseases, and Global Medicine at UCSF/ San Francisco General Hospital. She also serves as the Director of the UCSF Center for AIDS Research (CFAR) and the Medical director of the HIV Clinic at SFGH (“Ward 86”). Dr. Gandhi completed her M.D. at Harvard Medical School and then came to UCSF in 1996 for residency training in Internal Medicine. After her residency, Dr. Gandhi completed a fellowship in Infectious Diseases and a postdoctoral fellowship at the Center for AIDS Prevention Studies, both at UCSF. She also obtained a Masters in Public Health from Berkeley in 2001 with a focus on Epidemiology and Biostatistics.

https://profiles.ucsf.edu/monica.gandhi

Benzodiazepines Implicated in High Rate of ED Visits Across US

Seven out of eight emergency department (ED) visits attributed to adverse events from benzodiazepines involve self-harm or nonmedical use of these drugs, and more than 80% involve concurrent use of alcohol, illicit drugs, or other substances, new research shows.

Although benzodiazepines are typically not problematic in terms of acute overdoses when used alone, patients often don’t take them as prescribed or use them with other substances in a self-harm attempt, author Daniel S. Budnitz, MD, MPH, director of the Medication Safety Program, Centers for Disease Control and Prevention (CDC), told Medscape Medical News.

“Clinicians need to be aware of what other substances patients might be taking when they’re being prescribed a benzodiazepine,” Budnitz added.

The study was published online February 19 in the American Journal of Preventive Medicine.

Benzodiazepines Implicated in High Rate of ED Visits Across US – Medscape – Feb 25, 2020 – https://www.medscape.com/viewarticle/925686#vp_1