Better in their words…

This week the Atlantic published a long essay about a doctor: Michel Goldman, who has lymphoma, and who noticed that his cancer seemed to worsen after COVID19 mRNA boosting. Was the vaccine responsible?

Let me be clear: Is it possible his cancer got worse because of the booster? Absolutely, it is possible. Is it possible the cancer would have gotten worse without the booster? Absolutely, that often happens with lymphoma. Many patients experience what feels like a change in tempo, and it is hard to know what, if anything, precipitated it.

Imagine you put a gun to my head, and ask me to make the call. Is it related or unrelated? But you are a kind, and say you will give me 1 month, and allow me to use any data sources. I would do something very simple. I would go to a large electronic medical record with images. I would pick an incurable lymphoma where there is often repeat imagining— such as follicular lymphoma. I would extract images from patients (let us say 500). Some patients would have gotten boosters and others not— and it will not be random— this is a limitation. But, I can’t make excuses, I have a gun to my head.

I would use the raw images to calculate the g- or growth rate coefficient before COVID vaccination, and the g or growth rate after COVID vaccination (using established methods, see Fojo, et al.).

As a falsification test— (Learn about that here)— I would use the patients’ birthday to define a g before a birthday and a g after a birth day.

Here is the hypothesis: if the vaccine accelerates growth, the growth rate will change after boosting, but— let us be clear— it would not change at time of patient’s birthday. That’s the purpose of the falsification test— to serve as a negative control. You could also use a random day of the year for your falsification test. And you need a group of people to get a sense of the distribution.

With access to a nice dataset and omnibus IRB, a project like this could be done in 3 weeks. If I was allowed to involve Logan Powell— a Texas medical student who has done ~20 papers with me— we would be done in 2 weeks, because that kid doesn’t sleep. And, honestly, with Logan’s help (again, dude doesn’t sleep), I can think of 5 different studies to run to complement this analysis.

Do you know what I wouldn’t do? I wouldn’t extensively pour over the story of the individual Michel Goldman— because nothing can be found in one anecdote to help me. The yield will be low. And do you know what I really would not do: I wouldn’t broadcast this story in the Atlantic before I had strong evidence the link might be real!

Meanwhile, there is a proven safety signal I don’t hear much about in the legacy media. Myocarditis for boys after mRNA vaccination. It occurs as often as 1 in 3,000 after primary vaccination and 1 in 10,000 after boosting. It has very rarely but really resulted in young people ending up on Extracorporeal Membrane Oxygenation. It could be lowered (surely) if we banned Moderna in men <40, (possibly) if we lowered doses, (likely) if we spaced doses apart, and (surely) if we minimized doses in young men who already had COVID19. And yet, we have done nearly none of these things! The CDC only spread doses after a year of inaction, and we haven’t taken natural immunity seriously.

Vaccination means trying to maximize efficacy and minimize harm, but when it comes to young men, we haven’t taken the harm seriously and haven’t tried to minimize it. Yet, I don’t read this in the pages of the Atlantic. I just read about a famous old doctor who thinks the vaccine made his cancer grow faster. What is going on?

The entire episode led me to several conclusions:

1. If he wasn’t a rich doctor; this would not be in the news. How sad is it that the experience of everyday Americans is not considered acceptable for news coverage. Many people have felt a range of medical issues were triggered or worsened by vaccination, but the media steadfastly refuses to cover those stories. Yet, in this case, they make an exemption because the individual is famous. I find this problematic. I prefer to not cover any anecdote, but this idea that if it happens to an electrician- it is anti-vax, but if it happens to a doctor- it is news— that’s problematic.
2. Cancer accelerating after vaccination is not yet established as linked to COVID19 vaccination, but 2 things are fully established. Blood clots and runaway platelet activation after J&J vaccination is fully proven to be linked to the shot. And myocarditis, particularly in young men, has been linked to mRNA vaccines. And yet: I have never seen coverage of the human cost of either of these in any major news outlet!
3. The news media could easily cover a poor young man who was forced to be boosted by his college or university, and experienced myocarditis. This occurs at the rate of 1 in 10k. One news story like this would be powerful— and strongly discourage these mid level managers from mandating novel medical products. And yet the media is silent on these stories. Why does the doctor get special treatment for a side effect that has not yet been vetted?
4. What about this story of a 14 year old boy? Why is this (or a similar story) not in the Atlantic? Instead a doctor gets his unproven anecdote widely broadcast? 
   EmilyJo @eekymom

   🧵Today marks a year since Aiden woke me up at 4:30 am complaining of chest pain and pain with inspiration. He was 14. It was severe enough to wake him up from sleep. This was 2 days following his second Pfizer COVID vaccine 1/

   

   

   June 12th 2022

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5. What about the young woman who had clot and brain damage from J&J? What about her family? Why no coverage of that? The news could also note that some (dim) scientists on Twitter compared runaway platelet activation after J&J to a blood clot in the leg after oral contraceptives. This was a deceptive and ignorant comparison that furthered preventable harm. Why does the media not cover this story? Why only a possible side effect— unproven— in a famous scientist?
6. Consider the risk gradient here. Young people have far less to gain from each additional dose of vaccine, and even rare risks become salient. Older people who suffer from cancers that often lead to (or therapies lead to) b-cell inhibition face much higher risks of COVID19. Why are we covering an anecdote that might lead a higher risk population to forgo vaccination vs. lead colleges to consider that a lower risk population ought not be compelled? The whole thing is backwards.
7. The White House is doing massive damage to our institutions— particularly the FDA— as they push a new booster based solely on mouse data. Their unethical pressure led Gruber and Krause to resign. They could have compelled Pfizer to run RCTs, but chose not to. The legacy media is largely complicit with this, writing many articles defending this choice, but it is entirely unprecedented. And yet, instead, they are happy to cover a putative side effect that might not even be related?
8. I have no doubt there may be adverse events attributable to vaccines that are not yet established, but we don’t need to profile the people who have these (not yet), we need careful epidemiological studies. I agree the CDC’s passive collection is suboptimal, and I also no longer trust them, as I believe they have been captured by political winds, but the solution is better systems and independence, rather than covering anecdotes in the media.
9. The Atlantic coverage is balanced and fair, but that’s not the point. The mere act of covering the anecdote to millions of readers, elevates it to something intensely plausible or true. No matter how much confidence you place in it, the truth is mycocarditis is more plausible and more true and should be preferentially covered. And yet there is no story of a boy who lost a football scholarship because he can’t play. Or a kid still ravaged with late gad enhancement after surviving mycocarditis. This discrepancy is fundamentally unfair.

The media coverage of vaccines and side effects is awful. They lack a philosophical framework and are unmoored. This article nicely shows how that is the case. Whether they choose to improve is beyond me. They have too much allegiance to the Biden administration, and have failed American boys as a result.